Status: Active: Approved (STU)

Introduction

This profile sets minimum expectations for the Condition resource.

Mandatory fields

The following mandatory fields are defined in order to properly describe a Condition:

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. Asserted Date - 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” - ie 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. Body Site - snomed coding for the affected body part. Important to provide if possible and relevant

3. Context - 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.

   Note: Do not link to an Episode of Care, as this is deprecated in FHIR R4

4. 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 Care Connect adds a few more which perhaps makes it a bit more useful).

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

• 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.

• 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.

  Note: Do not use abatementBoolean, as this is deprecated in FHIR R4

Discouraged or Removed fields

• Episodicity (Care Connect Extension) - Discouraged.

• Verification Status - This appears to be a significant modifier of the Condition, however it has been removed by Care Connect. Note that an implication of this decision by Care Connect is that this becomes a set of Conditions which DO apply to the subject. Ie there is no mechanism to capture a “refuted” Condition.

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

This structure is derived from CareConnect-Condition-1

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	S	0..1	id	Logical id of this artifact
meta
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..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
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
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
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
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
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
extension:episodisity		0..*	Extension-CareConnect-ConditionEpisode-1	DISCOURAGED
Slices for identifier		0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
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.yhcr.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	S	1..1	code	active | recurrence | inactive | remission | resolved
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis | presenting-complaint Binding: Care Connect Condition Category (required)
severity	S	0..1	CodeableConcept	Subjective severity of condition
code	S	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Care Connect Condition Code (preferred)
coding		0..*	Coding	Code defined by a terminology system
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: SNOMED CT Body Structures (required)
coding		0..*	Coding	Code defined by a terminology system
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	S	1..1	Reference(CareConnectPatient1)	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
context	S	0..1	Reference(CareConnect-Encounter-1)	Encounter or episode when condition first asserted
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
assertedDate	S	1..1	dateTime	Date record was believed accurate
asserter	S	0..1	Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)	Person who asserts this condition
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
summary	S	1..1	CodeableConcept	Simple summary (disease specific) Binding: Condition Stage (required)
assessment		0..*	Reference(DiagnosticReport | CareConnect-Observation-1)	Formal record of assessment
evidence
code	S	0..*	CodeableConcept	Manifestation/symptom Binding: Manifestation and Symptom Codes (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
Condition.category	required	Care Connect Condition Category
Condition.code	preferred	Care Connect Condition Code
Condition.bodySite	required	SNOMED CT Body Structures
Condition.stage.summary	required	Condition Stage
Condition.evidence.code	preferred	Manifestation and Symptom Codes

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
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..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
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: Common Tags (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: Common Tags (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://yhcr.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: Common Tags (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://yhcr.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: Common Languages (extensible): 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
episodisity		0..*	code	DISCOURAGED URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ConditionEpisode-1 Binding: Care Connect Condition Episodicity (required): Specifies the episodicity of a condition.
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 (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
use	?!Σ	0..1	code	usual | official | temp | secondary (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.yhcr.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	code	active | recurrence | inactive | remission | resolved Binding: Condition Clinical Status Codes (required): The clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis | presenting-complaint Binding: Care Connect Condition Category (required)
severity	S	0..1	CodeableConcept	Subjective severity of condition Binding: Condition/Diagnosis Severity (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: Care Connect Condition Code (preferred)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Condition Code (required): A code from the SNOMED Clinical Terminology UK
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	Σ	1..1	string	Representation defined by the system
bodySite	SΣ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMED CT Body Structures (required)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (required): A code from SNOMED Clinical Terminology UK
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	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
context	SΣ	0..1	Reference(CareConnect-Encounter-1)	Encounter or episode when condition first asserted
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
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate
asserter	SΣ	0..1	Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)	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..1	BackboneElement	Stage/grade, usually assessed formally
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: Condition Stage (required)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	Σ	1..1	string	Representation defined by the system
assessment	C	0..*	Reference(DiagnosticReport | CareConnect-Observation-1)	Formal record of assessment
evidence	C	0..*	BackboneElement	Supporting evidence
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: Manifestation and Symptom Codes (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
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.clinicalStatus	required	Condition Clinical Status Codes
Condition.category	required	Care Connect Condition Category
Condition.severity	preferred	Condition/Diagnosis Severity
Condition.code	preferred	Care Connect Condition Code
Condition.code.coding:snomedCT	required	Care Connect Condition Code
Condition.bodySite	required	SNOMED CT Body Structures
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site
Condition.stage.summary	required	Condition Stage
Condition.evidence.code	preferred	Manifestation and Symptom Codes

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	error	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error : verificationStatus='entered-in-error' or clinicalStatus.exists()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'
dom-1	error	Condition	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	Condition.extension:episodisity, Condition.stage, Condition.evidence	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Condition.extension:episodisity	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
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.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
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: Common Tags (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: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
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://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
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: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
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://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
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: Common Languages (extensible): 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
episodisity		0..*	code	DISCOURAGED URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ConditionEpisode-1 Binding: Care Connect Condition Episodicity (required): Specifies the episodicity of a condition.
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	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..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(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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.yhcr.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(CareConnect-Organization-1)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	1..1	code	active | recurrence | inactive | remission | resolved Binding: Condition Clinical Status Codes (required): The clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis | presenting-complaint Binding: Care Connect Condition Category (required)
id		0..1	string	xml:id (or equivalent in JSON)
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	xml:id (or equivalent in JSON)
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
severity	S	0..1	CodeableConcept	Subjective severity of condition Binding: Condition/Diagnosis Severity (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: Care Connect Condition Code (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
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
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Condition Code (required): A code from the SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	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: SNOMED CT Body Structures (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
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
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (required): A code from SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	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(CareConnectPatient1)	Who has the condition? (A patient, NOT group)
id		0..1	string	xml:id (or equivalent in JSON)
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)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
context	SΣ	0..1	Reference(CareConnect-Encounter-1)	Encounter or episode when condition first asserted
id		0..1	string	xml:id (or equivalent in JSON)
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)
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		If/when in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementBoolean			boolean
abatementPeriod			Period
abatementRange			Range
abatementString			string
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate
asserter	SΣ	0..1	Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)	Person who asserts this condition
id		0..1	string	xml:id (or equivalent in JSON)
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)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
stage	C	0..1	BackboneElement	Stage/grade, usually assessed formally
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: Condition Stage (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	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
assessment	C	0..*	Reference(DiagnosticReport | CareConnect-Observation-1)	Formal record of assessment
evidence	C	0..*	BackboneElement	Supporting evidence
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: Manifestation and Symptom Codes (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
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(RelatedPerson | CareConnect-Practitioner-1 | CareConnectPatient1)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier.type	extensible	Identifier Type Codes
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.type	extensible	Identifier Type Codes
Condition.clinicalStatus	required	Condition Clinical Status Codes
Condition.category	required	Care Connect Condition Category
Condition.severity	preferred	Condition/Diagnosis Severity
Condition.code	preferred	Care Connect Condition Code
Condition.code.coding:snomedCT	required	Care Connect Condition Code
Condition.bodySite	required	SNOMED CT Body Structures
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site
Condition.stage.summary	required	Condition Stage
Condition.evidence.code	preferred	Manifestation and Symptom Codes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	Condition.extension:episodisity	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Condition.extension:episodisity	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from CareConnect-Condition-1

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	S	0..1	id	Logical id of this artifact
meta
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..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
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
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
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
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
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
extension:episodisity		0..*	Extension-CareConnect-ConditionEpisode-1	DISCOURAGED
Slices for identifier		0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
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.yhcr.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	S	1..1	code	active | recurrence | inactive | remission | resolved
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis | presenting-complaint Binding: Care Connect Condition Category (required)
severity	S	0..1	CodeableConcept	Subjective severity of condition
code	S	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Care Connect Condition Code (preferred)
coding		0..*	Coding	Code defined by a terminology system
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: SNOMED CT Body Structures (required)
coding		0..*	Coding	Code defined by a terminology system
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	S	1..1	Reference(CareConnectPatient1)	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
context	S	0..1	Reference(CareConnect-Encounter-1)	Encounter or episode when condition first asserted
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
assertedDate	S	1..1	dateTime	Date record was believed accurate
asserter	S	0..1	Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)	Person who asserts this condition
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
summary	S	1..1	CodeableConcept	Simple summary (disease specific) Binding: Condition Stage (required)
assessment		0..*	Reference(DiagnosticReport | CareConnect-Observation-1)	Formal record of assessment
evidence
code	S	0..*	CodeableConcept	Manifestation/symptom Binding: Manifestation and Symptom Codes (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
Condition.category	required	Care Connect Condition Category
Condition.code	preferred	Care Connect Condition Code
Condition.bodySite	required	SNOMED CT Body Structures
Condition.stage.summary	required	Condition Stage
Condition.evidence.code	preferred	Manifestation and Symptom Codes

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
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..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
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: Common Tags (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: Common Tags (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://yhcr.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: Common Tags (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://yhcr.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: Common Languages (extensible): 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
episodisity		0..*	code	DISCOURAGED URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ConditionEpisode-1 Binding: Care Connect Condition Episodicity (required): Specifies the episodicity of a condition.
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 (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
use	?!Σ	0..1	code	usual | official | temp | secondary (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.yhcr.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	code	active | recurrence | inactive | remission | resolved Binding: Condition Clinical Status Codes (required): The clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis | presenting-complaint Binding: Care Connect Condition Category (required)
severity	S	0..1	CodeableConcept	Subjective severity of condition Binding: Condition/Diagnosis Severity (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: Care Connect Condition Code (preferred)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Condition Code (required): A code from the SNOMED Clinical Terminology UK
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	Σ	1..1	string	Representation defined by the system
bodySite	SΣ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMED CT Body Structures (required)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (required): A code from SNOMED Clinical Terminology UK
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	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
context	SΣ	0..1	Reference(CareConnect-Encounter-1)	Encounter or episode when condition first asserted
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
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate
asserter	SΣ	0..1	Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)	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..1	BackboneElement	Stage/grade, usually assessed formally
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: Condition Stage (required)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	Σ	1..1	string	Representation defined by the system
assessment	C	0..*	Reference(DiagnosticReport | CareConnect-Observation-1)	Formal record of assessment
evidence	C	0..*	BackboneElement	Supporting evidence
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: Manifestation and Symptom Codes (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
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.clinicalStatus	required	Condition Clinical Status Codes
Condition.category	required	Care Connect Condition Category
Condition.severity	preferred	Condition/Diagnosis Severity
Condition.code	preferred	Care Connect Condition Code
Condition.code.coding:snomedCT	required	Care Connect Condition Code
Condition.bodySite	required	SNOMED CT Body Structures
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site
Condition.stage.summary	required	Condition Stage
Condition.evidence.code	preferred	Manifestation and Symptom Codes

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	error	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error : verificationStatus='entered-in-error' or clinicalStatus.exists()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'
dom-1	error	Condition	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	Condition.extension:episodisity, Condition.stage, Condition.evidence	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Condition.extension:episodisity	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
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.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
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: Common Tags (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: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
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://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
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: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
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://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
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: Common Languages (extensible): 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
episodisity		0..*	code	DISCOURAGED URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ConditionEpisode-1 Binding: Care Connect Condition Episodicity (required): Specifies the episodicity of a condition.
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	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..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(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this condition
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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.yhcr.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(CareConnect-Organization-1)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	1..1	code	active | recurrence | inactive | remission | resolved Binding: Condition Clinical Status Codes (required): The clinical status of the condition or diagnosis.
category	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis | presenting-complaint Binding: Care Connect Condition Category (required)
id		0..1	string	xml:id (or equivalent in JSON)
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	xml:id (or equivalent in JSON)
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
severity	S	0..1	CodeableConcept	Subjective severity of condition Binding: Condition/Diagnosis Severity (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: Care Connect Condition Code (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
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
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Condition Code (required): A code from the SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	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: SNOMED CT Body Structures (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
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
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (required): A code from SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	Optional Extensions Element URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	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(CareConnectPatient1)	Who has the condition? (A patient, NOT group)
id		0..1	string	xml:id (or equivalent in JSON)
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)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
context	SΣ	0..1	Reference(CareConnect-Encounter-1)	Encounter or episode when condition first asserted
id		0..1	string	xml:id (or equivalent in JSON)
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)
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		If/when in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementBoolean			boolean
abatementPeriod			Period
abatementRange			Range
abatementString			string
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate
asserter	SΣ	0..1	Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)	Person who asserts this condition
id		0..1	string	xml:id (or equivalent in JSON)
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)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
stage	C	0..1	BackboneElement	Stage/grade, usually assessed formally
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
summary	SC	1..1	CodeableConcept	Simple summary (disease specific) Binding: Condition Stage (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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	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
assessment	C	0..*	Reference(DiagnosticReport | CareConnect-Observation-1)	Formal record of assessment
evidence	C	0..*	BackboneElement	Supporting evidence
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	SΣC	0..*	CodeableConcept	Manifestation/symptom Binding: Manifestation and Symptom Codes (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
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(RelatedPerson | CareConnect-Practitioner-1 | CareConnectPatient1)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier.type	extensible	Identifier Type Codes
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.type	extensible	Identifier Type Codes
Condition.clinicalStatus	required	Condition Clinical Status Codes
Condition.category	required	Care Connect Condition Category
Condition.severity	preferred	Condition/Diagnosis Severity
Condition.code	preferred	Care Connect Condition Code
Condition.code.coding:snomedCT	required	Care Connect Condition Code
Condition.bodySite	required	SNOMED CT Body Structures
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site
Condition.stage.summary	required	Condition Stage
Condition.evidence.code	preferred	Manifestation and Symptom Codes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	Condition.extension:episodisity	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Condition.extension:episodisity	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CareConnect-Condition-1

Summary

Mandatory: 5 elements (16 nested mandatory elements)
Must-Support: 24 elements
Fixed Value: 3 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
• CareConnect-Encounter-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)
• CareConnect-Observation-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1)

Slices

This structure defines the following Slices:

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