InformationAndAdviceGiven

CareConnect-DCH-Condition-1

CareConnect-DCH-Condition-1

Condition
Definition
Control 0..*
Comments
Condition.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control 0..1 ?
Type Id
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID.

Condition.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control 0..1 ?
Type Meta
Comments
Condition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control 0..1 ?
Type Uri
Is Modifier True
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.

Condition.language
Definition

The base language in which the resource is written.

Control 0..1 ?
Binding

A human language.

The codes SHALL be taken from http://tools.ietf.org/html/bcp47

Type Code
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Condition.text
Definition

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control 0..1 ?
Type Narrative
Aliases narrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Condition.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control 0..*
Type Resource
Aliases inline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Condition.extension(episode)
Definition
Control 0..1
Type Extension
Comments
Condition.extension(related)
Definition
Control 0..*
Type Extension
Comments
Condition.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.

Control 0..* ?
Type Extension
Is Modifier True
Aliases 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.

Condition.identifier
Definition

This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

Control 0..* ?
Type Identifier
Requirements

Need to allow connection to a wider workflow.

Comments
Condition.identifier.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.identifier.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.identifier.use
Definition

The purpose of this identifier.

Control 0..1 ?
Binding

Identifies the purpose for this identifier, if known .

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/identifier-use

Type Code
Is Modifier True
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Condition.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control 0..1 ?
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. http://hl7.org/fhir/ValueSet/identifier-type

Type CodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Condition.identifier.type.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.identifier.type.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.identifier.type.coding
Definition

A reference to a code defined by a terminology system.

Control 0..* ?
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Condition.identifier.type.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.identifier.type.coding.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.identifier.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1 ?
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Condition.identifier.type.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1 ?
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Condition.identifier.type.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1 ?
Type Code
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Condition.identifier.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1 ?
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Condition.identifier.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1 ?
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Condition.identifier.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.identifier.system
Definition
Control 1..*
Comments
Condition.identifier.value
Definition
Control 1..*
Comments
Condition.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control 0..1 ?
Type Period
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Condition.identifier.period.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.identifier.period.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.identifier.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Condition.identifier.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Condition.identifier.assigner
Definition
Control 0..*
Type https://fhir.nhs.uk/StructureDefinition/CareConnect-DCH-Organization-1
Comments
Condition.identifier.assigner.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.identifier.assigner.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.identifier.assigner.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Condition.identifier.assigner.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1 ?
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Condition.patient
Definition
Control 0..*
Type https://fhir.nhs.uk/StructureDefinition/CareConnect-DCH-Patient-1
Comments
Condition.patient.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.patient.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.patient.reference
Definition
Control 1..*
Comments
Condition.patient.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1 ?
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Condition.encounter
Definition
Control 1..*
Type https://fhir.nhs.uk/StructureDefinition/CareConnect-DCH-Encounter-1
Comments
Condition.encounter.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.encounter.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.encounter.reference
Definition
Control 1..*
Comments
Condition.encounter.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1 ?
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Condition.asserter
Definition
Control 1..*
Type Choice of:
Comments
Condition.dateRecorded
Definition
Control 1..*
Comments
Condition.code
Definition

Identification of the condition, problem or diagnosis.

Control 1..1 ?
Binding

Identification of the condition or diagnosis.

For example codes, see http://hl7.org/fhir/ValueSet/condition-code

; other codes may be used where these codes are not suitable
Type CodeableConcept
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.

Condition.code.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.code.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.code.coding(SNOMED CT)
Definition
Control 1..1
Comments
Condition.code.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.code.coding.extension(snomedCTDescriptionID)
Definition
Control 0..*
Type Extension
Comments
Condition.code.coding.system
Definition
Control 1..*
Comments
Fixed Value http://snomed.info/sct
Condition.code.coding.code
Definition
Control 1..*
Comments
Condition.code.coding.display
Definition
Control 1..*
Comments
Condition.code.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1 ?
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Condition.code.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.category
Definition
Control 1..*
Binding

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionCategory-1

Comments
Condition.category.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.category.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.category.coding
Definition

A reference to a code defined by a terminology system.

Control 0..* ?
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Condition.category.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.category.coding.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.category.coding.system
Definition
Control 1..*
Comments
Condition.category.coding.code
Definition
Control 1..*
Comments
Condition.category.coding.display
Definition
Control 1..*
Comments
Condition.category.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.clinicalStatus
Definition
Control 0..*
Binding
Comments
Condition.verificationStatus
Definition

The verification status to support the clinical status of the condition.

Control 1..1 ?
Binding

The verification status to support or decline the clinical status of the condition or diagnosis.

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/condition-ver-status

Type Code
Is Modifier True
Comments

Note that FHIR strings may not exceed 1MB in size

Condition.severity
Definition
Control 0..*
Binding None Specified
Comments
Condition.severity.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.severity.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.severity.coding
Definition

A reference to a code defined by a terminology system.

Control 0..* ?
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Condition.severity.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.severity.coding.extension(snomedCTDescriptionID)
Definition

Optional Extensions Element - found in all resources.

Control 0..*
Type Extension
Comments
Condition.severity.coding.system
Definition
Control 1..*
Comments
Condition.severity.coding.code
Definition
Control 1..*
Comments
Condition.severity.coding.display
Definition
Control 1..*
Comments
Condition.severity.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1 ?
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Condition.severity.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.onsetDateTime
Definition
Control 0..*
Type DateTime
Must Support True
Comments
Condition.abatement[x]
Definition

The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

Control 0..1 ?
Type Choice of:
Comments

There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.

Condition.stage
Definition

Clinical stage or grade of a condition. May include formal severity assessments.

Control 0..1 ?
Type BackboneElement
Comments
Condition.stage.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.stage.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.stage.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 that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.

Control 0..* ?
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
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.

Condition.stage.summary
Definition

A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

Control 0..1 ?
Binding

Codes describing condition stages (e.g. Cancer stages).

For example codes, see http://hl7.org/fhir/ValueSet/condition-stage

; other codes may be used where these codes are not suitable
Type CodeableConcept
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.

Condition.stage.summary.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.stage.summary.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.stage.summary.coding(SNOMED CT)
Definition
Control 0..*
Comments
Condition.stage.summary.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.stage.summary.coding.extension(snomedCTDescriptionID)
Definition
Control 0..*
Type Extension
Comments
Condition.stage.summary.coding.system
Definition
Control 1..*
Comments
Fixed Value http://snomed.info/sct
Condition.stage.summary.coding.code
Definition
Control 1..*
Comments
Condition.stage.summary.coding.display
Definition
Control 1..*
Comments
Condition.stage.summary.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1 ?
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Condition.stage.summary.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.stage.assessment
Definition
Control 0..*
Type Choice of:
Comments
Condition.evidence
Definition

Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.

Control 0..* ?
Type BackboneElement
Comments

The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

Condition.evidence.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.evidence.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.evidence.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 that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.

Control 0..* ?
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
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.

Condition.evidence.code
Definition

A manifestation or symptom that led to the recording of this condition.

Control 0..1 ?
Binding

Codes that describe the manifestation or symptoms of a condition.

For example codes, see http://hl7.org/fhir/ValueSet/manifestation-or-symptom

; other codes may be used where these codes are not suitable
Type CodeableConcept
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.

Condition.evidence.code.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.evidence.code.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.evidence.code.coding
Definition

A reference to a code defined by a terminology system.

Control 0..* ?
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Condition.evidence.code.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.evidence.code.coding.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.evidence.code.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1 ?
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Condition.evidence.code.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1 ?
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Condition.evidence.code.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1 ?
Type Code
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Condition.evidence.code.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1 ?
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Condition.evidence.code.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1 ?
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Condition.evidence.code.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.evidence.detail
Definition

Links to other relevant information, including pathology reports.

Control 0..* ?
Type Resource
Comments
Condition.evidence.detail.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.evidence.detail.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.evidence.detail.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Condition.evidence.detail.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1 ?
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Condition.bodySite
Definition

The anatomical location where this condition manifests itself.

Control 0..* ?
Binding

Codes describing anatomical locations. May include laterality.

For example codes, see http://hl7.org/fhir/ValueSet/body-site

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments

May be a summary code, or a reference to a very precise definition of the location, or both.

Condition.bodySite.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.bodySite.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control 0..* ?
Type Extension
Aliases 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.

Condition.bodySite.coding(SNOMED CT)
Definition
Control 0..1
Comments
Condition.bodySite.coding.id
Definition

unique id for the element within a resource (for internal references).

Control 0..1 ?
Type Id
Comments

RFC 4122

Condition.bodySite.coding.extension(snomedCTDescriptionID)
Definition
Control 0..*
Type Extension
Comments
Condition.bodySite.coding.system
Definition
Control 1..*
Comments
Fixed Value http://snomed.info/sct
Condition.bodySite.coding.code
Definition
Control 1..*
Comments
Condition.bodySite.coding.display
Definition
Control 1..*
Comments
Condition.bodySite.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1 ?
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Condition.bodySite.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1 ?
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Condition.notes
Definition

Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

Control 0..1 ?
Type String
Comments

Note that FHIR strings may not exceed 1MB in size