Status: DRAFT: For Review

Introduction

This profile sets out the expectations for the interweave Condition resource. We use the UKCore-Condition structure definition as a base to this profile.

Mandatory fields

The following mandatory fields are defined:

1. Clinical Status - Essential to explain the status of the condition – eg is it currently active.

   This implies a need to keep this status up-to-date – and ideally this will be done, but in reality might not always be possible. For example in the case of historical records where the patient has moved on. At a minimum however this status must be valid as-at the “assertedDate”. This allows a viewer to make an informed judgement about the likelihood that it is still relevant now.

2. Code - Essential to describe what the condition actually is. Based on SNOMED codes eg "Sprain of shoulder". We pre-adopt the UK Core code list, which extends the default FHIR list with additional codes covering Social Care and Urgent Care

3. Subject - every Condition must be linked to a Patient (not a Group)

4. recordedDate - vital information about when the condition was noted. Provides essential guidance for a viewer about the recency and thus likely relevance / accuracy of historical records

Must Support fields

In addition the following fields are "Must Support" – i.e., they must be populated if relevant and known.

1. Identifier - a Local Id should be provided, such that could be quoted if manually getting in touch to find out more

2. Verification Status - The verification status to support the clinical status of the condition. verificationStatus may not be available for all conditions, for example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.

3. Category - There are a few codes here to classify a Condition eg “Encounter Diagnosis” or “Problem List Item”. (The original FHIR spec only has these two, but UK Core adds a couple more which perhaps makes it a bit more useful).

4. severity - A subjective assessment of the severity of the condition as evaluated by the clinician/ user.

5. Body Site - snomed coding for the affected body part. Important to provide if possible and relevant

6. encounter - a link to the Encounter when the condition was first asserted. Will not be relevant to all Conditions (eg historical lists), but should be populated if applicable. Should link to the lowest level possible in any hierarchy, thus providing maximum detail about where the condition was noted.

7. Asserter - Required to populate if known. The main purpose would be to provide details of a Practitioner who can give more information about the condition. Therefore it should not be populated with details of purely admin staff who may have keyed in the data. If the asserter is not populated then an unknown Practitioner should be assumed.

   A further consideration is the possibility of a Condition being asserted by a non-care-professional, for example the Patient themselves or a relative. FHIR caters for this possibiity by allowing the asserter to be a Patient or RelatedPerson, and this option is left open here.

Optional fields

Other fields are optional and may be populated if known – on the understanding that not all data consumers will necessarily make use of them. Points of note include:

• Stage - Additional information that may be useful for relevant conditions eg cancer

• Evidence - To some extent duplicates the “code”, but may optionally provide further information about what led to this code being assigned.

• Note - Only to be used with caution. Any notes may be shared widely across the region, including being viewed by the patient themselves.

• Onset and Abatement - these are important to provide if at all possible.

  • Onset might be omitted if genuinely not known (eg a long-standing historical condition), but should normally be populated
  • Abatement is obviously only relevant if the condition has actually abated – in which case useful and important to populate
  • Note that in both cases there are a variety of options for how to express this (eg datetime, age, period, etc). These do seem relevant for accurately conveying what is known - with the implication that Data Consumers will need corresponding flexibility in displaying this information.

Discouraged or Removed fields

• extension:conditionEpisode - Discouraged.

• recorder – Removed. Not relevant to the shared care record.

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

This structure is derived from UKCoreCondition

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	UKCoreCondition	Detailed information about conditions, problems or diagnoses
id	S	0..1	id	Logical id of this artifact
meta
id		0..0
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
version		0..0
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
version		0..0
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
extension:conditionEpisode		0..*	ExtensionUKCoreConditionEpisode	DISCOURAGED
Slices for identifier		0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
assigner		0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	S	0..1	Identifier	External Ids for this condition
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-condition-identifier
value	S	1..1	string	The Local condition Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
clinicalStatus		1..1	CodeableConcept	The clinical status of the condition.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: UK Core Condition Category (required)
code		1..1	CodeableConcept	Identification of the condition, problem or diagnosis. Binding: UK Core Condition Code (preferred)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
bodySite	S	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
subject		1..1	Reference(InterweavePatient)	Who has the condition? (A patient, NOT group)
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
encounter	S	0..1	Reference(InterweaveEncounter)	Encounter created as part of
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		0..1	string	If relevant, description of the referenced resource
onset[x]		0..1	dateTime	Estimated or actual date, date-time, or age
recordedDate	S	1..1	dateTime	Date record was first recorded
recorder		0..0
asserter	S	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
id		0..0
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
stage
id		0..0
summary	S	1..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (required)
assessment		0..*	Reference(DiagnosticReport | Observation)	Formal record of assessment
evidence
id		0..0
code	S	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (preferred)
detail		0..0
note		0..*	Annotation	Additional information about the Condition. NB: Any notes may be shared widely across the region, including being viewed by the patient themselves
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.category	required	UKCoreConditionCategory https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory from this IG
Condition.code	preferred	UKCoreConditionCode https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode from this IG
Condition.bodySite	required	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.stage.summary	required	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.evidence.code	preferred	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	UKCoreCondition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
conditionEpisode		0..*	CodeableConcept	DISCOURAGED URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ConditionEpisode
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-condition-identifier
value	SΣ	1..1	string	The Local condition Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
clinicalStatus	?!SΣC	1..1	CodeableConcept	The clinical status of the condition. Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	The verification status to support the clinical status of the condition. Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: UK Core Condition Category (required)
severity	S	0..1	CodeableConcept	A subjective assessment of the severity of the condition as evaluated by the clinician. Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis. Binding: UK Core Condition Code (preferred)
bodySite	SΣ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (required)
subject	SΣ	1..1	Reference(InterweavePatient)	Who has the condition? (A patient, NOT group)
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
encounter	SΣ	0..1	Reference(InterweaveEncounter)	Encounter created as part of
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	0..1	string	If relevant, description of the referenced resource
onset[x]	Σ	0..1	dateTime	Estimated or actual date, date-time, or age
recordedDate	SΣ	1..1	dateTime	Date record was first recorded
asserter	SΣ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (required)
assessment	C	0..*	Reference(DiagnosticReport | Observation)	Formal record of assessment
evidence	C	0..*	BackboneElement	Supporting evidence con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (preferred)
note		0..*	Annotation	Additional information about the Condition. NB: Any notes may be shared widely across the region, including being viewed by the patient themselves
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Condition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Condition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.category	required	UKCoreConditionCategory https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory from this IG
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	preferred	UKCoreConditionCode https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode from this IG
Condition.bodySite	required	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.stage.summary	required	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.evidence.code	preferred	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	UKCoreCondition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
conditionEpisode		0..*	CodeableConcept	DISCOURAGED URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ConditionEpisode
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-condition-identifier
value	SΣ	1..1	string	The Local condition Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	1..1	CodeableConcept	The clinical status of the condition. Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	The verification status to support the clinical status of the condition. Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: UK Core Condition Category (required)
severity	S	0..1	CodeableConcept	A subjective assessment of the severity of the condition as evaluated by the clinician. Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis. Binding: UK Core Condition Code (preferred)
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	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..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
bodySite	SΣ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (required)
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	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..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
subject	SΣ	1..1	Reference(InterweavePatient)	Who has the condition? (A patient, NOT group)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
encounter	SΣ	0..1	Reference(InterweaveEncounter)	Encounter created as part of
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	0..1	string	If relevant, description of the referenced resource
onset[x]	Σ	0..1	dateTime	Estimated or actual date, date-time, or age
abatement[x]	C	0..1		When in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	1..1	dateTime	Date record was first recorded
asserter	SΣ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (required)
assessment	C	0..*	Reference(DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Supporting evidence con-2: evidence SHALL have code or details
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (preferred)
note		0..*	Annotation	Additional information about the Condition. NB: Any notes may be shared widely across the region, including being viewed by the patient themselves
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Condition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Condition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Condition.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.identifier:localIdentifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.category	required	UKCoreConditionCategory https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory from this IG
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	preferred	UKCoreConditionCode https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode from this IG
Condition.bodySite	required	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Condition.encounter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Condition.asserter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Condition.stage.summary	required	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.stage.type	example	ConditionStageType http://hl7.org/fhir/ValueSet/condition-stage-type from the FHIR Standard
Condition.evidence.code	preferred	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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 UKCoreCondition

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	UKCoreCondition	Detailed information about conditions, problems or diagnoses
id	S	0..1	id	Logical id of this artifact
meta
id		0..0
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
version		0..0
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
version		0..0
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
extension:conditionEpisode		0..*	ExtensionUKCoreConditionEpisode	DISCOURAGED
Slices for identifier		0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
assigner		0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	S	0..1	Identifier	External Ids for this condition
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-condition-identifier
value	S	1..1	string	The Local condition Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
clinicalStatus		1..1	CodeableConcept	The clinical status of the condition.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: UK Core Condition Category (required)
code		1..1	CodeableConcept	Identification of the condition, problem or diagnosis. Binding: UK Core Condition Code (preferred)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
bodySite	S	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
subject		1..1	Reference(InterweavePatient)	Who has the condition? (A patient, NOT group)
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
encounter	S	0..1	Reference(InterweaveEncounter)	Encounter created as part of
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		0..1	string	If relevant, description of the referenced resource
onset[x]		0..1	dateTime	Estimated or actual date, date-time, or age
recordedDate	S	1..1	dateTime	Date record was first recorded
recorder		0..0
asserter	S	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
id		0..0
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
stage
id		0..0
summary	S	1..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (required)
assessment		0..*	Reference(DiagnosticReport | Observation)	Formal record of assessment
evidence
id		0..0
code	S	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (preferred)
detail		0..0
note		0..*	Annotation	Additional information about the Condition. NB: Any notes may be shared widely across the region, including being viewed by the patient themselves
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.category	required	UKCoreConditionCategory https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory from this IG
Condition.code	preferred	UKCoreConditionCode https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode from this IG
Condition.bodySite	required	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.stage.summary	required	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.evidence.code	preferred	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	UKCoreCondition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
conditionEpisode		0..*	CodeableConcept	DISCOURAGED URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ConditionEpisode
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-condition-identifier
value	SΣ	1..1	string	The Local condition Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
clinicalStatus	?!SΣC	1..1	CodeableConcept	The clinical status of the condition. Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	The verification status to support the clinical status of the condition. Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: UK Core Condition Category (required)
severity	S	0..1	CodeableConcept	A subjective assessment of the severity of the condition as evaluated by the clinician. Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis. Binding: UK Core Condition Code (preferred)
bodySite	SΣ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (required)
subject	SΣ	1..1	Reference(InterweavePatient)	Who has the condition? (A patient, NOT group)
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
encounter	SΣ	0..1	Reference(InterweaveEncounter)	Encounter created as part of
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	0..1	string	If relevant, description of the referenced resource
onset[x]	Σ	0..1	dateTime	Estimated or actual date, date-time, or age
recordedDate	SΣ	1..1	dateTime	Date record was first recorded
asserter	SΣ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (required)
assessment	C	0..*	Reference(DiagnosticReport | Observation)	Formal record of assessment
evidence	C	0..*	BackboneElement	Supporting evidence con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (preferred)
note		0..*	Annotation	Additional information about the Condition. NB: Any notes may be shared widely across the region, including being viewed by the patient themselves
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Condition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Condition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.category	required	UKCoreConditionCategory https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory from this IG
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	preferred	UKCoreConditionCode https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode from this IG
Condition.bodySite	required	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.stage.summary	required	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.evidence.code	preferred	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	UKCoreCondition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
conditionEpisode		0..*	CodeableConcept	DISCOURAGED URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ConditionEpisode
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-condition-identifier
value	SΣ	1..1	string	The Local condition Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	1..1	CodeableConcept	The clinical status of the condition. Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	The verification status to support the clinical status of the condition. Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: UK Core Condition Category (required)
severity	S	0..1	CodeableConcept	A subjective assessment of the severity of the condition as evaluated by the clinician. Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis. Binding: UK Core Condition Code (preferred)
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	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..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
bodySite	SΣ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (required)
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	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..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
subject	SΣ	1..1	Reference(InterweavePatient)	Who has the condition? (A patient, NOT group)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
encounter	SΣ	0..1	Reference(InterweaveEncounter)	Encounter created as part of
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	0..1	string	If relevant, description of the referenced resource
onset[x]	Σ	0..1	dateTime	Estimated or actual date, date-time, or age
abatement[x]	C	0..1		When in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	1..1	dateTime	Date record was first recorded
asserter	SΣ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (required)
assessment	C	0..*	Reference(DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Supporting evidence con-2: evidence SHALL have code or details
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (preferred)
note		0..*	Annotation	Additional information about the Condition. NB: Any notes may be shared widely across the region, including being viewed by the patient themselves
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Condition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Condition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Condition.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Condition.identifier:localIdentifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.category	required	UKCoreConditionCategory https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory from this IG
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	preferred	UKCoreConditionCode https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode from this IG
Condition.bodySite	required	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Condition.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Condition.encounter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Condition.asserter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Condition.stage.summary	required	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage from the FHIR Standard
Condition.stage.type	example	ConditionStageType http://hl7.org/fhir/ValueSet/condition-stage-type from the FHIR Standard
Condition.evidence.code	preferred	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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 UKCoreCondition

Summary

Mandatory: 5 elements(18 nested mandatory elements)
Must-Support: 20 elements
Fixed: 3 elements
Prohibited: 11 elements

Structures

This structure refers to these other structures:

• InterweaveOrganization (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Organization)
• InterweavePatient (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Patient)
• InterweaveEncounter (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Encounter)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Condition.meta.tag
• The element 1 is sliced based on the value of Condition.identifier