Diagnosis
Diagnosis are retrieved and stored through the Condition_Diagnosis profile. It supports to read or write any kind diagnosis that could read in medico itself.
ICD 10 The profile contains a dedicated slice within the condition's code section to support ICD10. This support is based on basisprofil.de:
Especially the extensions named for the condition profiles are used.
Unlike basisprofil the so-called post-coordinated codes are not supported: E.g. if there are primary and secondary diagnosis that are concatenated using + und * - than:
- these are expressed in individual condition resources
- each resource hold the simple ICD10 code for either the primary or secondary code
- each resource contains the full extensions
- using those extensions the post-coordinated codes could be created by the FHIR client
Example bundle containing a primary and secondary ICD10 diagnosis
{
"resourceType": "Bundle",
"entry": [
{
"resource": {
"resourceType": "Condition",
"id": "Diag-5040930",
"meta": {
"extension": [
{
"extension": [
{
"url": "responsibility",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "EncounterResponsibleDepartment"
}
]
}
},
{
"url": "reference",
"valueReference": {
"reference": "Organization/Department-PSY",
"identifier": {
"system": "https://fhir-cerner-eu.com/medico/dps/cs/Department",
"value": "PSY"
}
}
}
],
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Organizational_Responsibility_1"
}
],
"profile": [
"https://fhir-cerner-eu.com/medico/r4/sd/Condition_Diagnosis_1"
]
},
"extension": [
{
"extension": [
{
"url": "createDate",
"valueDateTime": "2019-06-13T14:19:40+02:00"
},
{
"url": "createUser",
"valueReference": {
"reference": "Practitioner/User-MIN",
"identifier": {
"system": "https://fhir-cerner-eu.com/medico/dps/cs/User",
"value": "MIN"
}
}
},
{
"url": "changeDate",
"valueDateTime": "2019-06-13T14:20:19+02:00"
},
{
"url": "changeUser",
"valueReference": {
"reference": "Practitioner/User-MIN",
"identifier": {
"system": "https://fhir-cerner-eu.com/medico/dps/cs/User",
"value": "MIN"
}
}
}
],
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_MetaCreateChangeInfo_1"
},
{
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Condition_DiagnosisWorkflow_1",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "discharge"
}
]
}
},
{
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Condition_DiagnosingOrganization_1",
"valueReference": {
"reference": "Organization/Department-PSY",
"type": "https://fhir-cerner-eu.com/medico/r4/sd/Organization_Department_1"
}
},
{
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Condition_DiagnosisAttributes_1",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "DiagAdminDRG"
},
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "DiagMedicalMain"
}
]
}
}
],
"identifier": [
{
"system": "https://fhir-cerner-eu.com/medico/dps/sid1/Diag",
"value": "5040930"
}
],
"clinicalStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/ValueSet/condition-clinical",
"code": "active"
}
]
},
"verificationStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/ValueSet/condition-ver-status",
"code": "confirmed"
}
]
},
"category": [
{
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "Diagnosis"
}
]
}
],
"severity": {
"text": "1"
},
"code": {
"coding": [
{
"extension": [
{
"url": "http://fhir.de/StructureDefinition/icd-10-gm-stern",
"valueCoding": {
"id": "Diag-5040932",
"system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
"version": "2018",
"code": "F00.1",
"display": "Demenz bei Alzheimer-Krankheit, mit spätem Beginn (Typ 1)"
}
},
{
"url": "http://fhir.de/StructureDefinition/icd-10-gm-haupt-kreuz",
"valueCoding": {
"id": "Diag-5040930",
"system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
"version": "2018",
"code": "F05.1",
"display": "Delir bei Demenz"
}
},
{
"url": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
"valueCoding": {
"system": "http://fhir.de/CodeSystem/kbv/s-icd-diagnosesicherheit",
"code": "G"
}
}
],
"system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
"version": "2018",
"code": "F05.1",
"display": "Delir bei Demenz"
}
]
},
"subject": {
"reference": "Patient/Patient-10734557"
},
"encounter": {
"reference": "Encounter/Case-9745450"
},
"asserter": {
"reference": "Practitioner/User-MIN"
}
}
},
{
"resource": {
"resourceType": "Condition",
"id": "Diag-5040932",
"meta": {
"extension": [
{
"extension": [
{
"url": "responsibility",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "EncounterResponsibleDepartment"
}
]
}
},
{
"url": "reference",
"valueReference": {
"reference": "Organization/Department-PSY",
"identifier": {
"system": "https://fhir-cerner-eu.com/medico/dps/cs/Department",
"value": "PSY"
}
}
}
],
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Organizational_Responsibility_1"
}
],
"profile": [
"https://fhir-cerner-eu.com/medico/r4/sd/Condition_Diagnosis_1"
]
},
"extension": [
{
"extension": [
{
"url": "createDate",
"valueDateTime": "2019-06-13T14:20:21+02:00"
},
{
"url": "createUser",
"valueReference": {
"reference": "Practitioner/User-MIN",
"identifier": {
"system": "https://fhir-cerner-eu.com/medico/dps/cs/User",
"value": "MIN"
}
}
}
],
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_MetaCreateChangeInfo_1"
},
{
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Condition_DiagnosisWorkflow_1",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "discharge"
}
]
}
},
{
"url": "https://fhir-cerner-eu.com/medico/r4/sd/MXT_Condition_DiagnosingOrganization_1",
"valueReference": {
"reference": "Organization/Department-PSY",
"type": "https://fhir-cerner-eu.com/medico/r4/sd/Organization_Department_1"
}
}
],
"identifier": [
{
"system": "https://fhir-cerner-eu.com/medico/dps/sid1/Diag",
"value": "5040932"
}
],
"clinicalStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/ValueSet/condition-clinical",
"code": "active"
}
]
},
"verificationStatus": {
"coding": [
{
"system": "http://hl7.org/fhir/ValueSet/condition-ver-status",
"code": "confirmed"
}
]
},
"category": [
{
"coding": [
{
"system": "https://fhir-cerner-eu.com/medico/cs1",
"code": "Diagnosis"
}
]
}
],
"severity": {
"text": "3"
},
"code": {
"coding": [
{
"extension": [
{
"url": "http://fhir.de/StructureDefinition/icd-10-gm-stern",
"valueCoding": {
"id": "Diag-5040932",
"system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
"version": "2018",
"code": "F00.1",
"display": "Demenz bei Alzheimer-Krankheit, mit spätem Beginn (Typ 1)"
}
},
{
"url": "http://fhir.de/StructureDefinition/icd-10-gm-haupt-kreuz",
"valueCoding": {
"id": "Diag-5040930",
"system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
"version": "2018",
"code": "F05.1",
"display": "Delir bei Demenz"
}
}
],
"system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
"version": "2018",
"code": "F00.1",
"display": "Demenz bei Alzheimer-Krankheit, mit spätem Beginn (Typ 1)"
}
]
},
"subject": {
"reference": "Patient/Patient-10734557"
},
"encounter": {
"reference": "Encounter/Case-9745450"
},
"asserter": {
"reference": "Practitioner/User-MIN"
}
}
}
}
}