The FHIR profiles used for the Problems list List
Heading Description
A summary of the problems that require investigation or treatment.
The following FHIR profiles are used to form the Problems list Problem List structure:
- CareConnect-List-1
- CareConnect-Condition-1
- CareConnect-Observation-1
- CareConnect-Encounter-1
- CareConnect-Location-1
- CareConnect-Practitioner-1
- CareConnect-PractitionerRole-1
The following profiles are referenced from the Patient demographics list structure:
Problems list Structure
Maternity data standard Mapping to FHIR profiles
Mapping Overview
| Data Standard Element | FHIR Resource Mapping | FHIR Element |
| Date/time | Condition | assertedDate |
| ODS/ORD Site Code | Location | identifier |
| SDS Job Role Name | PractitionerRole | code |
| Performing professional | Practitioner | name |
| Condition | Condition | code |
| Condition onset date | Condition | onsetDateTime |
| Condition end date | Condition | abatementDateTime |
| Fetal diagnosis | Observation | description |
| Comment | Condition | note |
Mapping for Problems list List
| > | Level 1 | List Resource | > | Level 2 | CareConnect-List-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Implementation |
|---|---|---|---|---|
| List | | Information summarized from a list of other resources Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource Constraint (lst-2): The deleted flag can only be used if the mode of the list is “changes” Constraint (lst-1): A list can only have an emptyReason if it is empty |
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| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-List-1' |
| - identifier | 0..* | Required | Identifier | Business identifier An identifier for this Problems list List |
| - - system | 1..1 | Required | Uri | The namespace for the identifier value The system from which the identifier came |
| - - value | 1..1 | Mandatory | String | The value that is unique A value for the identifier |
| - - assigner | 0..1 | Optional | Reference | Organization that issued id (may be just text) Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Organization-1 | |||
| - - - reference | 0..1 | Optional | String | Literal reference, Relative, internal or absolute URL |
| - - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - - display | 0..1 | Optional | String | Text alternative for the resource |
| - status | 1..1 | Mandatory | Code | current : retired : entered-in-error Binding (required): The current state of the list ListStatus The status of the list MUST contain the value 'current' |
| - mode | 1..1 | Mandatory | Code | working : snapshot : changes Binding (required): The processing mode that applies to this list ListMode The mode of the list MUST contain the value 'snapshot' |
| - title | 0..1 | Mandatory | String | Descriptive name for the list This MUST contain the value 'Problems list' Mapping to Maternity data item = 'PSRB Heading Problems list' |
| - code | 0..1 | Mandatory | CodeableConcept | What the purpose of this list is Binding (preferred): What the purpose of a list is CareConnect-ListCode-1 The PRSB heading for this list. Note: for Maternity the value stated below is used which is not from the preferred value set |
| - - coding | 0..* | Mandatory | Coding | Code defined by a terminology system The SNOMED CT concept for the PRSB heading type |
| - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system This MUST contain the value 'http://snomed.info/sct' |
| - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system This MUST contain the value 'tbc' |
| - - - display | 0..1 | Mandatory | String | Representation defined by the system This MUST contain the value 'Problems list' Mapping to Maternity data item = 'PSRB Heading Problems list' |
| - subject | 0..1 | Mandatory | Reference | If all resources have the same subject Constraint (ref-1): SHALL have a contained resource if a local reference is provided This is a reference to the Patient who is the subject of the list. |
| Mandatory | CareConnect-Patient-1 | This is the subject of the Problems list List. This MUST use the CareConnect patient profile. See patient resource reference for information on how to populate the resource. |
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| - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL A reference to the patient resource included in the Patient demographics list within the FHIR Bundle. Note the Patient demographics list is mandatory in the FHIR bundle |
| - date | 0..1 | Mandatory | dateTime | When the list was prepared This MUST contain a system date to indicate when the list created or updated |
| - note | 0..* | Optional | Annotation | Comments about the list |
| - - author[x] | 0..1 | Optional | Reference | Individual responsible for the annotation Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Practitioner-1 | |||
| Optional | String | Who authored the comment on the list. | ||
| - - time | 0..1 | Required | dateTime | When the annotation was made |
| - - text | 1..1 | Required | String | The annotation - text content |
| - entry | 0..* | Mandatory | BackboneElement | Entries in the list The entries MUST be as per the diagram for this PRSB headings list with the Condition/Observation resource being the focal resources. |
| - - date | 0..1 | Required | dateTime | When item added to list The SHOULD contain a system time of when the item was added to the list. |
| - - item | 1..1 | Required | Reference | Actual entry Constraint (ref-1): SHALL have a contained resource if a local reference is provided A reference to a Condition/Observation resource included in the list |
| - - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL |
Patient Reference
The Problems List has a mandated subject reference to the Patient resource. This means that any exchange of the Problems list heading data must also include the Patient demographics List.
Mapping for Problems list Encounter
| > | Level 1 | Encounter Resource | > | Level 2 | CareConnect-Encounter-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Implementation |
|---|---|---|---|---|
| Encounter | An interaction during which services are provided to the patient Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource |
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| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1' |
| - identifier | 0..* | Required | Identifier | Identifier(s) by which this encounter is known An identifier for this Encounter |
| - - system | 1..1 | Mandatory | Uri | The namespace for the identifier value The system from which the identifier came |
| - - value | 1..1 | Mandatory | String | The value that is unique A value for the identifier |
| - - assigner | 0..1 | Optional | Reference | Organization that issued id (may be just text) Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Organization-1 | |||
| - - - reference | 0..1 | Optional | String | Literal reference, Relative, internal or absolute URL |
| - - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - - display | 0..1 | Optional | String | Text alternative for the resource |
| - status | 1..1 | Mandatory | Code | planned : arrived : triaged : in-progress : onleave : finished : cancelled + Binding (required): Current state of the encounter EncounterStatus |
| - subject | 0..1 | Optional | Reference | The patient ro group present at the encounter Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Patient-1 | |||
| - - reference | 0..1 | Optional | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - participant | 0..1 | Required | BackboneElement | List of participants involved in the encounter |
| - - type | 0..* | Required | CodeableConcept | Role of participant in encounter Binding (extensible): Role of participant in encounter ParticipantType |
| - - - coding | 0..* | Required | Coding | Code defined by a terminology system |
| - - - - system | 0..1 | Required | Uri | Identity of the terminology system |
| - - - - code | 0..1 | Required | Code | Symbol in syntax defined by the system |
| - - - - display | 0..1 | Required | String | Representation defined by the system |
| - - - - userSelected | 0..1 | Optional | Boolean | If this coding was chosen directly by the user |
| - - - text | 0..1 | Optional | String | Plain text representation of the concept |
| - - period | 0..1 | Optional | Period | Period of time during the encounter that the participant participated Constraint (per-1): If present, start SHALL have a lower value than end |
| - - - start | 0..1 | Optional | dateTime | Starting time with inclusive boundary |
| - - - end | 0..1 | Optional | dateTime | End time with inclusive boundary, if not ongoing |
| - - individual | 0..1 | Required | Reference | Persons involved in the encounter other than the patient Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Required | RelatedPerson | |||
| Optional | CareConnect-Practitioner-1 | |||
| - - - reference | 0..1 | Required | String | Literal reference, Relative, internal or absolute URL |
| - - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - - display | 0..1 | Required | String | Text alternative for the resource |
| - location | 0..1 | Required | BackboneElement | List of locations where the patient has been |
| - - location | 1..1 | Mandatory | Reference | Location the encounter takes place Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Mandatory | CareConnect-Location-1 | |||
| - - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL |
| - - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - - display | 0..1 | Optional | String | Text alternative for the resource |
Mapping for Problems list Condition
| > | Level 1 | Condition Resource | > | Level 2 | CareConnect-Condition-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Implementation |
|---|---|---|---|---|
| Condition | | Detailed information about conditions, problems or diagnoses Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource Constraint (con-4): If condition is abated, then clinicalStatus must be either inactive, resolved, or remission Constraint (con-3): Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error |
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| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1' |
| - identifier | 0..* | Required | Identifier | External Ids for this condition An identifier for this Problem list Condition |
| - - system | 1..1 | Mandatory | Uri | The namespace for the identifier value The system from which the identifier came |
| - - value | 1..1 | Mandatory | String | The value that is unique A value for the identifier |
| - - assigner | 0..1 | Optional | Reference | Organization that issued id (may be just text) Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Organization-1 | |||
| - - - reference | 0..1 | Optional | String | Literal reference, Relative, internal or absolute URL |
| - - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - - display | 0..1 | Optional | String | Text alternative for the resource |
| - clinicalStatus | 0..1 | Optional | Code | active : recurrence : inactive : remission : resolved Binding (required): The clinical status of the condition or diagnosis. Condition Clinical Status Codes |
| - code | 1..1 | Mandatory | CodeableConcept | Identification of the condition, problem or diagnosis Binding (example): Identification of the condition or diagnosis. Condition/Problem/Diagnosis Codes Mapping to Digital Maternity data item ='Condition' Binding to SNOMED SCTID 999000131000000105 (Care planning health issues simple reference set) |
| - - coding | 0..* | Optional | Coding | Code defined by a terminology system Slicing: Discriminator: system, Ordering: false, Rules: Open |
| - - coding (snomedCT) | 0..1 | Optional | Coding | Code defined by a terminology system Binding (required): A code from the SNOMED Clinical Terminology UK CareConnect-ConditionCode-1 |
| - - - extension (snomedCTDescriptionID) | 0..1 | Optional | Extension-coding-sctdescid | Optional Extensions Element Constraint (ext-1): Must have either extensions or value[x], not both |
| - - - system | 1..1 | Mandatory | Uri | Identity of the terminology system The element MUST contain the value 'http://snomed.info/sct' |
| - - - code | 1..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - display | 1..1 | Mandatory | String | Representation defined by the system |
| - - - userSelected | 0..1 | Optional | Boolean | If this coding was chosen directly by the user |
| - - text | 0..1 | Optional | String | Plain text representation of the concept |
| - subject | 1..1 | Mandatory | Reference | Who has the condition? Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Mandatory | CareConnect-Patient-1 | |||
| - - reference | 1..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - context | 0..1 | Required | Reference | Encounter or episode when condition first asserted Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Required | CareConnect-Encounter-1 | |||
| - - reference | 0..1 | Required | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - onset[x] | 0..1 | Required | dateTime | Estimated or actual date, date-time, or age Mapping to Digital Maternity data item ='Condition onset date' |
| - abatement[x] | 0..1 | Required | dateTime | If/when in resolution/remission Mapping to Digital Maternity data item ='Condition end date' |
| - assertedDate | 1..1 | Mandatory | dateTime | Date record was believed accurate Mapping to Digital Maternity data item ='Date/time' |
| - asserter | 0..1 | Required | Reference | Person who asserts this condition Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Required | CareConnect-Practitioner-1 | |||
| - - reference | 0..1 | Required | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - note | 0..* | Optional | Annotation | Additional information about the Condition Mapping to Digital Maternity data item ='Comment' |
| - - author[x] | 0..1 | Optional | Reference | Individual responsible for the annotation Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | RelatedPerson | |||
| Optional | CareConnect-Practitioner-1 | |||
| Optional | CareConnect-Patient-1 | |||
| Optional | String | |||
| - - time | 0..1 | Optional | dateTime | When the annotation was made |
| - - text | 1..1 | Mandatory | String | The annotation - text content |
Mapping for Problems list Observation
| > | Level 1 | Observation Resource | > | Level 2 | CareConnect-Observation-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Implementation |
|---|---|---|---|---|
| Observation | | Measurements and simple assertions Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource Constraint (obs-7): If code is the same as a component code then the value element associated with the code SHALL NOT be present Constraint (obs-6): dataAbsentReason SHALL only be present if Observation.value[x] is not present |
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| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1' |
| - identifier | 0..* | Optional | Identifier | Business Identifier for observation An identifier for this Problems list Observation |
| - - system | 1..1 | Mandatory | Uri | The namespace for the identifier value The system from which the identifier came |
| - - value | 1..1 | Mandatory | String | The value that is unique A value for the identifier |
| - - assigner | 0..1 | Optional | Reference | Organization that issued id (may be just text) Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Organization-1 | |||
| - - - reference | 0..1 | Optional | String | Literal reference, Relative, internal or absolute URL |
| - - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - - display | 0..1 | Optional | String | Text alternative for the resource |
| - status | 1..1 | Mandatory | Code | registered : preliminary : final : amended + Binding (required): Codes providing the status of an observation. ObservationStatus This MUST contain the value 'final' |
| - code | 1..1 | Mandatory | CodeableConcept | Type of observation (code / type) Binding (example): Codes identifying names of simple observations. LOINC Codes Mapping to Digital Maternity data item = Fetal Diagnosis |
| - - coding | 0..1 | Required | Coding | Code defined by a terminology system Slicing: Discriminator: code, Ordering: false, Rules: Open |
| - - coding (snomedCT) | 0..1 | Optional | Coding | Code defined by a terminology system Binding (extensible): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation CareConnect-ObservationType-1 |
| - - - system | 1..1 | Mandatory | Uri | Identity of the terminology system This MUST contain the value 'http://snomed.info/sct' |
| - - - code | 1..1 | Mandatory | Code | Symbol in syntax defined by the system 699250000 |
| - - - display | 1..1 | Mandatory | String | Representation defined by the system Fetal diagnosis |
| - subject | 0..1 | Optional | Reference | Who and/or what this is about Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Optional | CareConnect-Patient-1 | |||
| - - reference | 0..1 | Optional | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - context | 0..1 | Required | Reference | Healthcare event during which this observation is made Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Required | CareConnect-Encounter-1 | |||
| - - reference | 0..1 | Required | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - performer | 0..1 | Required | Reference | Who is responsible for the observation Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Required | CareConnect-Practitioner-1 | |||
| - - reference | 0..1 | Required | String | Literal reference, Relative, internal or absolute URL |
| - - identifier | 0..1 | Optional | Identifier | Logical reference, when literal reference is not known |
| - - display | 0..1 | Optional | String | Text alternative for the resource |
| - value[x] | Optional | Boolean | Value has mapping to Digital Maternity data item 'Fetal diagnosis' |
Mapping for Problems list Location
The Problems list details has reference(s) to the Location resource. This means that any exchange of the Problems list details heading data must also include the Location Details
Mapping for Problems list Practitioner
The Problems list details has reference(s) to the Practitioner resource. This means that any exchange of the Problems list details heading data must also include the Practitioner Details
Mapping for Problems list PractitionerRole
The Problems list details has reference(s) to the Practitioner Role resource. This means that any exchange of the Problems list details heading data must also include the Practitioner Role Details