RIVO-Noord Zorgviewer Implementation Guide
1.1.0 - sprint35 Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide - Local Development build (v1.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Condition - Detailed Descriptions

Draft as of 2024-06-21

Definitions for the Condition resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Condition
Invariantszv-con-1: At least one of Condition.onsetDateTime or Condition.onsetPeriod SHALL be present (onsetDateTime.exists() or onsetPeriod.exists())
zv-con-2: Use either Condition.abatementDateTime or Condition.abatementPeriod for the resolved timestamp (abatementDateTime.exists() or abatementPeriod.exists())
2. Condition.clinicalStatus
Control1..?
Must Supporttrue
4. Condition.code
Control1..?
BindingUnless not suitable, these codes SHALL be taken from Zorgviewer probleem naam waardelijst
(extensible to http://hl7.nl/fhir/zorgviewer/ValueSet/ProbleemNaamCodelist)
Must Supporttrue
6. Condition.code.text
Must Supporttrue
8. Condition.onset[x]
Control1..?
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Must Supporttrue
10. Condition.abatement[x]
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Must Supporttrue
12. Condition.note
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. Condition
Definition

A problem describes a situation with regard to an individual’s health and/or welfare. This situation can be described by the person involved (the patient) themselves (in the form of a complaint) or by their healthcare provider (in the form of a diagnosis, for example).


A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

ShortProblemDetailed information about conditions, problems or diagnoses
Control0..*
Alternate NamesConcern, Probleem
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error (verificationStatus='entered-in-error' or clinicalStatus.exists())
zv-con-1: At least one of Condition.onsetDateTime or Condition.onsetPeriod SHALL be present (onsetDateTime.exists() or onsetPeriod.exists())
zv-con-2: Use either Condition.abatementDateTime or Condition.abatementPeriod for the resolved timestamp (abatementDateTime.exists() or abatementPeriod.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error (verificationStatus='entered-in-error' or clinicalStatus.exists())
2. 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.

ShortA set of rules under which this content was created
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. 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.

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
6. Condition.clinicalStatus
Definition

The problem status describes the condition of the problem:

  • Active problems are problems of which the patient experiences symptoms or for which evidence exists.
  • Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore..

The clinical status of the condition.

ShortProblemStatusactive | recurrence | inactive | remission | resolved
Comments

This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.

Control10..1
This element is affected by the following invariants: con-3, con-4
BindingThe codes SHALL be taken from Condition Clinical Status Codeshttp://hl7.org/fhir/ValueSet/condition-clinical
(required to http://hl7.org/fhir/ValueSet/condition-clinical)
Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesProbleemStatus
8. Condition.clinicalStatus.extension:ProblemStatusCodelist
Slice NameProblemStatusCodelist
Definition

Describes the condition of the problem, use this extension to include the original HCIM code

Shortclinicalstatus
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Probleemstatus
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Condition.clinicalStatus.extension:ProblemStatusCodelist.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
12. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

ShortValue of extension
Control10..1
TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 14. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]:valueCodeableConcept
    Slice NamevalueCodeableConcept
    Definition

    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortValue of extension
    Control10..1
    BindingUnless not suitable, these codes SHALL be taken from For codes, see ProbleemStatusCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.2--20171231000000)

    ProbleemStatusCodelijst

    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    16. Condition.verificationStatus
    Definition

    Clinical status of the problem or the diagnosis.


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

    ShortVerificationStatusprovisional | differential | confirmed | refuted | entered-in-error | unknown
    Comments

    verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.

    This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.

    Control0..1
    This element is affected by the following invariants: con-3
    BindingThe codes SHALL be taken from ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status
    (required to http://hl7.org/fhir/ValueSet/condition-ver-status)
    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate NamesVerificatieStatus
    Default Valueunknown
    18. Condition.verificationStatus.extension:VerificatieStatusCodelijst
    Slice NameVerificatieStatusCodelijst
    Definition

    Describes the verification status of the problem, use this extension to include the original HCIM code

    ShortVerificationstatus
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
    Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., VerificatieStatusCodelijst
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. Condition.verificationStatus.extension:VerificatieStatusCodelijst.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
    22. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]
    Definition

    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortValue of extension
    Control10..1
    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on Condition.verificationStatus.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 24. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

      ShortValue of extension
      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see VerificatieStatusCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.4--20171231000000)

      VerificatieStatusCodelijst

      TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      26. Condition.code
      Definition

      The problem name defines the problem. Depending on the setting, different code systems can be used. The ProblemNameCodelist provides an overview of the possible code systems.


      Identification of the condition, problem or diagnosis.

      ShortProblemNameIdentification of the condition, problem or diagnosis
      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see Zorgviewer probleem naam waardelijsthttp://hl7.org/fhir/ValueSet/condition-code
      (extensible to http://hl7.nl/fhir/zorgviewer/ValueSet/ProbleemNaamCodelist)
      TypeCodeableConcept
      Must Supporttrue
      Summarytrue
      Requirements

      0..1 to account for primarily narrative only resources.

      Alternate Namestype, ProbleemNaam
      28. 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.

      ShortPlain text representation of the concept
      Comments

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

      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      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.

      30. Condition.subject
      Definition

      Indicates the patient or group who the condition record is associated with.

      ShortWho has the condition?
      Control1..1
      TypeReference(nl-core-patient, Patient, Group)
      Summarytrue
      Requirements

      Group is typically used for veterinary or public health use cases.

      Alternate Namespatient
      32. Condition.onset[x]
      Definition

      Estimated or actual date or date-time the condition began, in the opinion of the clinician.

      ShortEstimated or actual date, date-time, or age
      Comments

      Age is generally used when the patient reports an age at which the Condition began to occur.

      Control10..1
      TypedateTime, string, Period, Range, Age
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      SlicingThis element introduces a set of slices on Condition.onset[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 34. Condition.onset[x]:onsetDateTime
        Slice NameonsetDateTime
        Definition

        Start of the disorder to which the problem applies. Especially in symptoms in which it takes longer for the final diagnosis, it is important to know not only the date of the diagnosis, but also how long the patient has had the disorder. A ‘vague’ date, such as only the year or the month and the year, is permitted.


        Estimated or actual date or date-time the condition began, in the opinion of the clinician.

        ShortProblemStartDateEstimated or actual date, date-time, or age
        Comments

        Age is generally used when the patient reports an age at which the Condition began to occur.

        Control0..1
        TypedateTime, string, Period, Range, Age
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Alternate NamesProbleemBeginDatum
        36. 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.

        ShortIf/when in resolution/remission
        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. When abatementString exists, it implies the condition is abated.

        Control0..1
        This element is affected by the following invariants: con-4
        TypedateTime, boolean, string, Period, Range, Age
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        SlicingThis element introduces a set of slices on Condition.abatement[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 38. Condition.abatement[x]:abatementDateTime
          Slice NameabatementDateTime
          Definition

          Date on which the disorder to which the problem applies, is considered not to be present anymore. This date does not need to be the same as the date of the change in problem status. A ‘vague’ date, such as only the year or the month and the year, is permitted.


          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.

          ShortProblemEndDateIf/when in resolution/remission
          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. When abatementString exists, it implies the condition is abated.

          Control0..1
          This element is affected by the following invariants: con-4
          TypedateTime, boolean, string, Period, Range, Age
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Alternate NamesProbleemEindDatum
          40. Condition.note
          Definition

          Comment by the one who determined or updated the Problem.


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

          ShortCommentAdditional information about the Condition
          Control0..*
          TypeAnnotation
          Must Supporttrue
          Alternate NamesToelichting

          Guidance on how to interpret the contents of this table can be found here

          0. Condition
          Definition

          A problem describes a situation with regard to an individual’s health and/or welfare. This situation can be described by the person involved (the patient) themselves (in the form of a complaint) or by their healthcare provider (in the form of a diagnosis, for example).

          ShortProblem
          Control0..*
          Alternate NamesConcern, Probleem
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
          con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')
          con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error (verificationStatus='entered-in-error' or clinicalStatus.exists())
          zv-con-1: At least one of Condition.onsetDateTime or Condition.onsetPeriod SHALL be present (onsetDateTime.exists() or onsetPeriod.exists())
          zv-con-2: Use either Condition.abatementDateTime or Condition.abatementPeriod for the resolved timestamp (abatementDateTime.exists() or abatementPeriod.exists())
          2. Condition.id
          Definition

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

          ShortLogical id of this artifact
          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.

          Control0..1
          Typeid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          4. 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.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Summarytrue
          6. 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.

          ShortA set of rules under which this content was created
          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.

          This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

          Control0..1
          Typeuri
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          8. Condition.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          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).

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from Common Languages
          (extensible to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          10. 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.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

          Control0..1
          This element is affected by the following invariants: dom-1
          TypeNarrative
          Alternate Namesnarrative, html, xhtml, display
          12. 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.

          ShortContained, inline 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.

          Control0..*
          TypeResource
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Condition.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource. 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.

          ShortAdditional Content defined by implementations
          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.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          16. 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.

          ShortExtensions that cannot be ignored
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Alternate Namesextensions, user content
          18. 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).

          ShortExternal Ids for this condition
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Summarytrue
          Requirements

          Need to allow connection to a wider workflow.

          20. Condition.clinicalStatus
          Definition

          The problem status describes the condition of the problem:

          • Active problems are problems of which the patient experiences symptoms or for which evidence exists.
          • Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore..
          ShortProblemStatus
          Comments

          This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.

          Control1..1
          This element is affected by the following invariants: con-3, con-4
          BindingThe codes SHALL be taken from Condition Clinical Status Codes
          (required to http://hl7.org/fhir/ValueSet/condition-clinical)
          Typecode
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesProbleemStatus
          22. Condition.clinicalStatus.id
          Definition

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

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          24. Condition.clinicalStatus.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 26. Condition.clinicalStatus.extension:ProblemStatusCodelist
            Slice NameProblemStatusCodelist
            Definition

            Describes the condition of the problem, use this extension to include the original HCIM code

            Shortclinicalstatus
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
            Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Probleemstatus
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. Condition.clinicalStatus.extension:ProblemStatusCodelist.id
            Definition

            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            30. Condition.clinicalStatus.extension:ProblemStatusCodelist.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.

            ShortAdditional Content defined by implementations
            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.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. Condition.clinicalStatus.extension:ProblemStatusCodelist.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
              34. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]
              Definition

              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

              ShortValue of extension
              Control1..1
              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 36. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]:valueCodeableConcept
                Slice NamevalueCodeableConcept
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control1..1
                BindingUnless not suitable, these codes SHALL be taken from ProbleemStatusCodelijst
                (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.2--20171231000000)

                ProbleemStatusCodelijst

                TypeCodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                38. Condition.clinicalStatus.value
                Definition

                Primitive value for code

                ShortPrimitive value for code
                Control0..1
                Typecode
                XML FormatIn the XML format, this property is represented as an attribute.
                40. Condition.verificationStatus
                Definition

                Clinical status of the problem or the diagnosis.

                ShortVerificationStatus
                Comments

                verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.

                This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.

                Control0..1
                This element is affected by the following invariants: con-3
                BindingThe codes SHALL be taken from ConditionVerificationStatus
                (required to http://hl7.org/fhir/ValueSet/condition-ver-status)
                Typecode
                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesVerificatieStatus
                Default Valueunknown
                42. Condition.verificationStatus.id
                Definition

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

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                44. Condition.verificationStatus.extension
                Definition

                An Extension

                ShortExtension
                Control0..*
                TypeExtension
                SlicingThis element introduces a set of slices on Condition.verificationStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 46. Condition.verificationStatus.extension:VerificatieStatusCodelijst
                  Slice NameVerificatieStatusCodelijst
                  Definition

                  Describes the verification status of the problem, use this extension to include the original HCIM code

                  ShortVerificationstatus
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                  Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., VerificatieStatusCodelijst
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  48. Condition.verificationStatus.extension:VerificatieStatusCodelijst.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  50. Condition.verificationStatus.extension:VerificatieStatusCodelijst.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.

                  ShortAdditional Content defined by implementations
                  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.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on Condition.verificationStatus.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 52. Condition.verificationStatus.extension:VerificatieStatusCodelijst.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                    54. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]
                    Definition

                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                    ShortValue of extension
                    Control1..1
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    SlicingThis element introduces a set of slices on Condition.verificationStatus.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 56. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]:valueCodeableConcept
                      Slice NamevalueCodeableConcept
                      Definition

                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                      ShortValue of extension
                      Control1..1
                      BindingUnless not suitable, these codes SHALL be taken from VerificatieStatusCodelijst
                      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.4--20171231000000)

                      VerificatieStatusCodelijst

                      TypeCodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      58. Condition.verificationStatus.value
                      Definition

                      Primitive value for code

                      ShortPrimitive value for code
                      Control0..1
                      Typecode
                      XML FormatIn the XML format, this property is represented as an attribute.
                      60. Condition.category
                      Definition

                      The type of problem; see the profile description.

                      ShortProblemType
                      Comments

                      The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

                      Control0..*
                      BindingUnless not suitable, these codes SHALL be taken from ProbleemTypeCodelijst
                      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.1--20171231000000)

                      The type of problem.

                      TypeCodeableConcept
                      Alternate NamesProbleemType
                      62. Condition.severity
                      Definition

                      A subjective assessment of the severity of the condition as evaluated by the clinician.

                      ShortSubjective severity of condition
                      Comments

                      Coding of the severity with a terminology is preferred, where possible.

                      Control0..1
                      BindingThe codes SHOULD be taken from Condition/Diagnosis Severity
                      (preferred to http://hl7.org/fhir/ValueSet/condition-severity)

                      A subjective assessment of the severity of the condition as evaluated by the clinician.

                      TypeCodeableConcept
                      64. Condition.code
                      Definition

                      The problem name defines the problem. Depending on the setting, different code systems can be used. The ProblemNameCodelist provides an overview of the possible code systems.

                      ShortProblemName
                      Control1..1
                      BindingUnless not suitable, these codes SHALL be taken from Zorgviewer probleem naam waardelijst
                      (extensible to http://hl7.nl/fhir/zorgviewer/ValueSet/ProbleemNaamCodelist)
                      TypeCodeableConcept
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      0..1 to account for primarily narrative only resources.

                      Alternate Namestype, ProbleemNaam
                      66. Condition.code.id
                      Definition

                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      Shortxml:id (or equivalent in JSON)
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      68. 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.

                      ShortAdditional Content defined by implementations
                      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.

                      Control0..*
                      TypeExtension
                      Alternate Namesextensions, user content
                      SlicingThis element introduces a set of slices on Condition.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 70. Condition.code.coding
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        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 labeled as UserSelected = true.

                        Control0..*
                        TypeCoding
                        Summarytrue
                        Requirements

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

                        72. 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.

                        ShortPlain text representation of the concept
                        Comments

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

                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        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.

                        74. Condition.bodySite
                        Definition

                        Anatomical location which is the focus of the procedure.

                        ShortProblemAnatomicalLocation
                        Comments

                        Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both.

                        Control0..*
                        BindingUnless not suitable, these codes SHALL be taken from ProbleemAnatomischeLocatieCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.5--20171231000000)

                        ProbleemAnatomischeLocatieCodelijst

                        TypeCodeableConcept
                        Summarytrue
                        Alternate NamesProbleemAnatomischeLocatie
                        76. Condition.bodySite.id
                        Definition

                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        Shortxml:id (or equivalent in JSON)
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        78. Condition.bodySite.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..*
                        TypeExtension
                        SlicingThis element introduces a set of slices on Condition.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 80. Condition.bodySite.extension:Laterality
                          Slice NameLaterality
                          Definition

                          Laterality adds information about body side to the anatomic location, e.g. left

                          ShortProblemLaterality
                          Control0..1
                          TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
                          Alternate NamesProbleemLateraliteit
                          82. Condition.bodySite.extension:Laterality.id
                          Definition

                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          Shortxml:id (or equivalent in JSON)
                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          84. Condition.bodySite.extension:Laterality.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.

                          ShortAdditional Content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Alternate Namesextensions, user content
                          SlicingThis element introduces a set of slices on Condition.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 86. Condition.bodySite.extension:Laterality.url
                            Definition

                            Source of the definition for the extension code - a logical name or a URL.

                            Shortidentifies the meaning of the extension
                            Comments

                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                            Control1..1
                            Typeuri
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
                            88. Condition.bodySite.extension:Laterality.value[x]
                            Definition

                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                            ShortValue of extension
                            Control0..1
                            TypeCodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            SlicingThis element introduces a set of slices on Condition.bodySite.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 90. Condition.bodySite.extension:Laterality.value[x]:valueCodeableConcept
                              Slice NamevalueCodeableConcept
                              Definition

                              Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

                              ShortBodySite qualifier
                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ProbleemLateraliteitCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.6--20171231000000)

                              ProblemLateralityCodelist

                              TypeCodeableConcept
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              92. Condition.bodySite.coding
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              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 labeled as UserSelected = true.

                              Control0..*
                              TypeCoding
                              Summarytrue
                              Requirements

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

                              94. 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.

                              ShortPlain text representation of the concept
                              Comments

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

                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              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.

                              96. Condition.subject
                              Definition

                              Indicates the patient or group who the condition record is associated with.

                              ShortWho has the condition?
                              Control1..1
                              TypeReference(nl-core-patient)
                              Summarytrue
                              Requirements

                              Group is typically used for veterinary or public health use cases.

                              Alternate Namespatient
                              98. Condition.context
                              Definition

                              Encounter during which the condition was first asserted.

                              ShortEncounter or episode when condition first asserted
                              Comments

                              This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

                              Control0..1
                              TypeReference(HCIM Encounter, nl-core-episodeofcare)
                              Summarytrue
                              Alternate Namesencounter
                              100. Condition.onset[x]
                              Definition

                              Estimated or actual date or date-time the condition began, in the opinion of the clinician.

                              ShortEstimated or actual date, date-time, or age
                              Comments

                              Age is generally used when the patient reports an age at which the Condition began to occur.

                              Control1..1
                              TypedateTime
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              SlicingThis element introduces a set of slices on Condition.onset[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 102. Condition.onset[x]:onsetDateTime
                                Slice NameonsetDateTime
                                Definition

                                Start of the disorder to which the problem applies. Especially in symptoms in which it takes longer for the final diagnosis, it is important to know not only the date of the diagnosis, but also how long the patient has had the disorder. A ‘vague’ date, such as only the year or the month and the year, is permitted.

                                ShortProblemStartDate
                                Comments

                                Age is generally used when the patient reports an age at which the Condition began to occur.

                                Control0..1
                                TypedateTime
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Alternate NamesProbleemBeginDatum
                                104. 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.

                                ShortIf/when in resolution/remission
                                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. When abatementString exists, it implies the condition is abated.

                                Control0..1
                                This element is affected by the following invariants: con-4
                                TypedateTime
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                SlicingThis element introduces a set of slices on Condition.abatement[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 106. Condition.abatement[x]:abatementDateTime
                                  Slice NameabatementDateTime
                                  Definition

                                  Date on which the disorder to which the problem applies, is considered not to be present anymore. This date does not need to be the same as the date of the change in problem status. A ‘vague’ date, such as only the year or the month and the year, is permitted.

                                  ShortProblemEndDate
                                  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. When abatementString exists, it implies the condition is abated.

                                  Control0..1
                                  This element is affected by the following invariants: con-4
                                  TypedateTime
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Alternate NamesProbleemEindDatum
                                  108. Condition.assertedDate
                                  Definition

                                  The date on which the existance of the Condition was first asserted or acknowledged.

                                  ShortDate record was believed accurate
                                  Comments

                                  The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.

                                  Control0..1
                                  TypedateTime
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  110. Condition.asserter
                                  Definition

                                  Individual who is making the condition statement.

                                  ShortPerson who asserts this condition
                                  Control0..1
                                  TypeReference(nl-core-relatedperson, nl-core-patient, nl-core-practitioner)
                                  Summarytrue
                                  112. Condition.asserter.id
                                  Definition

                                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  Shortxml:id (or equivalent in JSON)
                                  Control0..1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  114. Condition.asserter.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..*
                                  TypeExtension
                                  SlicingThis element introduces a set of slices on Condition.asserter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 116. Condition.asserter.extension:practitionerRole
                                    Slice NamepractitionerRole
                                    Definition

                                    Optional Extension Element - found in all resources.

                                    ShortOptional Extensions Element
                                    Control0..1
                                    TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                    118. Condition.asserter.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.

                                    ShortLiteral reference, Relative, internal or absolute URL
                                    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.

                                    Control0..1
                                    This element is affected by the following invariants: ref-1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    120. Condition.asserter.identifier
                                    Definition

                                    An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                    ShortLogical reference, when literal reference is not known
                                    Comments

                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control0..1
                                    TypeIdentifier
                                    Summarytrue
                                    122. Condition.asserter.display
                                    Definition

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

                                    ShortText alternative for the resource
                                    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.

                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    124. Condition.stage
                                    Definition

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

                                    ShortStage/grade, usually assessed formally
                                    Control0..1
                                    TypeBackboneElement
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                    con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
                                    126. Condition.stage.id
                                    Definition

                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    128. 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.

                                    ShortAdditional Content defined by implementations
                                    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.

                                    Control0..*
                                    TypeExtension
                                    Alternate Namesextensions, user content
                                    130. 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.

                                    ShortExtensions that cannot be ignored
                                    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.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                    Summarytrue
                                    Alternate Namesextensions, user content, modifiers
                                    132. Condition.stage.summary
                                    Definition

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

                                    ShortSimple summary (disease specific)
                                    Control0..1
                                    This element is affected by the following invariants: con-1
                                    BindingFor example codes, see Condition Stage
                                    (example to http://hl7.org/fhir/ValueSet/condition-stage)

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

                                    TypeCodeableConcept
                                    134. Condition.stage.assessment
                                    Definition

                                    Reference to a formal record of the evidence on which the staging assessment is based.

                                    ShortFormal record of assessment
                                    Control0..*
                                    This element is affected by the following invariants: con-1
                                    TypeReference(ClinicalImpression, DiagnosticReport, Observation)
                                    136. Condition.evidence
                                    Definition

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

                                    ShortSupporting evidence
                                    Comments

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

                                    Control0..*
                                    TypeBackboneElement
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                    con-2: evidence SHALL have code or details (code.exists() or detail.exists())
                                    138. Condition.evidence.id
                                    Definition

                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    140. 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.

                                    ShortAdditional Content defined by implementations
                                    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.

                                    Control0..*
                                    TypeExtension
                                    Alternate Namesextensions, user content
                                    142. 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.

                                    ShortExtensions that cannot be ignored
                                    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.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                    Summarytrue
                                    Alternate Namesextensions, user content, modifiers
                                    144. Condition.evidence.code
                                    Definition

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

                                    ShortManifestation/symptom
                                    Control0..*
                                    This element is affected by the following invariants: con-2
                                    BindingFor example codes, see Manifestation and Symptom Codes
                                    (example to http://hl7.org/fhir/ValueSet/manifestation-or-symptom)

                                    Codes that describe the manifestation or symptoms of a condition.

                                    TypeCodeableConcept
                                    Summarytrue
                                    146. Condition.evidence.detail
                                    Definition

                                    Links to other relevant information, including pathology reports.

                                    ShortSupporting information found elsewhere
                                    Control0..*
                                    This element is affected by the following invariants: con-2
                                    TypeReference(Resource)
                                    Summarytrue
                                    148. Condition.note
                                    Definition

                                    Comment by the one who determined or updated the Problem.

                                    ShortComment
                                    Control0..*
                                    TypeAnnotation
                                    Must Supporttrue
                                    Alternate NamesToelichting