Example Usage Scenarios:

The following are example usage scenarios for this profile:

• Query for a Patient's current or historical problems and health concerns
• Record or update a Patient's problems and health concerns

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Condition Must Have:

1. a category code of "problem-list-item" or "health-concern"
2. a code that identifies the condition*
3. a patient

Each Condition Must Support:

1. a timestamp when the resource last changed*
2. a clinical status of the condition (e.g., active or resolved)
3. a verification status
4. additional health status/assessment categories
5. a date of diagnosis*
6. abatement date (in other words, date of resolution or remission)
7. a date when recorded*

*see guidance below

Profile Specific Implementation Guidance:

• For Encounter Diagnosis, use the IE Core Condition Encounter Diagnosis Profile.
• *The Condition.code has an additional binding of "current" and a base "preferred" binding.
  • For the conformance rules on the current binding for coded data, review this section in the General Requirements page.
  • IECDI's applicable vocabulary standards for Problems/Health Concerns are SNOMED CT and ICD-10-CM.
    • The IE Core Condition Codes only supports ICD-9-CM for historical purposes. ICD-10-CM is available and SHOULD be used as the primary code for current encounter diagnoses.
• See the Screening and Assessments guidance page for more information when exchanging Social Determinants of Health (SDOH) Problems/Health Concerns.
• If Condition.category contains a Problem List item category (problem-list-item), Condition.clinicalStatus SHOULD be present.
• *There is no single element in Condition that represents the date of diagnosis. It may be the assertedDate Extension, Condition.onsetDateTime, or Condition.recordedDate.
  • Although all three are marked as Must Support, the server is not required to support all.
  • A server SHALL support Condition.recordedDate.
    • A server SHALL support at least one of assertedDate Extension and Condition.onsetDateTime. A server may support both, which means they support all 3 locations.
    • The client application SHALL support all three elements.
• * See the IE Core General Guidance page for Searching Using lastUpdated. Updates to Meta.lastUpdated SHOULD reflect:
  • New problems and health concerns
  • Changes in the clinical status or verifications status of problems or health concerns

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
meta	SΣ	0..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
lastUpdated	SΣ	0..1	instant	When the resource last changed ele-1: All FHIR elements must have a @value or children
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:assertedDate	S	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) ele-1: All FHIR elements must have a @value or children
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. ele-1: All FHIR elements must have a @value or children
category:ie-core	S	1..*	CodeableConcept	problem-list-item | health-concern Binding: IE Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
category:screening-assessment	S	0..*	CodeableConcept	IECDI Health Status/Assessments Data Class Binding: IE Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: IE Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient Additional Bindings Purpose IE Core Condition Codes Current ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(IE Core Patient Profile)	Who has the condition? ele-1: All FHIR elements must have a @value or children
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age ele-1: All FHIR elements must have a @value or children
onsetDateTime			dateTime
abatement[x]	SC	0..1		When in resolution/remission ele-1: All FHIR elements must have a @value or children
abatementDateTime			dateTime
recordedDate	SΣ	0..1	dateTime	Date record was first recorded ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status from the FHIR Standard
Condition.category	extensible	ConditionCategoryCodes http://hl7.org/fhir/ValueSet/condition-category from the FHIR Standard
Condition.category:ie-core	required	IECoreProblemOrHealthConcern http://iehr.ai/fhir/ie/core/ValueSet/ie-core-problem-or-health-concern from this IG
Condition.category:screening-assessment	required	IECoreScreeningAssessmentConditionCategory (a valid code from IE Core Category) http://iehr.ai/fhir/ie/core/ValueSet/ie-core-screening-assessment-condition-category from this IG
Condition.code	preferred	IECoreConditionCodes http://iehr.ai/fhir/ie/core/ValueSet/ie-core-condition-code from this IG

This structure is derived from Condition

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	Condition	Detailed information about conditions, problems or diagnoses
meta	S	0..1	Meta	Metadata about the resource
lastUpdated	S	0..1	instant	When the resource last changed
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	S	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
clinicalStatus	S	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	S	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	category codes Slice: Unordered, Open by pattern:$this
category:ie-core	S	1..*	CodeableConcept	problem-list-item | health-concern Binding: IE Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	IECDI Health Status/Assessments Data Class Binding: IE Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	S	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: IE Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient Additional Bindings Purpose IE Core Condition Codes Current
subject	S	1..1	Reference(IE Core Patient Profile S | Group)	Who has the condition?
onset[x]	S	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	S	0..1		When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	S	0..1	dateTime	Date record was first recorded
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status from the FHIR Standard
Condition.category:ie-core	required	IECoreProblemOrHealthConcern http://iehr.ai/fhir/ie/core/ValueSet/ie-core-problem-or-health-concern from this IG
Condition.category:screening-assessment	required	IECoreScreeningAssessmentConditionCategory (a valid code from IE Core Category) http://iehr.ai/fhir/ie/core/ValueSet/ie-core-screening-assessment-condition-category from this IG
Condition.code	preferred	IECoreConditionCodes http://iehr.ai/fhir/ie/core/ValueSet/ie-core-condition-code from this IG

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	When the resource last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	S	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:ie-core	S	1..*	CodeableConcept	problem-list-item | health-concern Binding: IE Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	IECDI Health Status/Assessments Data Class Binding: IE Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: IE Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient Additional Bindings Purpose IE Core Condition Codes Current
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject	SΣ	1..1	Reference(IE Core Patient Profile S | Group)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	Date record was first recorded
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Supporting evidence con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Condition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status from the FHIR Standard
Condition.category	extensible	ConditionCategoryCodes http://hl7.org/fhir/ValueSet/condition-category from the FHIR Standard
Condition.category:ie-core	required	IECoreProblemOrHealthConcern http://iehr.ai/fhir/ie/core/ValueSet/ie-core-problem-or-health-concern from this IG
Condition.category:screening-assessment	required	IECoreScreeningAssessmentConditionCategory (a valid code from IE Core Category) http://iehr.ai/fhir/ie/core/ValueSet/ie-core-screening-assessment-condition-category from this IG
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	preferred	IECoreConditionCodes http://iehr.ai/fhir/ie/core/ValueSet/ie-core-condition-code from this IG
Condition.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.stage.summary	example	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.stage.type	example	ConditionStageType http://hl7.org/fhir/ValueSet/condition-stage-type from the FHIR Standard
Condition.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
meta	SΣ	0..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
lastUpdated	SΣ	0..1	instant	When the resource last changed ele-1: All FHIR elements must have a @value or children
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:assertedDate	S	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required) ele-1: All FHIR elements must have a @value or children
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required) ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. ele-1: All FHIR elements must have a @value or children
category:ie-core	S	1..*	CodeableConcept	problem-list-item | health-concern Binding: IE Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
category:screening-assessment	S	0..*	CodeableConcept	IECDI Health Status/Assessments Data Class Binding: IE Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: IE Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient Additional Bindings Purpose IE Core Condition Codes Current ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(IE Core Patient Profile)	Who has the condition? ele-1: All FHIR elements must have a @value or children
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age ele-1: All FHIR elements must have a @value or children
onsetDateTime			dateTime
abatement[x]	SC	0..1		When in resolution/remission ele-1: All FHIR elements must have a @value or children
abatementDateTime			dateTime
recordedDate	SΣ	0..1	dateTime	Date record was first recorded ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status from the FHIR Standard
Condition.category	extensible	ConditionCategoryCodes http://hl7.org/fhir/ValueSet/condition-category from the FHIR Standard
Condition.category:ie-core	required	IECoreProblemOrHealthConcern http://iehr.ai/fhir/ie/core/ValueSet/ie-core-problem-or-health-concern from this IG
Condition.category:screening-assessment	required	IECoreScreeningAssessmentConditionCategory (a valid code from IE Core Category) http://iehr.ai/fhir/ie/core/ValueSet/ie-core-screening-assessment-condition-category from this IG
Condition.code	preferred	IECoreConditionCodes http://iehr.ai/fhir/ie/core/ValueSet/ie-core-condition-code from this IG

Differential View

This structure is derived from Condition

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	Condition	Detailed information about conditions, problems or diagnoses
meta	S	0..1	Meta	Metadata about the resource
lastUpdated	S	0..1	instant	When the resource last changed
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	S	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
clinicalStatus	S	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	S	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	category codes Slice: Unordered, Open by pattern:$this
category:ie-core	S	1..*	CodeableConcept	problem-list-item | health-concern Binding: IE Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	IECDI Health Status/Assessments Data Class Binding: IE Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	S	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: IE Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient Additional Bindings Purpose IE Core Condition Codes Current
subject	S	1..1	Reference(IE Core Patient Profile S | Group)	Who has the condition?
onset[x]	S	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	S	0..1		When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	S	0..1	dateTime	Date record was first recorded
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status from the FHIR Standard
Condition.category:ie-core	required	IECoreProblemOrHealthConcern http://iehr.ai/fhir/ie/core/ValueSet/ie-core-problem-or-health-concern from this IG
Condition.category:screening-assessment	required	IECoreScreeningAssessmentConditionCategory (a valid code from IE Core Category) http://iehr.ai/fhir/ie/core/ValueSet/ie-core-screening-assessment-condition-category from this IG
Condition.code	preferred	IECoreConditionCodes http://iehr.ai/fhir/ie/core/ValueSet/ie-core-condition-code from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	When the resource last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	S	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:ie-core	S	1..*	CodeableConcept	problem-list-item | health-concern Binding: IE Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	IECDI Health Status/Assessments Data Class Binding: IE Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: IE Core Condition Codes (preferred): Valueset to describe the actual problem experienced by the patient Additional Bindings Purpose IE Core Condition Codes Current
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject	SΣ	1..1	Reference(IE Core Patient Profile S | Group)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	Date record was first recorded
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Supporting evidence con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Condition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status from the FHIR Standard
Condition.category	extensible	ConditionCategoryCodes http://hl7.org/fhir/ValueSet/condition-category from the FHIR Standard
Condition.category:ie-core	required	IECoreProblemOrHealthConcern http://iehr.ai/fhir/ie/core/ValueSet/ie-core-problem-or-health-concern from this IG
Condition.category:screening-assessment	required	IECoreScreeningAssessmentConditionCategory (a valid code from IE Core Category) http://iehr.ai/fhir/ie/core/ValueSet/ie-core-screening-assessment-condition-category from this IG
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	preferred	IECoreConditionCodes http://iehr.ai/fhir/ie/core/ValueSet/ie-core-condition-code from this IG
Condition.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.stage.summary	example	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.stage.type	example	ConditionStageType http://hl7.org/fhir/ValueSet/condition-stage-type from the FHIR Standard
Condition.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

This structure is derived from Condition

Summary

Mandatory: 3 elements
Must-Support: 13 elements

Structures

This structure refers to these other structures:

• IE Core Patient Profile (http://iehr.ai/fhir/ie/core/StructureDefinition/ie-core-patient)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-assertedDate

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Condition.category

Maturity: 3

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the IE Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only IE Core Profiles (Profile Only Support) are not required to support these interactions. See the IE Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• See the Scopes Format section for a description of the SMART scopes syntax.
• See the Search Syntax section for a description of the IE Core search syntax.
• See the General Requirements section for additional rules and expectations when a server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

IE Core Scopes

Servers providing access to problems and health concern data SHALL support these IE Core SMART Scopes:

• resource level scopes: <patient|user|system>/Condition.rs

• granular scopes: <patient|user|system>.Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item

• granular scopes: <patient|user|system>.Condition.rs?category=http://iehr.ai/fhir/ie/core/CodeSystem/condition-category|health-concern

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching for all conditions including problems, health concerns, and encounter diagnosis for a patient using the patient search parameter:

   GET [base]/Condition?patient={Type/}[id]

   Example:

   1. GET [base]/Condition?patient=1137192

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient (how to search by reference)

2. SHALL support searching using the combination of the patient and category search parameters:

   GET [base]/Condition?patient={Type/}[id]&category={system|}[code]

   Example:

   1. GET [base]/Condition?patient=1032702&category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item
   2. GET [base]/Condition?patient=1032702&category=http://iehr.ai/fhir/ie/core/CodeSystem/condition-category|health-concern
   3. GET [base]/Condition?patient=1032702&category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and category. (how to search by reference and how to search by token)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and clinical-status search parameters:

   GET [base]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission

   Example:

   1. GET [base/Condition?patient=1032702&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and all "active" statuses (active,relapse,remission). This will exclude diagnoses and health concerns without a clinicalStatus specified. (how to search by reference and how to search by token)

2. SHOULD support searching using the combination of the patient and category and clinical-status search parameters:

   GET [base]/Condition?patient={Type/}[id]&category={system|}[code]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission

   Example:

   1. GET [base]/Condition?patient=1032702&category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and category for all "active" statuses (active,relapse,remission). This will exclude diagnoses and health concerns without a clinicalStatus specified. (how to search by reference and how to search by token)

3. SHOULD support searching using the combination of the patient and category and encounter search parameters:

   GET [base]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]

   Example:

   1. GET [base]/Condition?patient=1032702&category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis&encounter=1036

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and category and encounter. When category = "encounter-diagnosis" will return the encounter diagnosis for the encounter. (how to search by reference and how to search by token)

4. SHOULD support searching using the combination of the patient and code search parameters:

   GET [base]/Condition?patient={Type/}[id]&code={system|}[code]

   Example:

   1. GET [base]/Condition?patient=1032702&code=[http://snomed.info/sct|442311008]

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and code. (how to search by reference and how to search by token)

5. SHOULD support searching using the combination of the patient and onset-date search parameters:
   • including support for these onset-date comparators: gt,lt,ge,le
   • including optional support for AND search on onset-date (e.g.onset-date=[date]&onset-date=[date]]&...)

   GET [base]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Condition?patient=555580&onset-date=ge2018-01-14

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)

6. SHOULD support searching using the combination of the patient and asserted-date search parameters:
   • including support for these asserted-date comparators: gt,lt,ge,le
   • including optional support for AND search on asserted-date (e.g.asserted-date=[date]&asserted-date=[date]]&...)

   GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Condition?patient=555580&asserted-date=ge2018-01-14

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)

7. SHOULD support searching using the combination of the patient and recorded-date search parameters:
   • including support for these recorded-date comparators: gt,lt,ge,le
   • including optional support for AND search on recorded-date (e.g.recorded-date=[date]&recorded-date=[date]]&...)

   GET [base]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Condition?patient=555580&recorded-date=ge2018-01-14

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)

8. SHOULD support searching using the combination of the patient and abatement-date search parameters:
   • including support for these abatement-date comparators: gt,lt,ge,le
   • including optional support for AND search on abatement-date (e.g.abatement-date=[date]&abatement-date=[date]]&...)

   GET [base]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Condition?patient=555580&abatement-date=ge2018-01-14

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and date. (how to search by reference and how to search by date)

9. SHOULD support searching using the combination of the patient and _lastUpdated search parameters:
   • including support for these _lastUpdated comparators: gt,lt,ge,les
   • including optional support for AND search on _lastUpdated (e.g._lastUpdated=[date]&_lastUpdated=[date]]&...)

   GET [base]/Condition?patient={Type/}[id]&_lastUpdated={gt|lt|ge|le}[date]{&_lastUpdated={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/Condition?patient=1032702&_lastUpdated=ge2024-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all Condition resources for the specified patient and _lastUpdated. See the IE Core General Guidance page for Searching Using lastUpdated. (how to search by reference and how to search by token and how to search by date)