Profiles & Operations Index > Profile: Condition

Profile: Condition

Canonical URL:http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-condition

Simplifier project page: Condition (PS-ON)

Derived from: Condition (R4)

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work

Differential View

idΣ0..1System.String
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
identifierΣ0..*Identifier
clinicalStatusS Σ ?! I1..1CodeableConceptBinding
verificationStatusΣ ?! I0..1CodeableConceptBinding
category0..*Codeable Concept (PS-ON)Binding
severitySCTCAΣ0..*Coding (PS-ON)Binding
textS Σ0..1string
codeSCTCAS Σ0..*Coding (PS-ON)Binding
absentOrUnknownProblemS Σ0..*Coding (PS-ON)Binding
textS Σ0..1string
bodySiteΣ0..*Codeable Concept (PS-ON)Binding
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
encounterΣ I0..1Reference(Encounter)
onsetAgeAge
onsetRangeRange
onsetStringstring
onsetDateTimeS Σ0..1dateTime
onsetPeriodΣ0..1Period
abatementAgeAge
abatementRangeRange
abatementStringstring
abatementDateTimeS I0..1dateTime
abatementPeriodI0..1Period
recordedDateΣ0..1dateTime
recorderΣ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
asserterS Σ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
summaryI0..1CodeableConcept
assessmentI0..*Reference(ClinicalImpression | DiagnosticReport | Observation)
type0..1CodeableConcept
codeΣ I0..*CodeableConcept
detailΣ I0..*Reference(Resource)
note0..*Annotation

Hybrid View

idΣ0..1System.String
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
identifierΣ0..*Identifier
clinicalStatusS Σ ?! I1..1CodeableConceptBinding
verificationStatusΣ ?! I0..1CodeableConceptBinding
category0..*Codeable Concept (PS-ON)Binding
severitySCTCAΣ0..*Coding (PS-ON)Binding
textS Σ0..1string
codeSCTCAS Σ0..*Coding (PS-ON)Binding
absentOrUnknownProblemS Σ0..*Coding (PS-ON)Binding
textS Σ0..1string
bodySiteΣ0..*Codeable Concept (PS-ON)Binding
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
encounterΣ I0..1Reference(Encounter)
onsetAgeAge
onsetRangeRange
onsetStringstring
onsetDateTimeS Σ0..1dateTime
onsetPeriodΣ0..1Period
abatementAgeAge
abatementRangeRange
abatementStringstring
abatementDateTimeS I0..1dateTime
abatementPeriodI0..1Period
recordedDateΣ0..1dateTime
recorderΣ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
asserterS Σ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
summaryI0..1CodeableConcept
assessmentI0..*Reference(ClinicalImpression | DiagnosticReport | Observation)
type0..1CodeableConcept
codeΣ I0..*CodeableConcept
detailΣ I0..*Reference(Resource)
note0..*Annotation

Snapshot View

idΣ0..1System.String
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
identifierΣ0..*Identifier
clinicalStatusS Σ ?! I1..1CodeableConceptBinding
verificationStatusΣ ?! I0..1CodeableConceptBinding
category0..*Codeable Concept (PS-ON)Binding
severitySCTCAΣ0..*Coding (PS-ON)Binding
textS Σ0..1string
codeSCTCAS Σ0..*Coding (PS-ON)Binding
absentOrUnknownProblemS Σ0..*Coding (PS-ON)Binding
textS Σ0..1string
bodySiteΣ0..*Codeable Concept (PS-ON)Binding
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
encounterΣ I0..1Reference(Encounter)
onsetAgeAge
onsetRangeRange
onsetStringstring
onsetDateTimeS Σ0..1dateTime
onsetPeriodΣ0..1Period
abatementAgeAge
abatementRangeRange
abatementStringstring
abatementDateTimeS I0..1dateTime
abatementPeriodI0..1Period
recordedDateΣ0..1dateTime
recorderΣ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
asserterS Σ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
summaryI0..1CodeableConcept
assessmentI0..*Reference(ClinicalImpression | DiagnosticReport | Observation)
type0..1CodeableConcept
codeΣ I0..*CodeableConcept
detailΣ I0..*Reference(Resource)
note0..*Annotation

Table View

Condition..
Condition.id..
Condition.meta1..
Condition.meta.profile1..
Condition.clinicalStatus1..
Condition.verificationStatus..
Condition.categoryCodeable Concept (PS-ON)..
Condition.severityCodeable Concept (PS-ON)0..1
Condition.severity.codingCoding (PS-ON)..
Condition.severity.coding..
Condition.codeCodeable Concept (PS-ON)1..1
Condition.code.codingCoding (PS-ON)..
Condition.code.coding..
Condition.code.coding..
Condition.bodySiteCodeable Concept (PS-ON)..
Condition.subjectReference(Patient (PS-ON))..
Condition.subject.reference1..
Condition.onset[x]..
Condition.onsetDateTimedateTime..
Condition.onsetPeriodPeriod..
Condition.abatement[x]..
Condition.abatement[x]dateTime..
Condition.abatement[x]Period..
Condition.asserter..


JSON View

{
    "resourceType": "StructureDefinition",
    "id": "ca-on-ps-profile-condition",
    "url": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-condition",
    "version": "0.9.1",
    "name": "ConditionPSON",
    "title": "Condition (PS-ON)",
    "status": "draft",
    "date": "2021-10-04T11:30:20+00:00",
    "publisher": "Ontario Health",
    "description": "This profile defines a set of constraints to the FHIR Condition resource for use in Ontario Patient Summaries (PS-ON).  It refines constraints applied  constraints applied to the Condition resource by the PS-CA project, which is informed by the constraints of the [Condition-UV-IPS profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Condition-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-condition.html) to allow for cross-border and cross-jurisdiction sharing of A record of a problem is represented in the patient summary as an instance of the Condition resource constrained by this profile.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Condition",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Condition",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Condition",
                "path": "Condition",
                "short": "Condition Profile",
                "definition": "The Condition Profile is based upon the core FHIR Condition Resource"
            },
            {
                "id": "Condition.id",
                "path": "Condition.id",
                "definition": "Logical id of this artifact"
            },
            {
                "id": "Condition.meta",
                "path": "Condition.meta",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Condition.meta.profile",
                "path": "Condition.meta.profile",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Condition.clinicalStatus",
                "path": "Condition.clinicalStatus",
                "comment": "Some implementers may not capture status directly as a field for condition, but have other means of differentiating between current and historical conditions. Implementers are expected to be able to differentiate between active and inactive conditions to generate a compliant patient summary",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Condition.verificationStatus",
                "path": "Condition.verificationStatus",
                "comment": "This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid. While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing verificationStatus, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element using additional data from the system when developing the patient summary instance",
                "mustSupport": false
            },
            {
                "id": "Condition.category",
                "path": "Condition.category",
                "definition": "A category assigned to the condition. In this profile, a health problem of the patient, therefore a 'problem-list-item'.",
                "comment": "While IPS-UV considers this a MS element, some systems will not have a field directly representing category but it may be possible to hardcode. Further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element using additional data from the system when developing the patient summary instance. If this element is relaxed in the first release the constraint on the data type will also be relaxed.",
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept"
                        ]
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://hl7.org/fhir/ValueSet/condition-category"
                }
            },
            {
                "id": "Condition.severity",
                "path": "Condition.severity",
                "comment": "While IPS-UV considers this a MS element, some systems will not have a field directly representing severity. Further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. If this element is relaxed in the first release the constraint on the data type will also be relaxed.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept"
                        ]
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "severitySCTCA"
                        }
                    ],
                    "strength": "preferred",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/severitycode"
                }
            },
            {
                "id": "Condition.severity.coding",
                "path": "Condition.severity.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "description": "Discriminated by value set",
                    "rules": "open"
                },
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding"
                        ]
                    }
                ]
            },
            {
                "id": "Condition.severity.coding:severitySCTCA",
                "path": "Condition.severity.coding",
                "sliceName": "severitySCTCA",
                "short": "Optional slice for representing the severity of a problem from the SNOMED CT Canadian edition value set.",
                "definition": "Code for the severity of a problem that is selected from the SNOMED CT Canadian edition value set.",
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "severitySCTCA"
                        }
                    ],
                    "strength": "required",
                    "description": "severitySCTCA",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/severitycode"
                }
            },
            {
                "id": "Condition.code",
                "path": "Condition.code",
                "definition": "Identification of the condition, problem or diagnosis or recording of \"problem absent\" or of \"problems unknown\".",
                "comment": "Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for condition.code",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "preferred",
                    "description": "Codes for problems from the SNOMED CT Canadian edition value set",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/clinicalfindingcode"
                }
            },
            {
                "id": "Condition.code.coding",
                "path": "Condition.code.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "description": "Discriminated by the bound value set",
                    "rules": "open"
                },
                "mustSupport": true,
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding"
                        ]
                    }
                ]
            },
            {
                "id": "Condition.code.coding:codeSCTCA",
                "path": "Condition.code.coding",
                "sliceName": "codeSCTCA",
                "short": "Optional slice for representing the code for a problem from the SNOMED CT Canadian edition value set",
                "definition": "Code for representing the code for a problem that is selected from the SNOMED CT Canadian edition value set.",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "Codes for problems from the SNOMED CT Canadian edition value set",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/clinicalfindingcode"
                }
            },
            {
                "id": "Condition.code.coding:absentOrUnknownProblem",
                "path": "Condition.code.coding",
                "sliceName": "absentOrUnknownProblem",
                "short": "Optional slice for representing the code for absent problem or for unknown problem",
                "definition": "Code representing the statement \"absent problem\" or the statement \"problems unknown\"",
                "mustSupport": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "absentOrUnknownProblem"
                        }
                    ],
                    "strength": "required",
                    "description": "Absent problem or unknown problem",
                    "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-problems-uv-ips"
                }
            },
            {
                "id": "Condition.bodySite",
                "path": "Condition.bodySite",
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "ConditionBodySite"
                        }
                    ],
                    "strength": "preferred",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode"
                },
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept"
                        ]
                    }
                ]
            },
            {
                "id": "Condition.subject",
                "path": "Condition.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Condition.subject.reference",
                "path": "Condition.subject.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Condition.onset[x]",
                "path": "Condition.onset[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                },
                "comment": "IPS-UV constrains the condition onset element to only DateTime and Period data types. Both IPS-UV and PS-ON prefer the use of onsetDateTime",
                "mustSupport": true
            },
            {
                "id": "Condition.onsetDateTime:onsetDateTime",
                "path": "Condition.onsetDateTime",
                "sliceName": "onsetDateTime",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Condition.onsetPeriod:onsetPeriod",
                "path": "Condition.onsetPeriod",
                "sliceName": "onsetPeriod",
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "mustSupport": false
            },
            {
                "id": "Condition.abatement[x]",
                "path": "Condition.abatement[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                },
                "mustSupport": true
            },
            {
                "id": "Condition.abatement[x]:abatementDateTime",
                "path": "Condition.abatement[x]",
                "sliceName": "abatementDateTime",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Condition.abatement[x]:abatementPeriod",
                "path": "Condition.abatement[x]",
                "sliceName": "abatementPeriod",
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "mustSupport": false
            },
            {
                "id": "Condition.asserter",
                "path": "Condition.asserter",
                "definition": "Individual who is making the condition statement.\nInformation source.",
                "mustSupport": true
            }
        ]
    }
}

Usage

The Condition Resource is used to populate entries in the Problems and History of Past Illness sections of a Patient Summary.

Notes

.id

  • used to uniquely identify the resource
  • if a persistent identity for the resource is not available to use when constructing the composition Bundle, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)
  • Where .id is populated with a persistent identifier, consumers SHALL NOT expect to be able to resolve the resource and SHALL always use the version of the resource contained in the Bundle to render the composition.

.meta.profile

  • used to declare conformance to this profile
  • populate with a fixed value: http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-condition|0.9.1

.meta.versionId

  • SHALL be populated by the Patient Summary Repository server
  • consuming systems can expect this element to be populated when retrieving patient summary instances from the repository
  • source systems do not need to populate this element prior to submission

.clinicalStatus

  • .clinicalStatus is used to differentiate Problem List entries from Past Illness entries. Conditions with 'active' .clinicalStatus should be entered in the Problem section of the Composition and Conditions with 'inactive' .clinicalStatus should be entered in the Past Illness History section.
  • mustSupport element in international patient summary

.verificationStatus

  • SHOULD be used to convey the level of certainty about the allergy or intolerance in the entry where data is available
  • mustSupport element in international patient summary

.category

  • expected value is 'problem-list-item'
  • Implementers should be aware that IPS strongly encourages a LOINC value of 75326-9 be sent as an additional coding for category. However, the method that IPS will use to enforce this coding is still evolving and therefore not reflected in this current profile.

.code

  • SHALL be used to either:
    • identify the health problem conveyed in the entry, or
    • to explicitly state that the patient has no known or unknown health problems when the section in the patient summary does not contain a health problem
  • in situations where a health problem is present:
    • a description SHALL be provided in .text for display
    • a coded value SHOULD also be provided in .coding
  • in situations where a health problem is not present, this SHALL be coveyed using .coding from the prescribed valueSet
    • in situations where the EMR cannot distinguish between no-known and no information about patient conditions, then the code for no information should be used. In the instance where a patient is KNOWN to have no conditions, the no-known code should be used.
  • the "codeSCTCA" slice provides the preferred choice of terminology for this element in Ontario
  • mustSupport element in international patient summary

.subject

  • SHALL provide a .reference to the same Patient resource identified in Composition.subject
  • mustSupport element in international patient summary

.onset

  • SHOULD be used to indicate when the condition began
  • while only DateTime is marked as MustSupport, consuming applications should expect to handle any of the datatypes, as submitting applications may sometimes provide datatypes other than DateTime
  • mustSupport element in international patient summary

.abatement

  • SHOULD be used to indicate when the condition was resolved, if applicable
  • while only DateTime is marked as MustSupport, consuming applications should expect to handle any of the datatypes, as submitting applications may sometimes provide datatypes other than DateTime
  • mustSupport element in international patient summary

.asserter

  • If the asserter is known to be someone other than Composition.author, that information should be conveyed using this element. Otherwise, it may be left empty.