Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Condition | Σ | DomainResource | Detailed information about conditions, problems or diagnoses | |
identifier | Σ | 0..* | Identifier | External Ids for this condition |
patient | Σ | 1..1 | Reference( Patient) | Who has the condition? |
encounter | Σ | 0..1 | Reference( Encounter) | Encounter when condition first asserted |
asserter | Σ | 0..1 | Reference( Practitioner | Patient) | Person who asserts this condition |
dateRecorded | Σ | 0..1 | date | When first entered |
code | Σ | 1..1 | CodeableConcept | Identification of the condition, problem or diagnosis
Condition/Problem/Diagnosis Codes ( Example) |
category | Σ | 0..1 | CodeableConcept | complaint | symptom | finding | diagnosis
Condition Category Codes ( Preferred) |
clinicalStatus | ?! Σ | 0..1 | code | active | relapse | remission | resolved
Condition Clinical Status Codes ( Preferred) |
verificationStatus | ?! Σ | 1..1 | code | provisional | differential | confirmed | refuted | entered-in-error | unknown
ConditionVerificationStatus ( Required) |
severity | Σ | 0..1 | CodeableConcept | Subjective severity of condition
Condition/Diagnosis Severity ( Preferred) |
onset[x] | Σ | 0..1 | Estimated or actual date, date-time, or age | |
onsetDateTime | dateTime | |||
onsetQuantity | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
abatement[x] | Σ | 0..1 | If/when in resolution/remission | |
abatementDateTime | dateTime | |||
abatementQuantity | Age | |||
abatementBoolean | boolean | |||
abatementPeriod | Period | |||
abatementRange | Range | |||
abatementString | string | |||
stage | Σ I | 0..1 | BackboneElement | Stage/grade, usually assessed formally
Stage SHALL have summary or assessment |
summary | Σ I | 0..1 | CodeableConcept | Simple summary (disease specific)
Condition Stage ( Example) |
assessment | Σ I | 0..* | Reference( ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment |
evidence | Σ I | 0..* | BackboneElement | Supporting evidence
evidence SHALL have code or details |
code | Σ I | 0..1 | CodeableConcept | Manifestation/symptom
Manifestation and Symptom Codes ( Example) |
detail | Σ I | 0..* | Reference( Any) | Supporting information found elsewhere |
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant
SNOMED CT Body Structures ( Example) |
notes | Σ | 0..1 | string | Additional information about the Condition |
Documentation for this format |