Condition

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

Overview

The condition could be a point in time diagnosis in context of an encounter, it could be an item on the practitioner's Problem List, or it could be a concern that doesn't exist on the practitioner's Problem List.

This profile is used to define the content that will be returned by the API Server in response to requests to access Condition resources. All elements described in the Definition and Detailed Definitions below are supported, which means that the API Server is capable of supplying these fields from the product database when they have been populated via the product or its APIs.

This resource is referenced by: CarePlan.

List of profiles we support:

Definition

The official URL for this profile is:

https://fhir.athena.io/StructureDefinition/ah-condition

The base definition for this profile is:

Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. ConditionC0..*ConditionDetailed information about conditions, problems or diagnoses
... idΣ0..1idLogical id of this artifact
... metaΣ0..1MetaMetadata about the resource
... implicitRules?!Σ0..1uriA set of rules under which this content was created
... text0..1NarrativeText summary of the resource, for human interpretation
... contained0..*ResourceContained, inline Resources
... Slices for extension1..*ExtensionExtension
Slice: Unordered, Open by value:url
... ahChartSharingGroup0..1Reference(Organization)athenahealth Chart Sharing Group
URL: https://fhir.athena.io/StructureDefinition/ah-chart-sharing-group
... ahPractice1..1Reference(Organization)athenahealth Practice
URL: https://fhir.athena.io/StructureDefinition/ah-practice
... ahSectionNote0..1stringathenahealth Section Note
URL: https://fhir.athena.io/StructureDefinition/ah-section-note
... ahConditionProblemTypeCategory0..1codeathenahealth Condition Problem Type Category
URL: https://fhir.athena.io/StructureDefinition/ah-condition-problem-type-category
Binding: athenahealth Condition Problem Type Category Value Set (required)
... modifierExtension?!0..*ExtensionExtensions that cannot be ignored
... identifierΣ0..*IdentifierExternal Ids for this condition
... clinicalStatus?!ΣC0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus?!ΣC0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category0..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... codeΣ0..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.

... bodySiteΣ0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... subjectΣ1..1Reference(Patient)Who has the condition?
... encounterΣ0..1Reference(Encounter)Encounter created as part of
... onset[x]Σ0..1dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)Estimated or actual date, date-time, or age
... abatement[x]C0..1dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)When in resolution/remission
... recordedDateΣ0..1dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)Date record was first recorded
... recorderΣ0..1Reference(Practitioner)Who recorded the condition
... note0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Condition.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleConditionCategoryCodes
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.codeexampleCondition/Problem/DiagnosisCodes
Condition.bodySiteexampleSNOMEDCTBodyStructures
Condition.stage.summaryexampleConditionStage
Condition.stage.typeexampleConditionStageType
Condition.evidence.codeexampleManifestationAndSymptomCodes

Detailed Definitions


Condition

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

Cardinality 0..*
Type Root

Condition.id

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

Cardinality 0..1
Type id
Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Condition.meta

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

Cardinality 0..1
Type Meta

Condition.implicitRules

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Cardinality 0..1
Type uri
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Condition.language

The base language in which the resource is written.

Cardinality 0..1
Type code Binding: CommonLanguages (preferred)
Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Condition.text

A human-readable narrative that contains a summary of the resource and can 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.

Cardinality 0..1
Type Narrative
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 information is added later.

Condition.contained

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.

Cardinality 0..*
Type Resource
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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Condition.extension

An Extension

Cardinality 1..*
Type Extension

Condition.extension:ahChartSharingGroup

An Extension used to reference a specific athenahealth chart sharing group Organization.

Cardinality 0..1
Type Extension(AthenaChartSharingGroup)

Condition.extension:ahPractice

An Extension used to reference a specific athenahealth practice Organization.

Cardinality 1..1
Type Extension(AthenaPractice)

Condition.extension:ahSectionNote

An Extension containing a notes field that appears in athenahealth for a particular data section.

Cardinality 0..1
Type Extension(AthenaSectionNote)

Condition.extension:ahConditionProblemTypeCategory

An Extension to Condition for problems that contains the type of the problem.

Cardinality 0..1
Type Extension(AthenaConditionProblemTypeCategory)

Condition.modifierExtension

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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*
Type Extension
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.
Requirements Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Condition.identifier

Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Cardinality 0..*
Type Identifier
Comments This is a business identifier, not a resource identifier (see discussion. It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
Requirements Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

Condition.clinicalStatus

The clinical status of the condition.

Cardinality 0..1
Type CodeableConcept Binding: ConditionClinicalStatusCodes (required)
Comments The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

Condition.verificationStatus

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

Cardinality 0..1
Type CodeableConcept Binding: ConditionVerificationStatus (required)
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. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

Condition.category

A category assigned to the condition.

Cardinality 0..*
Type CodeableConcept Binding: ConditionCategoryCodes (extensible)
Comments The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

Condition.severity

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

Cardinality 0..1
Type CodeableConcept Binding: Condition/DiagnosisSeverity (preferred)
Comments Coding of the severity with a terminology is preferred, where possible.

Condition.code

Identification of the condition, problem or diagnosis.

Cardinality 0..1
Type CodeableConcept Binding: Condition/Problem/DiagnosisCodes (example)
Requirements 0..1 to account for primarily narrative only resources.

Condition.bodySite

The anatomical location where this condition manifests itself.

Cardinality 0..*
Type CodeableConcept Binding: SNOMEDCTBodyStructures (example)
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 bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Condition.subject

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

Cardinality 1..1
Type Reference(Patient)
Requirements Group is typically used for veterinary or public health use cases.

Condition.encounter

The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

Cardinality 0..1
Type Reference(Encounter)
Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. 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".

Condition.onset[x]

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

Cardinality 0..1
Type dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)
Comments Age is generally used when the patient reports an age at which the Condition began to occur.

Condition.abatement[x]

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.

Cardinality 0..1
Type dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)
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.

Condition.recordedDate

The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

Cardinality 0..1
Type dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)

Condition.recorder

Individual who recorded the record and takes responsibility for its content.

Cardinality 0..1
Type Reference(Practitioner)

Condition.note

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

Cardinality 0..*
Type Annotation

Interactions

READ

Read interactions are executed as specified in the HL7 FHIR RESTful API read specification. To read Condition resources, an application will perform an HTTP GET specifying the logical ID of the Condition being retrieved.

The [patient|user|system]/Condition.read authorization scope is required.

GET
/fhir/r4/Condition/{logicalId}
Try in Postman

Parameters

required

conditional required

Name Type Description
logicalId string (REQUIRED) The logical ID of the resource (alias: Resource.id). It is specified in the URL path and not as a query parameter.

Response Codes

Response code Description
200 OK The requested Condition resource was found and is contained within the body of the HTTP response.
400 Bad Request The server could not understand the request due to invalid syntax. The body of the HTTP response will contain an OperationOutcome resource that indicates the invalid request could not be processed.
404 Not Found The requested resource does not exist. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found.
410 Gone The requested resource has been permanently deleted from server with no forwarding address. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found.
500 Internal Server Error The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
5xx Server Error The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.

GET SEARCH

Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for Condition resources using the HTTP GET method, an application will perform the HTTP GET specifying the query parameters associated with the Condition in the URL.

The [patient|user|system]/Condition.read authorization scope is required.

The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:

  • [patient|user|system]/Encounter.read
  • [patient|user|system]/Organization.read
  • [patient|user|system]/Patient.read
  • [patient|user|system]/Provenance.read

GET
/fhir/r4/Condition
Try in Postman

Parameters

Condition search requests conditionally require one of the following search parameters or search parameter combinations in order to match and return a result set:
  • encounter
  • patient
  • _id

required

conditional required

Name Type Description
ah-practice reference Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]')
_id token (CONDITIONAL REQUIRED) Resource id (not a full URL)
patient reference (CONDITIONAL REQUIRED) Who has the condition?
encounter reference (CONDITIONAL REQUIRED) Encounter to which this Condition is associated
ah-chart-sharing-group reference Search by athenahealth Chart Sharing Group (e.g., 'ah-chart-sharing-group=Organization/a-[practiceId].CSG-[csgId]') for resources containing the 'Athena Chart Sharing Group' Extension
_count number The number of Condition resources to return per page for paged search results.
cursor token Search by cursor token for first resource to return in a paged search result
_lastUpdated date Last updated date associated with the condition (format: YYYY-MM-DD)
_include string Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
  • Condition:ah-chart-sharing-group - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • Condition:ah-practice - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • Condition:encounter - Included resource(s) Encounter and required scope(s) [patient|user|system]/Encounter.read
  • Condition:patient - Included resource(s) Patient and required scope(s) [patient|user|system]/Patient.read
_revinclude string Requests the server to include the associated resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _revinclude parameter values are:
  • Provenance:target - Associated resource(s) Provenance and required scope(s) [patient|user|system]/Provenance.read

Response Codes

Response code Description
200 OK The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search.
403 Forbidden The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters.
500 Internal Server Error The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
5xx Server Error The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.

POST SEARCH

Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for Condition resources using the HTTP POST method, an application will perform the HTTP POST specifying the query parameters associated with the Condition in the request body.

The [patient|user|system]/Condition.read authorization scope is required.

The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:

  • [patient|user|system]/Encounter.read
  • [patient|user|system]/Organization.read
  • [patient|user|system]/Patient.read
  • [patient|user|system]/Provenance.read

POST
/fhir/r4/Condition/_search
Try in Postman

Request Header

Content-Type: application/x-www-form-urlencoded

Request Body

param1=value1&param2=value2...

Parameters

Condition search requests conditionally require one of the following search parameters or search parameter combinations in order to match and return a result set:
  • encounter
  • patient
  • _id

required

conditional required

Name Type Description
ah-practice reference Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]')
_id token (CONDITIONAL REQUIRED) Resource id (not a full URL)
patient reference (CONDITIONAL REQUIRED) Who has the condition?
encounter reference (CONDITIONAL REQUIRED) Encounter to which this Condition is associated
ah-chart-sharing-group reference Search by athenahealth Chart Sharing Group (e.g., 'ah-chart-sharing-group=Organization/a-[practiceId].CSG-[csgId]') for resources containing the 'Athena Chart Sharing Group' Extension
_count number The number of Condition resources to return per page for paged search results.
cursor token Search by cursor token for first resource to return in a paged search result
_lastUpdated date Last updated date associated with the condition (format: YYYY-MM-DD)
_include string Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
  • Condition:ah-chart-sharing-group - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • Condition:ah-practice - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • Condition:encounter - Included resource(s) Encounter and required scope(s) [patient|user|system]/Encounter.read
  • Condition:patient - Included resource(s) Patient and required scope(s) [patient|user|system]/Patient.read
_revinclude string Requests the server to include the associated resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _revinclude parameter values are:
  • Provenance:target - Associated resource(s) Provenance and required scope(s) [patient|user|system]/Provenance.read

Response Codes

Response code Description
200 OK The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search.
403 Forbidden The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters.
500 Internal Server Error The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
5xx Server Error The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
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