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HdBe-Probleem

CBB	Concept	Status
HdBe-Problem	Een probleem beschrijft een toestand met betrekking tot de gezondheid en/of het welzijn van een individu. Deze toestand kan zijn benoemd door de betroffene (de patiënt) zelf (een klacht), of door zijn of haar zorgverlener (onder andere een diagnose). De toestand kan aanleiding zijn voor diagnostisch of therapeutisch beleid. Een probleem omvat allerlei soorten medische of verpleegkundige gegevens, die een gezondheidsprobleem representeren. Een probleem kan verschillende typen gezondheidsproblemen representeren: Een klacht (Complaint, finding by patient): een subjectieve, als negatief ervaren waarneming van de gezondheid. Voorbeelden: buikpijn, geheugenverlies Een symptoom (Symptom): een waarneming door of over de patiënt die betrekking zou kunnen hebben op een bepaalde ziekte. Voorbeelden : koorts, bloed bij de ontlasting, witte vlekken op het gehemelte; Een diagnose (Diagnosis): medische interpretatie van klachten en bevindingen. Voorbeelden: Diabetes Mellitus type II, pneumonie, Hemolytisch Uremisch Syndroom. Een functionele beperking (Functional Limitation): een vermindering van functionele mogelijkheden. Voorbeelden: verminderde mobiliteit, hulp nodig bij aankleden. Een complicatie (Complication): Iedere diagnose die door de zorgverlener gezien wordt als een onvoorzien en ongewenst gevolg van medisch handelen. Voorbeelden: wondinfectie na chirurgie, gehoorverlies door antibioticagebruik. Purpose Een overzicht van de problemen met betrekking tot de gezondheid van een patiënt heeft tot doel om alle bij de patiënt betrokken zorgverleners te informeren over de gezondheidstoestand van de patiënt in het heden en het verleden. Het geeft inzicht in welke problemen medisch handelen verlangen en welke niet meer actueel zijn. Het probleemoverzicht geeft ook direct de medische context weer voor toegediende medicatie en uitgevoerde procedures. Het overzicht bevordert een gerichte en efficiënte voortzetting van de zorg voor de patiënt. Een volledige probleemlijst is van belang ten behoeve van geautomatiseerde beslissingsondersteuning en het bepalen van contra-indicaties.	active

CBB

Concept

Status

HdBe-Problem

Een probleem beschrijft een toestand met betrekking tot de gezondheid en/of het welzijn van een individu. Deze toestand kan zijn benoemd door de betroffene (de patiënt) zelf (een klacht), of door zijn of haar zorgverlener (onder andere een diagnose). De toestand kan aanleiding zijn voor diagnostisch of therapeutisch beleid. Een probleem omvat allerlei soorten medische of verpleegkundige gegevens, die een gezondheidsprobleem representeren. Een probleem kan verschillende typen gezondheidsproblemen representeren:

Een klacht (Complaint, finding by patient): een subjectieve, als negatief ervaren waarneming van de gezondheid. Voorbeelden: buikpijn, geheugenverlies
Een symptoom (Symptom): een waarneming door of over de patiënt die betrekking zou kunnen hebben op een bepaalde ziekte. Voorbeelden : koorts, bloed bij de ontlasting, witte vlekken op het gehemelte;
Een diagnose (Diagnosis): medische interpretatie van klachten en bevindingen. Voorbeelden: Diabetes Mellitus type II, pneumonie, Hemolytisch Uremisch Syndroom.
Een functionele beperking (Functional Limitation): een vermindering van functionele mogelijkheden. Voorbeelden: verminderde mobiliteit, hulp nodig bij aankleden.
Een complicatie (Complication): Iedere diagnose die door de zorgverlener gezien wordt als een onvoorzien en ongewenst gevolg van medisch handelen. Voorbeelden: wondinfectie na chirurgie, gehoorverlies door antibioticagebruik.

Purpose

Een overzicht van de problemen met betrekking tot de gezondheid van een patiënt heeft tot doel om alle bij de patiënt betrokken zorgverleners te informeren over de gezondheidstoestand van de patiënt in het heden en het verleden. Het geeft inzicht in welke problemen medisch handelen verlangen en welke niet meer actueel zijn. Het probleemoverzicht geeft ook direct de medische context weer voor toegediende medicatie en uitgevoerde procedures. Het overzicht bevordert een gerichte en efficiënte voortzetting van de zorg voor de patiënt. Een volledige probleemlijst is van belang ten behoeve van geautomatiseerde beslissingsondersteuning en het bepalen van contra-indicaties.

active

Problem			Problem	Element id Problem Short description Probleem Definition Rootconcept van de bouwsteen Probleem. Een probleem beschrijft een toestand met betrekking tot de gezondheid en/of het welzijn van een individu. Deze toestand kan zijn benoemd door de patiënt zelf (een klacht), of door zijn of haar zorgverlener (onder andere een diagnose). Data type Problem Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Problem.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Problem.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
ProblemType		0..1	CodeableConceptBinding	Element id Problem.ProblemType Short description ProbleemType Definition Het type probleem, zie de conceptbeschrijving. 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. Data type CodeableConcept Binding ProblemType codes ProblemType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ProblemName		1..1	CodeableConceptBinding	Element id Problem.ProblemName Short description ProbleemNaam Definition De probleemnaam definieert het probleem. 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. Data type CodeableConcept Binding ProblemName codes ProblemName (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
FurtherSpecificationProblemName		0..1	string	Element id Problem.FurtherSpecificationProblemName Short description NadereSpecificatieProbleemNaam Definition Nadere specificatie van de probleem naam wanneer deze via een thesaurus of codesysteem wordt vastgelegd en de vereiste mate van detail (nog) niet beschikbaar is. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ProblemAnatomicalLocation		0..1	BackboneElement	Element id Problem.ProblemAnatomicalLocation Short description ProbleemAnatomischeLocatie Definition Anatomische locatie die de focus is van het probleem. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Problem.ProblemAnatomicalLocation.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Problem.ProblemAnatomicalLocation.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Problem.ProblemAnatomicalLocation.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
Location		0..1	CodeableConceptBinding	Element id Problem.ProblemAnatomicalLocation.Location Short description Locatie Definition Localisatie op/in het lichaam. 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. Data type CodeableConcept Binding Location codes Location (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Laterality		0..1	CodeableConceptBinding	Element id Problem.ProblemAnatomicalLocation.Laterality Short description Lateraliteit Definition Lateraliteit verbijzondert de anatomische locatie door, indien van toepassing, de zijdigheid vast te leggen, bijvoorbeeld links. 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. Data type CodeableConcept Binding Laterality codes Laterality (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ProblemStartDate		0..1	dateTime	Element id Problem.ProblemStartDate Short description ProbleemBeginDatum Definition Begin van de klacht, beperking, complicatie of het symptoom of de datum van de diagnose waarop het probleem betrekking heeft. Een vage datum, bijv. alleen een jaartal of een maand en een jaartal, is toegestaan. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ProblemEndDate		0..1	dateTime	Element id Problem.ProblemEndDate Short description ProbleemEindDatum Definition Datum waarop de aandoening, waarop het probleem betrekking heeft, als niet meer aanwezig wordt beschouwd. Deze datum hoeft niet gelijk te zijn aan de datum waarop de statuswijzinging van het probleem is vastgelegd. Een vage datum, bijv. alleen een jaartal of een maand en een jaartal, is toegestaan. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ProblemStatus		0..1	CodeableConceptBinding	Element id Problem.ProblemStatus Short description ProbleemStatus Definition De probleemstatus beschrijft de toestand van het probleem: Actuele problemen zijn problemen waar de patiënt symptomen van ondervindt of waar bewijsmateriaal voor is. Problemen met status 'Niet actueel' verwijzen naar problemen waar de patiënt geen last meer van heeft of waar geen aanwijzingen meer voor zijn. 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. Data type CodeableConcept Binding ProblemStatus codes ProblemStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
VerificationStatus		0..1	CodeableConceptBinding	Element id Problem.VerificationStatus Short description VerificatieStatus Definition Klinische status van het probleem of de diagnose. 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. Data type CodeableConcept Binding VerificationStatus codes VerificationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Comment		0..1	string	Element id Problem.Comment Short description Toelichting Definition Toelichting van diegene die het Probleem heeft vastgesteld of bijgewerkt. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
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	rim: n/a
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Problem.ProblemType
Definition	The type of problem; see the concept description.
Cardinality	0...1
Type	CodeableConcept
Binding	ProblemType codes ProblemType (extensible)
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Problem.ProblemName
Definition	The problem name defines the problem.
Cardinality	1...1
Type	CodeableConcept
Binding	ProblemName codes ProblemName (extensible)
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
Problem.ProblemAnatomicalLocation
Definition	Anatomical location which is the focus of the problem.
Cardinality	0...1
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
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	rim: n/a
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Problem.ProblemAnatomicalLocation.Location
Definition	Location on/in the body.
Cardinality	0...1
Type	CodeableConcept
Binding	Location codes Location (required)
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
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 Laterality (required)
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
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 ProblemStatus (required)
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Problem.VerificationStatus
Definition	Clinical status of the problem or the diagnosis.
Cardinality	0...1
Type	CodeableConcept
Binding	VerificationStatus codes VerificationStatus (required)
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
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	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

problem
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
`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
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