Inera Core Implementation Guide
0.2.0 - ci-build Sweden

Inera Core Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Condition Diagnosis Inera ( Experimental )

Official URL: https://inera.se/fhir/core/StructureDefinition/condition-diagnosis-inera Version: 0.2.0
Draft as of 2025-11-24 Computable Name: ConditionDiagnosisInera

Swedish profile for diagnoses as retrieved from GetDiagnosis TKB service. This profile represents the Swedish national requirements for diagnosis documentation.

Mapping from TKB GetDiagnosis v2.0:

  • See ConceptMap: ConceptMapGetDiagnosisTKBToCondition
  • TKB Service: GetDiagnosis v2.0
  • TKB Domain: clinicalprocess:healthcond:description v2.1

Swedish Terminology:

  • ICD-10-SE: Swedish edition of ICD-10 classification
  • SNOMED CT SE: Swedish edition of SNOMED CT

Key TKB Mappings:

  • diagnos.diagnosKod → code.coding (ICD-10-SE, 1..1 in TKB)
  • diagnos.diagnosDisplayName → code.text (1..1 in TKB)
  • diagnos.diagnosTid → onsetDateTime (1..1 in TKB)
  • accountableHealthcareProfessional → recorder + Provenance
  • healthcareProfessionalCareUnitHSAId → encounter.serviceProvider

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* ConditionBaseInera Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business identifier from source EHR system
... clinicalStatus ?!SΣC 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept problem-list-item | encounter-diagnosis
Slice: Unordered, Open by value:coding.code
Binding: Condition Category ValueSet (extensible)
.... category:diagnosisCategory S 1..1 CodeableConcept problem-list-item | encounter-diagnosis
Binding: Condition Category ValueSet (extensible)
... severity S 0..1 CodeableConcept Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣ 1..1 CodeableConcept Identification of the condition, problem or diagnosis
Binding: Condition Code ValueSet (extensible)
.... Slices for coding SΣ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:icd10se SΣ 1..1 Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://terminologitjansten.inera.se/inera-kodverksforvaltning/kodverk/icd-10-se
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
..... coding:snomedct SΣ 0..1 Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
.... text SΣ 1..1 string Plain text representation of the concept
... bodySite SΣ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example)
... subject SΣ 1..1 Reference(Patient Base Inera) Who has the condition?
... encounter SΣ 1..1 Reference(Encounter Base Inera) Encounter created as part of
... Slices for onset[x] SΣ 0..1 When condition was first identified or symptoms began
Slice: Unordered, Open by type:$this
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
.... onset[x]:onsetDateTime SΣ 0..1 dateTime When condition was first identified or symptoms began
.... onset[x]:onsetPeriod SΣ 0..1 Period When condition was first identified or symptoms began
... abatement[x] SC 0..1 When condition resolved or went into remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate SΣ 1..1 dateTime Date condition was first recorded
... recorder SΣ 1..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera) Who recorded the condition
... asserter SΣ 0..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera | Patient Base Inera | RelatedPerson) Person who asserts this condition
... stage SC 0..* BackboneElement Stage/grade, usually assessed formally
Constraints: con-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... evidence SC 0..* BackboneElement Supporting evidence
Constraints: con-2
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... note S 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Condition.clinicalStatus Base required Condition Clinical Status Codes 📦4.0.1 FHIR Std.
Condition.verificationStatus Base required ConditionVerificationStatus 📦4.0.1 FHIR Std.
Condition.category Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.category:diagnosisCategory Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.severity Base preferred Condition/Diagnosis Severity 📦4.0.1 FHIR Std.
Condition.code Base extensible Condition Code ValueSet 📦0.2.0 This IG
Condition.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
con-1 error Condition.stage Stage SHALL have summary or assessment summary.exists() or assessment.exists()
con-2 error Condition.evidence evidence SHALL have code or details code.exists() or detail.exists()
con-3 best practice Condition Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4 error Condition If condition is abated, then clinicalStatus must be either inactive, resolved, or remission abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5 error Condition Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2 error Condition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Condition If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Condition 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-5 error Condition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Condition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from ConditionBaseInera

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition 0..* ConditionBaseInera Detailed information about conditions, problems or diagnoses
... identifier 1..* Identifier Business identifier from source EHR system
... Slices for category 1..* CodeableConcept problem-list-item | encounter-diagnosis
Slice: Unordered, Open by value:coding.code
.... category:diagnosisCategory S 1..1 CodeableConcept problem-list-item | encounter-diagnosis
..... coding
...... system 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/condition-category
...... code 1..1 code Symbol in syntax defined by the system
Required Pattern: encounter-diagnosis
... code
.... coding 1..* Coding Code defined by a terminology system
.... Slices for coding Content/Rules for all slices
..... coding:icd10se S 1..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://terminologitjansten.inera.se/inera-kodverksforvaltning/kodverk/icd-10-se
...... code 1..1 code Symbol in syntax defined by the system
...... display S 0..1 string Representation defined by the system
..... coding:snomedct S 0..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code 1..1 code Symbol in syntax defined by the system
...... display S 0..1 string Representation defined by the system
.... text 1..1 string Plain text representation of the concept
... encounter 1..1 Reference(Encounter Base Inera) Encounter created as part of
... Slices for onset[x] 0..1 dateTime, Age, Period, Range, string When condition was first identified or symptoms began
Slice: Unordered, Open by type:$this
.... onset[x]:onsetDateTime S 0..1 dateTime When condition was first identified or symptoms began
.... onset[x]:onsetPeriod S 0..1 Period When condition was first identified or symptoms began
... recordedDate 1..1 dateTime Date condition was first recorded
... recorder 1..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera) Who recorded the condition

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* ConditionBaseInera Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business identifier from source EHR system
... clinicalStatus ?!SΣC 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept problem-list-item | encounter-diagnosis
Slice: Unordered, Open by value:coding.code
Binding: Condition Category ValueSet (extensible)
.... category:diagnosisCategory S 1..1 CodeableConcept problem-list-item | encounter-diagnosis
Binding: Condition Category ValueSet (extensible)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/condition-category
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
Required Pattern: encounter-diagnosis
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... severity S 0..1 CodeableConcept Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣ 1..1 CodeableConcept Identification of the condition, problem or diagnosis
Binding: Condition Code ValueSet (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding SΣ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:icd10se SΣ 1..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://terminologitjansten.inera.se/inera-kodverksforvaltning/kodverk/icd-10-se
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:snomedct SΣ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text SΣ 1..1 string Plain text representation of the concept
... bodySite SΣ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example)
... subject SΣ 1..1 Reference(Patient Base Inera) Who has the condition?
... encounter SΣ 1..1 Reference(Encounter Base Inera) Encounter created as part of
... Slices for onset[x] SΣ 0..1 When condition was first identified or symptoms began
Slice: Unordered, Open by type:$this
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
.... onset[x]:onsetDateTime SΣ 0..1 dateTime When condition was first identified or symptoms began
.... onset[x]:onsetPeriod SΣ 0..1 Period When condition was first identified or symptoms began
... abatement[x] SC 0..1 When condition resolved or went into remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate SΣ 1..1 dateTime Date condition was first recorded
... recorder SΣ 1..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera) Who recorded the condition
... asserter SΣ 0..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera | Patient Base Inera | RelatedPerson) Person who asserts this condition
... stage SC 0..* BackboneElement Stage/grade, usually assessed formally
Constraints: con-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... summary C 0..1 CodeableConcept Simple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
.... assessment C 0..* Reference(ClinicalImpression | DiagnosticReport | Observation) Formal record of assessment
.... type 0..1 CodeableConcept Kind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
... evidence SC 0..* BackboneElement Supporting evidence
Constraints: con-2
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note S 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Condition.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Condition.clinicalStatus Base required Condition Clinical Status Codes 📦4.0.1 FHIR Std.
Condition.verificationStatus Base required ConditionVerificationStatus 📦4.0.1 FHIR Std.
Condition.category Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.category:diagnosisCategory Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.severity Base preferred Condition/Diagnosis Severity 📦4.0.1 FHIR Std.
Condition.code Base extensible Condition Code ValueSet 📦0.2.0 This IG
Condition.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
Condition.stage.summary Base example Condition Stage 📍4.0.1 FHIR Std.
Condition.stage.type Base example Condition Stage Type 📍4.0.1 FHIR Std.
Condition.evidence.code Base example Manifestation and Symptom Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
con-1 error Condition.stage Stage SHALL have summary or assessment summary.exists() or assessment.exists()
con-2 error Condition.evidence evidence SHALL have code or details code.exists() or detail.exists()
con-3 best practice Condition Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4 error Condition If condition is abated, then clinicalStatus must be either inactive, resolved, or remission abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5 error Condition Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2 error Condition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Condition If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Condition 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-5 error Condition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Condition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from ConditionBaseInera

Summary

Mandatory: 11 elements(3 nested mandatory elements)
Must-Support: 7 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Condition.category
  • The element 1 is sliced based on the value of Condition.onset[x]

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* ConditionBaseInera Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business identifier from source EHR system
... clinicalStatus ?!SΣC 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept problem-list-item | encounter-diagnosis
Slice: Unordered, Open by value:coding.code
Binding: Condition Category ValueSet (extensible)
.... category:diagnosisCategory S 1..1 CodeableConcept problem-list-item | encounter-diagnosis
Binding: Condition Category ValueSet (extensible)
... severity S 0..1 CodeableConcept Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣ 1..1 CodeableConcept Identification of the condition, problem or diagnosis
Binding: Condition Code ValueSet (extensible)
.... Slices for coding SΣ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:icd10se SΣ 1..1 Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://terminologitjansten.inera.se/inera-kodverksforvaltning/kodverk/icd-10-se
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
..... coding:snomedct SΣ 0..1 Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
.... text SΣ 1..1 string Plain text representation of the concept
... bodySite SΣ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example)
... subject SΣ 1..1 Reference(Patient Base Inera) Who has the condition?
... encounter SΣ 1..1 Reference(Encounter Base Inera) Encounter created as part of
... Slices for onset[x] SΣ 0..1 When condition was first identified or symptoms began
Slice: Unordered, Open by type:$this
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
.... onset[x]:onsetDateTime SΣ 0..1 dateTime When condition was first identified or symptoms began
.... onset[x]:onsetPeriod SΣ 0..1 Period When condition was first identified or symptoms began
... abatement[x] SC 0..1 When condition resolved or went into remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate SΣ 1..1 dateTime Date condition was first recorded
... recorder SΣ 1..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera) Who recorded the condition
... asserter SΣ 0..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera | Patient Base Inera | RelatedPerson) Person who asserts this condition
... stage SC 0..* BackboneElement Stage/grade, usually assessed formally
Constraints: con-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... evidence SC 0..* BackboneElement Supporting evidence
Constraints: con-2
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... note S 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Condition.clinicalStatus Base required Condition Clinical Status Codes 📦4.0.1 FHIR Std.
Condition.verificationStatus Base required ConditionVerificationStatus 📦4.0.1 FHIR Std.
Condition.category Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.category:diagnosisCategory Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.severity Base preferred Condition/Diagnosis Severity 📦4.0.1 FHIR Std.
Condition.code Base extensible Condition Code ValueSet 📦0.2.0 This IG
Condition.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
con-1 error Condition.stage Stage SHALL have summary or assessment summary.exists() or assessment.exists()
con-2 error Condition.evidence evidence SHALL have code or details code.exists() or detail.exists()
con-3 best practice Condition Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4 error Condition If condition is abated, then clinicalStatus must be either inactive, resolved, or remission abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5 error Condition Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2 error Condition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Condition If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Condition 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-5 error Condition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Condition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from ConditionBaseInera

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition 0..* ConditionBaseInera Detailed information about conditions, problems or diagnoses
... identifier 1..* Identifier Business identifier from source EHR system
... Slices for category 1..* CodeableConcept problem-list-item | encounter-diagnosis
Slice: Unordered, Open by value:coding.code
.... category:diagnosisCategory S 1..1 CodeableConcept problem-list-item | encounter-diagnosis
..... coding
...... system 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/condition-category
...... code 1..1 code Symbol in syntax defined by the system
Required Pattern: encounter-diagnosis
... code
.... coding 1..* Coding Code defined by a terminology system
.... Slices for coding Content/Rules for all slices
..... coding:icd10se S 1..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://terminologitjansten.inera.se/inera-kodverksforvaltning/kodverk/icd-10-se
...... code 1..1 code Symbol in syntax defined by the system
...... display S 0..1 string Representation defined by the system
..... coding:snomedct S 0..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code 1..1 code Symbol in syntax defined by the system
...... display S 0..1 string Representation defined by the system
.... text 1..1 string Plain text representation of the concept
... encounter 1..1 Reference(Encounter Base Inera) Encounter created as part of
... Slices for onset[x] 0..1 dateTime, Age, Period, Range, string When condition was first identified or symptoms began
Slice: Unordered, Open by type:$this
.... onset[x]:onsetDateTime S 0..1 dateTime When condition was first identified or symptoms began
.... onset[x]:onsetPeriod S 0..1 Period When condition was first identified or symptoms began
... recordedDate 1..1 dateTime Date condition was first recorded
... recorder 1..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera) Who recorded the condition

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Condition C 0..* ConditionBaseInera Detailed information about conditions, problems or diagnoses
Constraints: con-3, con-4, con-5
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..* Identifier Business identifier from source EHR system
... clinicalStatus ?!SΣC 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... Slices for category S 1..* CodeableConcept problem-list-item | encounter-diagnosis
Slice: Unordered, Open by value:coding.code
Binding: Condition Category ValueSet (extensible)
.... category:diagnosisCategory S 1..1 CodeableConcept problem-list-item | encounter-diagnosis
Binding: Condition Category ValueSet (extensible)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/condition-category
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
Required Pattern: encounter-diagnosis
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... severity S 0..1 CodeableConcept Subjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣ 1..1 CodeableConcept Identification of the condition, problem or diagnosis
Binding: Condition Code ValueSet (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding SΣ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:icd10se SΣ 1..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://terminologitjansten.inera.se/inera-kodverksforvaltning/kodverk/icd-10-se
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:snomedct SΣ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display SΣ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text SΣ 1..1 string Plain text representation of the concept
... bodySite SΣ 0..* CodeableConcept Anatomical location, if relevant
Binding: SNOMEDCTBodyStructures (example)
... subject SΣ 1..1 Reference(Patient Base Inera) Who has the condition?
... encounter SΣ 1..1 Reference(Encounter Base Inera) Encounter created as part of
... Slices for onset[x] SΣ 0..1 When condition was first identified or symptoms began
Slice: Unordered, Open by type:$this
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
.... onset[x]:onsetDateTime SΣ 0..1 dateTime When condition was first identified or symptoms began
.... onset[x]:onsetPeriod SΣ 0..1 Period When condition was first identified or symptoms began
... abatement[x] SC 0..1 When condition resolved or went into remission
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate SΣ 1..1 dateTime Date condition was first recorded
... recorder SΣ 1..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera) Who recorded the condition
... asserter SΣ 0..1 Reference(Practitioner Base Inera | PractitionerRole Base Inera | Patient Base Inera | RelatedPerson) Person who asserts this condition
... stage SC 0..* BackboneElement Stage/grade, usually assessed formally
Constraints: con-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... summary C 0..1 CodeableConcept Simple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
.... assessment C 0..* Reference(ClinicalImpression | DiagnosticReport | Observation) Formal record of assessment
.... type 0..1 CodeableConcept Kind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
... evidence SC 0..* BackboneElement Supporting evidence
Constraints: con-2
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note S 0..* Annotation Additional information about the Condition

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Condition.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Condition.clinicalStatus Base required Condition Clinical Status Codes 📦4.0.1 FHIR Std.
Condition.verificationStatus Base required ConditionVerificationStatus 📦4.0.1 FHIR Std.
Condition.category Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.category:diagnosisCategory Base extensible Condition Category ValueSet 📦0.2.0 This IG
Condition.severity Base preferred Condition/Diagnosis Severity 📦4.0.1 FHIR Std.
Condition.code Base extensible Condition Code ValueSet 📦0.2.0 This IG
Condition.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
Condition.stage.summary Base example Condition Stage 📍4.0.1 FHIR Std.
Condition.stage.type Base example Condition Stage Type 📍4.0.1 FHIR Std.
Condition.evidence.code Base example Manifestation and Symptom Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
con-1 error Condition.stage Stage SHALL have summary or assessment summary.exists() or assessment.exists()
con-2 error Condition.evidence evidence SHALL have code or details code.exists() or detail.exists()
con-3 best practice Condition Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4 error Condition If condition is abated, then clinicalStatus must be either inactive, resolved, or remission abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5 error Condition Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2 error Condition If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Condition If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Condition 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-5 error Condition If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Condition A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from ConditionBaseInera

Summary

Mandatory: 11 elements(3 nested mandatory elements)
Must-Support: 7 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Condition.category
  • The element 1 is sliced based on the value of Condition.onset[x]

 

Other representations of profile: CSV, Excel, Schematron