HdBe-Problem
CBB | Description | Status |
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HdBe-Problem | A problem describes a situation with regard to an individual’s health and/or welfare. This situation can be described by the person involved (the patient) themselves (in the form of a complaint), or by their healthcare professional (in the form of a diagnosis, for example). The situation can form cause for diagnostic or therapeutic policy. A problem includes all kinds of medical or nursing information that represents a health problem. A problem can represent various types of health problems:
PurposeAn overview of a patient’s health problems has the purpose of informing all healthcare professionals involved in the patient’s care on the patient’s current and past health condition. It provides insight into which problems require medical action, which are under control and which are no longer current. The problem overview also directly provides medical context for medication administered and procedures carried out. The overview promotes an efficient, targeted continuation of the patient’s care. A complete list of problems is of importance for automated decision support and determining contraindications. | active |
Problem | Problem | ||
id | 0..1 | string | |
extension | I | 0..* | Extension |
ProblemType | 0..1 | CodeableConceptBinding | |
ProblemName | 1..1 | CodeableConceptBinding | |
FurtherSpecificationProblemName | 0..1 | string | |
ProblemAnatomicalLocation | 0..1 | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
Location | 0..1 | CodeableConceptBinding | |
Laterality | 0..1 | CodeableConceptBinding | |
ProblemStartDate | 0..1 | dateTime | |
ProblemEndDate | 0..1 | dateTime | |
ProblemStatus | 0..1 | CodeableConceptBinding | |
VerificationStatus | 0..1 | CodeableConceptBinding | |
Comment | 0..1 | string |
Problem | 0..* | |
Problem.ProblemType | CodeableConcept | 0..1 |
Problem.ProblemName | CodeableConcept | 1..1 |
Problem.FurtherSpecificationProblemName | string | 0..1 |
Problem.ProblemAnatomicalLocation | BackboneElement | 0..1 |
Problem.ProblemAnatomicalLocation.Location | CodeableConcept | 0..1 |
Problem.ProblemAnatomicalLocation.Laterality | CodeableConcept | 0..1 |
Problem.ProblemStartDate | dateTime | 0..1 |
Problem.ProblemEndDate | dateTime | 0..1 |
Problem.ProblemStatus | CodeableConcept | 0..1 |
Problem.VerificationStatus | CodeableConcept | 0..1 |
Problem.Comment | string | 0..1 |
Problem | |
Definition | Root concept of the Problem information model. A problem describes a situation with regard to an individual’s health and/or welfare. This situation can be described by the patient themselves (in the form of a complaint) or by their health professional (in the form of a diagnosis, for example). |
Cardinality | 0...* |
Invariants |
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Mappings |
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Problem.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Problem.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Problem.ProblemType | |
Definition | The type of problem; see the concept description. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | ProblemType codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Problem.ProblemName | |
Definition | The problem name defines the problem. |
Cardinality | 1...1 |
Type | CodeableConcept |
Binding | ProblemName codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Problem.FurtherSpecificationProblemName | |
Definition | Further specification of problem name when it is recorded via a thesaurus or code system in which the required level of detail is not (yet) available. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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Problem.ProblemAnatomicalLocation | |
Definition | Anatomical location which is the focus of the problem. |
Cardinality | 0...1 |
Type | BackboneElement |
Invariants |
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Mappings |
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Problem.ProblemAnatomicalLocation.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Problem.ProblemAnatomicalLocation.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Problem.ProblemAnatomicalLocation.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Problem.ProblemAnatomicalLocation.Location | |
Definition | Location on/in the body. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | Location codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Problem.ProblemAnatomicalLocation.Laterality | |
Definition | Laterality adds information about body site to the anatomic location, e.g. left. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | Laterality codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Problem.ProblemStartDate | |
Definition | Onset of the symptom, complaint, functional limitation, complication or date of diagnosis. A ‘vague’ date, such as only the year or the month and the year, is permitted. |
Cardinality | 0...1 |
Type | dateTime |
Invariants |
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Mappings |
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Problem.ProblemEndDate | |
Definition | Date on which the disorder to which the problem applies, is considered not to be present anymore.This datum needs not to be the same as the date of the change in problem status. A ‘vague’ date, such as only the year or the month and the year, is permitted. |
Cardinality | 0...1 |
Type | dateTime |
Invariants |
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Mappings |
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Problem.ProblemStatus | |
Definition | The problem status describes the condition of the problem: 1. Active problems are problems of which the patient experiences symptoms or for which evidence exists. 1. Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | ProblemStatus codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Problem.VerificationStatus | |
Definition | Clinical status of the problem or the diagnosis. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | VerificationStatus codes |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Problem.Comment | |
Definition | Comment by the one who determined or updated the Problem. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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Example instances
problem | |
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ProblemType | 282291009 - Diagnosis interpretation (code by SNOMED CT) |
ProblemName | 4241002 - Listeriosis (code by SNOMED CT) |
FurtherSpecificationProblemName | |
ProblemAnatomicalLocation | --- |
ProblemAnatomicalLocation.Location | |
ProblemAnatomicalLocation.Laterality | |
ProblemStartDate | 2022-05-03T12:00:00 |
ProblemEndDate | |
ProblemStatus | 55561003 - Active (code by SNOMED CT) |
VerificationStatus | 410605003 - Confirmed present (code by SNOMED CT) |
Comment |
zib Problem-v4.4 difference
Concept | Category | Description |
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ProblemType |
terminology | Changed SNOMED code 116223007 (Complication) with 263718001 (Complication) because 116223007 is not included in the International Edition of SNOMED. |
ProblemName |
terminology | Removed all CodeSystems execpt SNOMED CT and changed binding strenght from required to extensible. |
ProblemStatus |
cardinality | Relaxed cardinality from 1..1 to 0..1 because it is very likely that the status is not always known. Also, the FHIR spec does not make a status mandatory. |
VerificationStatus |
terminology | Replaced NullFlavor Unknown code with SNOMED CT Unknown code. |
Problem |
textual | Replaced 'himself' by 'themselves'. |
description.concept | textual | Put a period after 'Examples: stomach ache, amnesia'. |
description.concept | textual | Put a period after 'roof of the mouth'. |
Terminology Bindings
Path | Name | Strength | URL |
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ProblemType | ProblemType | extensible | https://fhir.healthdata.be/ValueSet/ProblemType |
ProblemName | ProblemName | extensible | https://fhir.healthdata.be/ValueSet/ProblemName |
ProblemAnatomicalLocation.Location | Location | required | https://fhir.healthdata.be/ValueSet/Location |
ProblemAnatomicalLocation.Laterality | Laterality | required | https://fhir.healthdata.be/ValueSet/Laterality |
ProblemStatus | ProblemStatus | required | https://fhir.healthdata.be/ValueSet/ProblemStatus |
VerificationStatus | VerificationStatus | required | https://fhir.healthdata.be/ValueSet/VerificationStatus |