Structure definition: CareConnect-Condition-1

Name: CareConnect-Condition-1 URL: https://fhir.hl7.org.uk/StructureDefinition/CareConnect-Condition-1
Version: 1.0.0 Constrained type: Condition Constrained URL: http://hl7.org/fhir/Condition.html Status: draft
Description: This Condition resource records detailed information about conditions or diagnoses recognised by a clinician.
Published by: HL7 UK Created date: 23/02/17 Last updated: 08/05/17 Kind: Resource
FHIR Version: DSTU2 DisplayName: Abstract: No Context type:
Copyright © 2016+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html
Name Flags Card. Type Description/Constraints
Condition Σ I 0..* Profile
Detailed information about conditions, problems or diagnoses
Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources
Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative
id Σ I 0..1 Id
Logical id of this artifact
meta Σ I 0..1 Meta
Metadata about the resource
implicitRules Σ ?! I 0..1 Uri
A set of rules under which this content was created
language I 0..1 Code
Language of the resource content
Binding (required): A human language. ( http://tools.ietf.org/html/bcp47.html )
text I 0..1 Narrative
Text summary of the resource, for human interpretation
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
status I 1..1 Code
generated | extensions | additional | empty
Binding (required): The status of a resource narrative ( http://hl7.org/fhir/DSTU2/valueset-narrative-status.html )
div I 1..1 Xhtml
Limited xhtml content
Constraint (txt-3): The narrative SHALL contain only the basic html formatting attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
Constraint (txt-1): The narrative SHALL contain only the basic html formatting elements described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
Constraint (txt-2): The narrative SHALL have some non-whitespace content
contained 0..* Resource
Contained, inline Resources
extension (episode) I 0..1 Extension
The episodicity status of a condition
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
url I 1..1 Uri
Identifies The Meaning Of The Extension
valueCode I 1..1 Code
first | new | review | flare | end
Binding (required): Specifies the episodicity of a condition. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionEpisodicity-1.html )
extension (related) I 0..* Extension
Related condition
modifierExtension ?! I 0..* Extension
Extensions that cannot be ignored
identifier Σ I 0..* Identifier
External Ids for this condition
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
use Σ ?! I 0..1 Code
usual | official | temp | secondary (If known)
Binding (required): Identifies the purpose for this identifier, if known . ( http://hl7.org/fhir/DSTU2/valueset-identifier-use.html )
type Σ I 0..1 CodeableConcept
Description of identifier
Binding (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ( http://hl7.org/fhir/DSTU2/valueset-identifier-type.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
system Σ I 0..1 Uri
Identity of the terminology system
version Σ I 0..1 String
Version of the system - if relevant
code Σ I 0..1 Code
Symbol in syntax defined by the system
display Σ I 0..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
system Σ I 1..1 Uri
The namespace for the identifier
Example Value: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
value Σ I 1..1 String
The value that is unique
Example Value: 123456
period Σ I 0..1 Period
Time period when id is/was valid for use
Constraint (per-1): If present, start SHALL have a lower value than end
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
start Σ I 0..1 dateTime
Starting time with inclusive boundary
end Σ I 0..1 dateTime
End time with inclusive boundary, if not ongoing
assigner Σ I 0..1 Reference ( CareConnect-Organization-1 )
Organization that issued id (may be just text)
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
reference Σ I 0..1 String
Relative, internal or absolute URL reference
display Σ I 0..1 String
Text alternative for the resource
patient Σ I 1..1 Reference ( CareConnect-Patient-1 )
Who has the condition?
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
reference Σ I 0..1 String
Relative, internal or absolute URL reference
display Σ I 0..1 String
Text alternative for the resource
encounter Σ I 0..1 Reference ( CareConnect-Encounter-1 )
Encounter when condition first asserted
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
reference Σ I 0..1 String
Relative, internal or absolute URL reference
display Σ I 0..1 String
Text alternative for the resource
asserter Σ I 1..1 Reference ( CareConnect-Patient-1 | CareConnect-Practitioner-1 )
Person who asserts this condition
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
dateRecorded Σ I 1..1 Date
When first entered
code Σ I 1..1 CodeableConcept
Identification of the condition, problem or diagnosis
Binding (example): Identification of the condition or diagnosis. ( http://hl7.org/fhir/DSTU2/valueset-condition-code.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 1..* Coding
Code defined by a terminology system
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) Σ I 1..1 Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
category Σ I 1..1 CodeableConcept
complaint | symptom | finding | diagnosis | problem | need
Binding (extensible): A category assigned to the condition. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionCategory-1.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: https://fhir.hl7.org.uk/CareConnect-ConditionCategory-1
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
text Σ I 0..1 String
Plain text representation of the concept
clinicalStatus Σ ?! I 0..1 Code
active | inactive | relapse | remission | resolved
Binding (required): The clinical status of the condition or diagnosis. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionClinicalStatus-1.html )
verificationStatus Σ ?! I 1..1 Code
provisional | differential | confirmed | refuted | entered-in-error | unknown
Binding (required): The verification status to support or decline the clinical status of the condition or diagnosis. ( http://hl7.org/fhir/DSTU2/valueset-condition-ver-status.html )
severity Σ I 0..1 CodeableConcept
Subjective severity of condition
Binding (extensible): A subjective assessment of the severity of the condition as evaluated by the clinician. ( http://hl7.org/fhir/DSTU2/valueset-condition-severity.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display.
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
onset[x] Σ I 0..1 dateTime | Quantity ( Age ) | Period | Range | String
Estimated or actual date, date-time, or age
abatement[x] Σ I 0..1 dateTime | Quantity ( Age ) | Boolean | Period | Range | String
If/when in resolution/remission
stage Σ I 0..1 BackboneElement
Stage/grade, usually assessed formally
Constraint (con-1): Stage SHALL have summary or assessment
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
modifierExtension ?! I 0..* Extension
Extensions that cannot be ignored
summary Σ I 0..1 CodeableConcept
Simple summary (disease specific)
Binding (example): Codes describing condition stages (e.g. Cancer stages). ( http://hl7.org/fhir/DSTU2/valueset-condition-stage.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
assessment Σ I 0..* Reference ( ClinicalImpression | DiagnosticReport | CareConnect-Observation-1 )
Formal record of assessment
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
evidence Σ I 0..* BackboneElement
Supporting evidence
Constraint (con-2): evidence SHALL have code or details
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
modifierExtension ?! I 0..* Extension
Extensions that cannot be ignored
code Σ I 0..1 CodeableConcept
Manifestation/symptom
Binding (example): Codes that describe the manifestation or symptoms of a condition. ( http://hl7.org/fhir/DSTU2/valueset-manifestation-or-symptom.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
system Σ I 0..1 Uri
Identity of the terminology system
version Σ I 0..1 String
Version of the system - if relevant
code Σ I 0..1 Code
Symbol in syntax defined by the system
display Σ I 0..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
detail Σ I 0..* Reference ( Resource )
Supporting information found elsewhere
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
reference Σ I 0..1 String
Relative, internal or absolute URL reference
display Σ I 0..1 String
Text alternative for the resource
bodySite Σ I 0..* CodeableConcept
Anatomical location, if relevant
Binding (example): Codes describing anatomical locations. May include laterality. ( http://hl7.org/fhir/DSTU2/valueset-body-site.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) Σ I 0..1 Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
notes Σ I 0..1 String
Additional information about the Condition
Name Flags Card. Type Description/Constraints
Condition 0..* Profile
extension (episode) 0..1 Extension
The episodicity status of a condition
valueCode 1..1 Code
extension (related) 0..* Extension
identifier 0..* Identifier
system 1..1 Uri
value 1..1 String
assigner 0..1 Reference ( CareConnect-Organization-1 )
patient 1..1 Reference ( CareConnect-Patient-1 )
encounter 0..1 Reference ( CareConnect-Encounter-1 )
asserter 1..1 Reference ( CareConnect-Patient-1 | CareConnect-Practitioner-1 )
dateRecorded 1..1 Date
code 1..1 CodeableConcept
coding 1..* Coding
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) 1..1 Coding
extension (snomedCTDescriptionID) 0..1 Extension
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String
category 1..1 CodeableConcept
complaint | symptom | finding | diagnosis | problem | need
Binding (extensible): A category assigned to the condition. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionCategory-1.html )
coding 0..* Coding
system 1..1 Uri
Fixed Value: https://fhir.hl7.org.uk/CareConnect-ConditionCategory-1
version 0..0 String
code 1..1 Code
display 1..1 String
userSelected 0..0 Boolean
clinicalStatus 0..1 Code
active | inactive | relapse | remission | resolved
Binding (required): The clinical status of the condition or diagnosis. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionClinicalStatus-1.html )
severity 0..1 CodeableConcept
Binding (extensible): A subjective assessment of the severity of the condition as evaluated by the clinician. ( http://hl7.org/fhir/DSTU2/valueset-condition-severity.html )
coding 0..* Coding
extension (snomedCTDescriptionID) 0..1 Extension
The SNOMED CT Description ID for the display.
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String
stage 0..1 BackboneElement
summary 0..1 CodeableConcept
coding 0..* Coding
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) 0..* Coding
extension (snomedCTDescriptionID) 0..1 Extension
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String
assessment 0..* Reference ( ClinicalImpression | DiagnosticReport | CareConnect-Observation-1 )
bodySite 0..* CodeableConcept
coding 0..* Coding
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) 0..1 Coding
extension (snomedCTDescriptionID) 0..1 Extension
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String

Details

Condition
Definition Use to record detailed information about conditions, problems or diagnoses recognized by a clinician. There are many uses including: recording a diagnosis during an encounter; populating a problem list or a summary statement, such as a discharge summary.
Cardinality 0..*
Type Profile
Summary True
Invariants Affect this element

dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (xpath: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))) severity: error

dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (xpath: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))) severity: error

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (xpath: not(parent::f:contained and f:contained)) severity: error

dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (xpath: not(parent::f:contained and f:text)) severity: error
Mappings rim: Entity. Role, or Act

v2: PPR message

rim: Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]

w5: clinical.general
Condition.id
Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality 0..1
Type Id
Summary True
Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID.
Condition.meta
Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality 0..1
Type Meta
Summary True
Condition.implicitRules
Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality 0..1
Type Uri
Summary True
Modifier True
Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.
Condition.language
Definition The base language in which the resource is written.
Cardinality 0..1
Binding Bcp47.html: A human language. (required)
Type Code
Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Condition.text
Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality 0..1
Type Narrative
Alternate Names narrative; html; xhtml; display
Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.
Mappings rim: Act.text?
Condition.text.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.text.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.text.status
Definition The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.
Cardinality 1..1
Binding ValuesetNarrativeStatus.html: The status of a resource narrative (required)
Type Code
Comments Note that FHIR strings may not exceed 1MB in size
Condition.text.div
Definition The actual narrative content, a stripped down version of XHTML.
Cardinality 1..1
Type Xhtml
Comments The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
Invariants Affect this element

txt-3: The narrative SHALL contain only the basic html formatting attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (xpath: not(descendant-or-self::*/@*[not(name(.)=('abbr', 'accesskey', 'align', 'alt', 'axis', 'bgcolor', 'border', 'cellhalign', 'cellpadding', 'cellspacing', 'cellvalign', 'char', 'charoff', 'charset', 'cite', 'class', 'colspan', 'compact', 'coords', 'dir', 'frame', 'headers', 'height', 'href', 'hreflang', 'hspace', 'id', 'lang', 'longdesc', 'name', 'nowrap', 'rel', 'rev', 'rowspan', 'rules', 'scope', 'shape', 'span', 'src', 'start', 'style', 'summary', 'tabindex', 'title', 'type', 'valign', 'value', 'vspace', 'width'))])) severity: error

txt-1: The narrative SHALL contain only the basic html formatting elements described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (xpath: not(descendant-or-self::*[not(local-name(.)=('a', 'abbr', 'acronym', 'b', 'big', 'blockquote', 'br', 'caption', 'cite', 'code', 'col', 'colgroup', 'dd', 'dfn', 'div', 'dl', 'dt', 'em', 'h1', 'h2', 'h3', 'h4', 'h5', 'h6', 'hr', 'i', 'img', 'li', 'ol', 'p', 'pre', 'q', 'samp', 'small', 'span', 'strong', 'table', 'tbody', 'td', 'tfoot', 'th', 'thead', 'tr', 'tt', 'ul', 'var'))])) severity: error

txt-2: The narrative SHALL have some non-whitespace content (xpath: descendant::text()[normalize-space(.)!=''] or descendant::h:img[@src]) severity: error
Condition.contained
Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality 0..*
Type Resource
Alternate Names inline resources; anonymous resources; contained resources
Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
Mappings rim: Entity. Role, or Act
Condition.extension(episode)
Definition Episodicity of condition.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.extension(episode).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.extension(episode).extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.extension(episode).url
Definition Source of the definition for the extension code - a logical name or a URL.
Cardinality 1..1
Type Uri
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.
Condition.extension(episode).valueCode
Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
Cardinality 1..1
Binding CareConnectConditionEpisodicity1.html: Specifies the episodicity of a condition. (required)
Type Code
Condition.extension(related)
Definition Related condition.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.modifierExtension
Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Modifier True
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.identifier
Definition This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Cardinality 0..*
Type Identifier
Requirements Need to allow connection to a wider workflow.
Summary True
Mappings v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)

rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]

servd: Identifier

rim: .id

w5: id
Condition.identifier.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.identifier.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.identifier.use
Definition The purpose of this identifier.
Cardinality 0..1
Binding ValuesetIdentifierUse.html: Identifies the purpose for this identifier, if known . (required)
Type Code
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Summary True
Modifier True
Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Mappings rim: Role.code or implied by context
Condition.identifier.type
Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality 0..1
Binding ValuesetIdentifierType.html: A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. (extensible)
Type CodeableConcept
Requirements Allows users to make use of identifiers when the identifier system is not known.
Summary True
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

v2: CX.5

rim: Role.code or implied by context
Condition.identifier.type.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.identifier.type.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.identifier.type.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.identifier.type.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.identifier.type.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.identifier.type.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.identifier.type.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Condition.identifier.type.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.identifier.type.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.identifier.type.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.identifier.type.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.identifier.system
Definition Establishes the namespace in which set of possible id values is unique.
Cardinality 1..1
Type Uri
Requirements There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.
Summary True
Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Mappings v2: CX.4 / EI-2-4

rim: II.root or Role.id.root

servd: ./IdentifierType
Condition.identifier.value
Definition The portion of the identifier typically displayed to the user and which is unique within the context of the system.
Cardinality 1..1
Type String
Summary True
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.
Mappings v2: CX.1 / EI.1

rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)

servd: ./Value
Condition.identifier.period
Definition Time period during which identifier is/was valid for use.
Cardinality 0..1
Type Period
Summary True
Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Invariants Affect this element

per-1: If present, start SHALL have a lower value than end (xpath: not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)) severity: error
Mappings v2: DR

rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

v2: CX.7 + CX.8

rim: Role.effectiveTime or implied by context

servd: ./StartDate and ./EndDate
Condition.identifier.period.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.identifier.period.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.identifier.period.start
Definition The start of the period. The boundary is inclusive.
Cardinality 0..1
Type dateTime
Summary True
Comments If the low element is missing, the meaning is that the low boundary is not known.
Mappings v2: DR.1

rim: ./low
Condition.identifier.period.end
Definition The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Cardinality 0..1
Type dateTime
Summary True
Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Mappings v2: DR.2

rim: ./high
Condition.identifier.assigner
Definition Organization that issued/manages the identifier.
Cardinality 0..1
Type Reference ( CareConnect-Organization-1 )
Summary True
Comments The reference may be just a text description of the assigner.
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

v2: CX.4 / (CX.4,CX.9,CX.10)

rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper

servd: ./IdentifierIssuingAuthority
Condition.identifier.assigner.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.identifier.assigner.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.identifier.assigner.reference
Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality 0..1
Type String
Summary True
Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Condition.identifier.assigner.display
Definition Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality 0..1
Type String
Summary True
Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Condition.patient
Definition Indicates the patient who the condition record is associated with.
Cardinality 1..1
Type Reference ( CareConnect-Patient-1 )
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

v2: PID-3

rim: .participation[typeCode=SBJ].role[classCode=PAT]

w5: who.focus
Condition.patient.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.patient.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.patient.reference
Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality 0..1
Type String
Summary True
Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Condition.patient.display
Definition Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality 0..1
Type String
Summary True
Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Condition.encounter
Definition Encounter during which the condition was first asserted.
Cardinality 0..1
Type Reference ( CareConnect-Encounter-1 )
Summary True
Comments This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

v2: PV1-19 (+PV1-54)

rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

w5: context
Condition.encounter.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.encounter.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.encounter.reference
Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality 0..1
Type String
Summary True
Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Condition.encounter.display
Definition Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality 0..1
Type String
Summary True
Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Condition.asserter
Definition Individual who is making the condition statement.
Cardinality 1..1
Type Reference ( CareConnect-Patient-1 | CareConnect-Practitioner-1 )
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

v2: REL-7.1 identifier + REL-7.12 type code

rim: .participation[typeCode=AUT].role

w5: who.author
Condition.dateRecorded
Definition A date, when the Condition statement was documented.
Cardinality 1..1
Type Date
Summary True
Comments The Date Recorded represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified. ??The date of the last record modification can be retrieved from the resource metadata.
Mappings v2: REL-11

rim: .participation[typeCode=AUT].time

w5: when.recorded
Condition.code
Definition Identification of the condition, problem or diagnosis.
Cardinality 1..1
Binding ValuesetConditionCode.html: Identification of the condition or diagnosis. (example)
Type CodeableConcept
Summary True
Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

v2: PRB-3

rim: .value

w5: what
Condition.code.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.code.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.code.coding
Definition A reference to a code defined by a terminology system.
Cardinality 1..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Slicing This element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: system
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.code.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.code.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.code.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.code.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Condition.code.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.code.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.code.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.code.coding(SNOMED CT)
Definition A reference to a code defined by a terminology system.
Cardinality 1..1
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.code.coding(SNOMED CT).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.code.coding(SNOMED CT).extension(snomedCTDescriptionID)
Definition The SNOMED CT Description ID for the display.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.code.coding(SNOMED CT).system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.code.coding(SNOMED CT).code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.code.coding(SNOMED CT).display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.code.coding(SNOMED CT).userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.code.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.category
Definition A category assigned to the condition.
Cardinality 1..1
Binding CareConnectConditionCategory1.html: A category assigned to the condition. (extensible)
Type CodeableConcept
Summary True
Comments The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

v2: 'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message

rim: .code

w5: class
Condition.category.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.category.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.category.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.category.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.category.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.category.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.category.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.category.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.category.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.clinicalStatus
Definition The clinical status of the condition.
Cardinality 0..1
Binding CareConnectConditionClinicalStatus1.html: The clinical status of the condition or diagnosis. (required)
Type Code
Summary True
Modifier True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: PRB-14 / DG1-6

w5: status
Condition.verificationStatus
Definition The verification status to support the clinical status of the condition.
Cardinality 1..1
Binding ValuesetConditionVerStatus.html: The verification status to support or decline the clinical status of the condition or diagnosis. (required)
Type Code
Summary True
Modifier True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: PRB-13

rim: .code (pre or post-coordinated in) Can use valueNegationInd for refuted

w5: status
Condition.severity
Definition A subjective assessment of the severity of the condition as evaluated by the clinician.
Cardinality 0..1
Binding ValuesetConditionSeverity.html: A subjective assessment of the severity of the condition as evaluated by the clinician. (extensible)
Type CodeableConcept
Summary True
Comments Coding of the severity with a terminology is preferred, where possible.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

v2: PRB-26 / ABS-3

rim: Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value

w5: grade
Condition.severity.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.severity.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.severity.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.severity.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.severity.coding.extension(snomedCTDescriptionID)
Definition Optional Extensions Element - found in all resources.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.severity.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.severity.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.severity.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.severity.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.severity.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.onset[x]
Definition Estimated or actual date or date-time the condition began, in the opinion of the clinician.
Cardinality 0..1
Type dateTime | Quantity ( Age ) | Period | Range | String
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Comments Age is generally used when the patient reports an age at which the Condition began to occur.
Mappings v2: PRB-16

rim: .effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value

w5: when.init
Condition.abatement[x]
Definition The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.
Cardinality 0..1
Type dateTime | Quantity ( Age ) | Boolean | Period | Range | String
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Comments There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.
Mappings rim: .effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed

w5: when.done
Condition.stage
Definition Clinical stage or grade of a condition. May include formal severity assessments.
Cardinality 0..1
Type BackboneElement
Summary True
Invariants Affect this element

con-1: Stage SHALL have summary or assessment (xpath: exists(f:summary) or exists(f:assessment)) severity: error
Mappings rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]
Condition.stage.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.stage.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.stage.modifierExtension
Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content; modifiers
Modifier True
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.stage.summary
Definition A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.
Cardinality 0..1
Binding ValuesetConditionStage.html: Codes describing condition stages (e.g. Cancer stages). (example)
Type CodeableConcept
Summary True
Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

v2: PRB-14

rim: .value
Condition.stage.summary.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.stage.summary.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.stage.summary.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Slicing This element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: system
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.stage.summary.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.stage.summary.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.stage.summary.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.stage.summary.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Condition.stage.summary.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.stage.summary.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.stage.summary.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.stage.summary.coding(SNOMED CT)
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.stage.summary.coding(SNOMED CT).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.stage.summary.coding(SNOMED CT).extension(snomedCTDescriptionID)
Definition The SNOMED CT Description ID for the display.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.stage.summary.coding(SNOMED CT).system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.stage.summary.coding(SNOMED CT).code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.stage.summary.coding(SNOMED CT).display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.stage.summary.coding(SNOMED CT).userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.stage.summary.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.stage.assessment
Definition Reference to a formal record of the evidence on which the staging assessment is based.
Cardinality 0..*
Type Reference ( ClinicalImpression | DiagnosticReport | CareConnect-Observation-1 )
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

rim: .self
Condition.evidence
Definition Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.
Cardinality 0..*
Type BackboneElement
Summary True
Comments The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.
Invariants Affect this element

con-2: evidence SHALL have code or details (xpath: exists(f:code) or exists(f:detail)) severity: error
Mappings rim: .outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]
Condition.evidence.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.evidence.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.evidence.modifierExtension
Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content; modifiers
Modifier True
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.evidence.code
Definition A manifestation or symptom that led to the recording of this condition.
Cardinality 0..1
Binding ValuesetManifestationOrSymptom.html: Codes that describe the manifestation or symptoms of a condition. (example)
Type CodeableConcept
Summary True
Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rim: [code="diagnosis"].value
Condition.evidence.code.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.evidence.code.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.evidence.code.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.evidence.code.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.evidence.code.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.evidence.code.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.evidence.code.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Condition.evidence.code.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.evidence.code.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.evidence.code.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.evidence.code.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.evidence.detail
Definition Links to other relevant information, including pathology reports.
Cardinality 0..*
Type Reference ( Resource )
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

rim: .self
Condition.evidence.detail.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.evidence.detail.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.evidence.detail.reference
Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality 0..1
Type String
Summary True
Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Condition.evidence.detail.display
Definition Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality 0..1
Type String
Summary True
Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Condition.bodySite
Definition The anatomical location where this condition manifests itself.
Cardinality 0..*
Binding ValuesetBodySite.html: Codes describing anatomical locations. May include laterality. (example)
Type CodeableConcept
Summary True
Comments May be a summary code, or a reference to a very precise definition of the location, or both.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rim: .targetBodySiteCode
Condition.bodySite.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.bodySite.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.bodySite.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Slicing This element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: system
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.bodySite.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.bodySite.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.bodySite.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.bodySite.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Condition.bodySite.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.bodySite.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.bodySite.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.bodySite.coding(SNOMED CT)
Definition A reference to a code defined by a terminology system.
Cardinality 0..1
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Condition.bodySite.coding(SNOMED CT).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Condition.bodySite.coding(SNOMED CT).extension(snomedCTDescriptionID)
Definition The SNOMED CT Description ID for the display.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Condition.bodySite.coding(SNOMED CT).system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Condition.bodySite.coding(SNOMED CT).code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Condition.bodySite.coding(SNOMED CT).display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Condition.bodySite.coding(SNOMED CT).userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Condition.bodySite.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Condition.notes
Definition Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.
Cardinality 0..1
Type String
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: NTE child of PRB

rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Bindings

Path Definition Type Reference
Condition.language The base language in which the resource is written. required http://tools.ietf.org/html/bcp47.html
Condition.text.status The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data. required http://hl7.org/fhir/DSTU2/valueset-narrative-status.html
Condition.extension.valueCode Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). required https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionEpisodicity-1.html
Condition.identifier.use The purpose of this identifier. required http://hl7.org/fhir/DSTU2/valueset-identifier-use.html
Condition.identifier.type A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. extensible http://hl7.org/fhir/DSTU2/valueset-identifier-type.html
Condition.code Identification of the condition, problem or diagnosis. example http://hl7.org/fhir/DSTU2/valueset-condition-code.html
Condition.category A category assigned to the condition. extensible https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionCategory-1.html
Condition.clinicalStatus The clinical status of the condition. required https://fhir.hl7.org.uk/ValueSet/CareConnect-ConditionClinicalStatus-1.html
Condition.verificationStatus The verification status to support the clinical status of the condition. required http://hl7.org/fhir/DSTU2/valueset-condition-ver-status.html
Condition.severity A subjective assessment of the severity of the condition as evaluated by the clinician. extensible http://hl7.org/fhir/DSTU2/valueset-condition-severity.html
Condition.stage.summary A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific. example http://hl7.org/fhir/DSTU2/valueset-condition-stage.html
Condition.evidence.code A manifestation or symptom that led to the recording of this condition. example http://hl7.org/fhir/DSTU2/valueset-manifestation-or-symptom.html
Condition.bodySite The anatomical location where this condition manifests itself. example http://hl7.org/fhir/DSTU2/valueset-body-site.html

Structure definition: Extension-CareConnect-DateRecorded-1

Name: Extension-CareConnect-DateRecorded-1 URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-CareConnect-DateRecorded-1
Version: 1.0.0 Constrained type: Extension Constrained URL: http://hl7.org/fhir/extensibility.html#extension Status: draft
Description: This Extension resource is constrained to support the date that an event was recorded.
Published by: HL7 UK Created date: 28/02/17 Last updated: 08/05/17 Kind: Datatype
FHIR Version: DSTU2 DisplayName: Abstract: No Context type: resource
Use context: Immunization, Procedure
Copyright © 2016+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html
Name Flags Card. Type Description/Constraints
Extension I 0..* Profile
The date that the event was recorded
Constraint (ele-1): All FHIR elements must have a @value or children
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
url I 1..1 Uri
Identifies The Meaning Of The Extension
valueDateTime I 1..1 dateTime
The date that the event was recorded
Name Flags Card. Type Description/Constraints
Extension 0..* Profile
The date that the event was recorded
url 1..1 Uri
valueDateTime 1..1 dateTime
The date that the event was recorded

Details

Extension
Definition The date that the event was recorded.
Cardinality 0..*
Type Profile
Invariants Affect this element

ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div) severity: error
Extension.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Extension.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension.url
Definition Source of the definition for the extension code - a logical name or a URL.
Cardinality 1..1
Type Uri
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.
Extension.valueDateTime
Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
Cardinality 1..1
Type dateTime

Structure definition: Extension-CareConnect-MedicationStatementQuantity-1

Name: Extension-CareConnect-MedicationStatementQuantity-1 URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-CareConnect-MedicationStatementQuantity-1
Version: 1.0.0 Constrained type: Extension Constrained URL: http://hl7.org/fhir/extensibility.html#extension Status: draft
Description: Indicates the amount of medication to supply per dispense.
Published by: HL7 UK Created date: 24/02/17 Last updated: 08/05/17 Kind: Datatype
FHIR Version: DSTU2 DisplayName: Abstract: No Context type: resource
Use contexts: MedicationStatement
Copyright © 2016+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html
Name Flags Card. Type Description/Constraints
Extension I 0..* Profile
Amount of medication to supply per dispense
Constraint (ele-1): All FHIR elements must have a @value or children
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (quantity) I 1..1 Extension
Amount of medication to supply per dispense
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
url I 1..1 Uri
Identifies The Meaning Of The Extension
Fixed Value: Quantity
valueQuantity I 1..1 Quantity
Amount of medication to supply per dispense
extension (quantityText) I 1..1 Extension
Quantity representation
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
url I 1..1 Uri
Identifies The Meaning Of The Extension
Fixed Value: quantityText
valueString I 1..1 String
Quantity representation
url I 1..1 Uri
Identifies The Meaning Of The Extension
Name Flags Card. Type Description/Constraints
Extension 0..* Profile
Amount of medication to supply per dispense
extension (quantity) 1..1 Extension
Amount of medication to supply per dispense
url 1..1 Uri
Fixed Value: Quantity
valueQuantity 1..1 Quantity
Amount of medication to supply per dispense
extension (quantityText) 1..1 Extension
Quantity representation
url 1..1 Uri
Fixed Value: quantityText
valueString 1..1 String
Quantity representation
url 1..1 Uri
value[x] 0..0 *

Details

Extension
Definition Amount of medication to supply per dispense.
Cardinality 0..*
Type Profile
Invariants Affect this element

ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div) severity: error
Extension.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Extension.extension(quantity)
Definition Amount of medication to supply per dispense.
Cardinality 1..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension.extension(quantity).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Extension.extension(quantity).extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension.extension(quantity).url
Definition Source of the definition for the extension code - a logical name or a URL.
Cardinality 1..1
Type Uri
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.
Extension.extension(quantity).valueQuantity
Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
Cardinality 1..1
Type Quantity
Extension.extension(quantityText)
Definition Quantity representation.
Cardinality 1..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension.extension(quantityText).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Extension.extension(quantityText).extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension.extension(quantityText).url
Definition Source of the definition for the extension code - a logical name or a URL.
Cardinality 1..1
Type Uri
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.
Extension.extension(quantityText).valueString
Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
Cardinality 1..1
Type String
Extension.url
Definition Source of the definition for the extension code - a logical name or a URL.
Cardinality 1..1
Type Uri
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Structure definition: CareConnect-FamilyMemberHistory-1

Name: CareConnect-FamilyMemberHistory-1 URL: https://fhir.hl7.org.uk/StructureDefinition/CareConnect-FamilyMemberHistory-1
Version: 1.0.0 Constrained type: FamilyMemberHistory Constrained URL: http://hl7.org/fhir/FamilyMemberHistory.html Status: draft
Description: Significant health events and conditions for a person related to the patient relevant in the context of care for the patient.
Published by: HL7 UK Created date: 27/02/17 Last updated: 11/05/17 Kind: Resource
FHIR Version: DSTU2 DisplayName: Abstract: No Context type:
Copyright © 2016+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html
Name Flags Card. Type Description/Constraints
FamilyMemberHistory I 0..* Profile
Information about patient's relatives, relevant for patient
Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources
Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative
Constraint (fhs-1): Can have age[x] or born[x], but not both
id Σ I 0..1 Id
Logical id of this artifact
meta Σ I 0..1 Meta
Metadata about the resource
implicitRules Σ ?! I 0..1 Uri
A set of rules under which this content was created
language I 0..1 Code
Language of the resource content
Binding (required): A human language. ( http://tools.ietf.org/html/bcp47.html )
text I 0..1 Narrative
Text summary of the resource, for human interpretation
contained 0..* Resource
Contained, inline Resources
extension (recorder) I 0..1 Extension
Who recorded the event
extension (encounter) I 0..1 Extension
An associated encounter reference
modifierExtension ?! I 0..* Extension
Extensions that cannot be ignored
identifier Σ I 0..* Identifier
External Id(s) for this record
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
use Σ ?! I 0..1 Code
usual | official | temp | secondary (If known)
Binding (required): Identifies the purpose for this identifier, if known . ( http://hl7.org/fhir/DSTU2/valueset-identifier-use.html )
type Σ I 0..1 CodeableConcept
Description of identifier
Binding (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ( http://hl7.org/fhir/DSTU2/valueset-identifier-type.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
system Σ I 0..1 Uri
Identity of the terminology system
version Σ I 0..1 String
Version of the system - if relevant
code Σ I 0..1 Code
Symbol in syntax defined by the system
display Σ I 0..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
system Σ I 1..1 Uri
The namespace for the identifier
Example Value: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
value Σ I 1..1 String
The value that is unique
Example Value: 123456
period Σ I 0..1 Period
Time period when id is/was valid for use
Constraint (per-1): If present, start SHALL have a lower value than end
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
start Σ I 0..1 dateTime
Starting time with inclusive boundary
end Σ I 0..1 dateTime
End time with inclusive boundary, if not ongoing
assigner Σ I 0..1 Reference ( CareConnect-Organization-1 )
Organization that issued id (may be just text)
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
reference Σ I 0..1 String
Relative, internal or absolute URL reference
display Σ I 0..1 String
Text alternative for the resource
patient Σ I 1..1 Reference ( CareConnect-Patient-1 )
Patient history is about
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
reference Σ I 0..1 String
Relative, internal or absolute URL reference
display Σ I 0..1 String
Text alternative for the resource
date Σ I 0..1 dateTime
When history was captured/updated
status Σ ?! I 1..1 Code
partial | completed | entered-in-error | health-unknown
Binding (required): A code that identifies the status of the family history record. ( http://hl7.org/fhir/DSTU2/valueset-history-status.html )
name Σ I 0..1 String
The family member described
relationship Σ I 1..1 CodeableConcept
Relationship to the subject
Binding (example): The nature of the relationship between the patient and the related person being described in the family member history. ( http://hl7.org/fhir/DSTU2/v3/FamilyMember/index.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) Σ I 0..1 Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
gender Σ I 0..1 Code
male | female | other | unknown
Binding (required): The gender of a person used for administrative purposes. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-AdministrativeGender-1.html )
born[x] Σ I 0..1 Period | Date | String
(Approximate) Date Of Birth
Constraint (per-1): If present, start SHALL have a lower value than end
age[x] (Age) Σ I 0..1 Quantity ( Age ) | Range | String
(Approximate) Age
Constraint (qty-3): If a code for the unit is present, the system SHALL also be present
Constraint (age-1): There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. If value is present, it SHALL be positive.
deceased[x] I 0..1 Boolean | Quantity ( Age ) | Range | Date | String
Dead? How old/when?
note Σ I 0..1 Annotation
General note about related person
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
author[x] Σ I 0..1 Reference ( Practitioner | Patient | RelatedPerson ) | String
Individual responsible for the annotation
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
time Σ I 0..1 dateTime
When the annotation was made
text Σ I 1..1 String
The annotation - text content
condition I 0..* BackboneElement
Condition that the related person had
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
modifierExtension ?! I 0..* Extension
Extensions that cannot be ignored
code Σ I 1..1 CodeableConcept
Condition suffered by relation
Binding (example): Identification of the Condition or diagnosis. ( http://hl7.org/fhir/DSTU2/valueset-condition-code.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
outcome Σ I 0..1 CodeableConcept
deceased | permanent disability | etc.
Binding (example): The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. ( http://hl7.org/fhir/DSTU2/valueset-condition-outcome.html )
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
coding Σ I 0..* Coding
Code defined by a terminology system
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) Σ I 0..* Coding
Code defined by a terminology system
id I 0..1 Id
xml:id (or equivalent in JSON)
extension (snomedCTDescriptionID) I 0..1 Extension
The SNOMED CT Description ID for the display
system Σ I 1..1 Uri
Identity of the terminology system
Fixed Value: http://snomed.info/sct
code Σ I 1..1 Code
Symbol in syntax defined by the system
display Σ I 1..1 String
Representation defined by the system
userSelected Σ I 0..1 Boolean
If this coding was chosen directly by the user
text Σ I 0..1 String
Plain text representation of the concept
onset[x] (Age) Σ I 0..1 Quantity ( Age ) | Range | Period | String
When condition first manifested
Constraint (qty-3): If a code for the unit is present, the system SHALL also be present
Constraint (age-1): There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. If value is present, it SHALL be positive.
note Σ I 0..1 Annotation
Extra information about condition
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
author[x] Σ I 0..1 Reference ( RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1 ) | String
Individual responsible for the annotation
Constraint (ref-1): SHALL have a local reference if the resource is provided inline
time Σ I 0..1 dateTime
When the annotation was made
text Σ I 1..1 String
The annotation - text content
Name Flags Card. Type Description/Constraints
FamilyMemberHistory 0..* Profile
extension (recorder) 0..1 Extension
extension (encounter) 0..1 Extension
identifier 0..* Identifier
system 1..1 Uri
value 1..1 String
assigner 0..1 Reference ( CareConnect-Organization-1 )
patient 1..1 Reference ( CareConnect-Patient-1 )
relationship 1..1 CodeableConcept
coding 0..* Coding
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) 0..1 Coding
extension (snomedCTDescriptionID) 0..1 Extension
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String
gender 0..1 Code
Binding (required): The gender of a person used for administrative purposes. ( https://fhir.hl7.org.uk/ValueSet/CareConnect-AdministrativeGender-1.html )
condition 0..* BackboneElement
code 1..1 CodeableConcept
coding 0..* Coding
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) 0..* Coding
extension (snomedCTDescriptionID) 0..1 Extension
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String
outcome 0..1 CodeableConcept
coding 0..* Coding
Slicing: Discriminator: system, Ordering: false, Rules: open
coding (SNOMED CT) 0..* Coding
extension (snomedCTDescriptionID) 0..1 Extension
system 1..1 Uri
Fixed Value: http://snomed.info/sct
version 0..0 String
code 1..1 Code
display 1..1 String
note 0..1 Annotation
author[x] 0..1 Reference ( RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1 ) | String

Details

FamilyMemberHistory
Definition Significant health events and conditions for a person related to the patient relevant in the context of care for the patient.
Cardinality 0..*
Type Profile
Invariants Affect this element

dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (xpath: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))) severity: error

dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (xpath: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))) severity: error

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (xpath: not(parent::f:contained and f:contained)) severity: error

dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (xpath: not(parent::f:contained and f:text)) severity: error

fhs-1: Can have age[x] or born[x], but not both (xpath: not (*[starts-with(local-name(.), 'age')] and *[starts-with(local-name(.), 'birth')])) severity: error
Mappings rim: Entity. Role, or Act

v2: Not in scope for v2

rim: Observation[classCode=OBS, moodCode=EVN]

w5: clinical.general
FamilyMemberHistory.id
Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality 0..1
Type Id
Summary True
Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID.
FamilyMemberHistory.meta
Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality 0..1
Type Meta
Summary True
FamilyMemberHistory.implicitRules
Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality 0..1
Type Uri
Summary True
Modifier True
Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.
FamilyMemberHistory.language
Definition The base language in which the resource is written.
Cardinality 0..1
Binding Bcp47.html: A human language. (required)
Type Code
Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
FamilyMemberHistory.text
Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality 0..1
Type Narrative
Alternate Names narrative; html; xhtml; display
Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.
Mappings rim: Act.text?
FamilyMemberHistory.contained
Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality 0..*
Type Resource
Alternate Names inline resources; anonymous resources; contained resources
Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
Mappings rim: Entity. Role, or Act
FamilyMemberHistory.extension(recorder)
Definition Who recorded the event.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.extension(encounter)
Definition An associated encounter reference.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.modifierExtension
Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Modifier True
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.identifier
Definition This records identifiers associated with this family member history record that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Cardinality 0..*
Type Identifier
Requirements Need to allow connection to a wider workflow.
Summary True
Mappings v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)

rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]

servd: Identifier

rim: id

w5: id
FamilyMemberHistory.identifier.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.identifier.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.identifier.use
Definition The purpose of this identifier.
Cardinality 0..1
Binding ValuesetIdentifierUse.html: Identifies the purpose for this identifier, if known . (required)
Type Code
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Summary True
Modifier True
Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Mappings rim: Role.code or implied by context
FamilyMemberHistory.identifier.type
Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality 0..1
Binding ValuesetIdentifierType.html: A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. (extensible)
Type CodeableConcept
Requirements Allows users to make use of identifiers when the identifier system is not known.
Summary True
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

v2: CX.5

rim: Role.code or implied by context
FamilyMemberHistory.identifier.type.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.identifier.type.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.identifier.type.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.identifier.type.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.identifier.type.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.identifier.type.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.identifier.type.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
FamilyMemberHistory.identifier.type.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.identifier.type.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.identifier.type.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.identifier.type.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
FamilyMemberHistory.identifier.system
Definition Establishes the namespace in which set of possible id values is unique.
Cardinality 1..1
Type Uri
Requirements There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.
Summary True
Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Mappings v2: CX.4 / EI-2-4

rim: II.root or Role.id.root

servd: ./IdentifierType
FamilyMemberHistory.identifier.value
Definition The portion of the identifier typically displayed to the user and which is unique within the context of the system.
Cardinality 1..1
Type String
Summary True
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.
Mappings v2: CX.1 / EI.1

rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)

servd: ./Value
FamilyMemberHistory.identifier.period
Definition Time period during which identifier is/was valid for use.
Cardinality 0..1
Type Period
Summary True
Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Invariants Affect this element

per-1: If present, start SHALL have a lower value than end (xpath: not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)) severity: error
Mappings v2: DR

rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

v2: CX.7 + CX.8

rim: Role.effectiveTime or implied by context

servd: ./StartDate and ./EndDate
FamilyMemberHistory.identifier.period.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.identifier.period.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.identifier.period.start
Definition The start of the period. The boundary is inclusive.
Cardinality 0..1
Type dateTime
Summary True
Comments If the low element is missing, the meaning is that the low boundary is not known.
Mappings v2: DR.1

rim: ./low
FamilyMemberHistory.identifier.period.end
Definition The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Cardinality 0..1
Type dateTime
Summary True
Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Mappings v2: DR.2

rim: ./high
FamilyMemberHistory.identifier.assigner
Definition Organization that issued/manages the identifier.
Cardinality 0..1
Type Reference ( CareConnect-Organization-1 )
Summary True
Comments The reference may be just a text description of the assigner.
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

v2: CX.4 / (CX.4,CX.9,CX.10)

rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper

servd: ./IdentifierIssuingAuthority
FamilyMemberHistory.identifier.assigner.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.identifier.assigner.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.identifier.assigner.reference
Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality 0..1
Type String
Summary True
Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
FamilyMemberHistory.identifier.assigner.display
Definition Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality 0..1
Type String
Summary True
Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
FamilyMemberHistory.patient
Definition The person who this history concerns.
Cardinality 1..1
Type Reference ( CareConnect-Patient-1 )
Alternate Names Proband
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

rim: participation[typeCode=SBJ].role

w5: who.focus
FamilyMemberHistory.patient.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.patient.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.patient.reference
Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality 0..1
Type String
Summary True
Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
FamilyMemberHistory.patient.display
Definition Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality 0..1
Type String
Summary True
Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
FamilyMemberHistory.date
Definition The date (and possibly time) when the family member history was taken.
Cardinality 0..1
Type dateTime
Requirements Allows determination of how current the summary is.
Summary True
Comments This should be captured even if the same as the date on the List aggregating the full family history.
Mappings rim: participation[typeCode=AUT].time

w5: when.recorded
FamilyMemberHistory.status
Definition A code specifying a state of a Family Member History record.
Cardinality 1..1
Binding ValuesetHistoryStatus.html: A code that identifies the status of the family history record. (required)
Type Code
Summary True
Modifier True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings w5: status
FamilyMemberHistory.name
Definition This will either be a name or a description; e.g. "Aunt Susan", "my cousin with the red hair".
Cardinality 0..1
Type String
Requirements Allows greater ease in ensuring the same person is being talked about.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings rim: name
FamilyMemberHistory.relationship
Definition The type of relationship this person has to the patient (father, mother, brother etc.).
Cardinality 1..1
Binding Index.html: The nature of the relationship between the patient and the related person being described in the family member history. (example)
Type CodeableConcept
Summary True
Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rim: code
FamilyMemberHistory.relationship.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.relationship.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.relationship.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Slicing This element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: system
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.relationship.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.relationship.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.relationship.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.relationship.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
FamilyMemberHistory.relationship.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.relationship.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.relationship.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.relationship.coding(SNOMED CT)
Definition A reference to a code defined by a terminology system.
Cardinality 0..1
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.relationship.coding(SNOMED CT).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.relationship.coding(SNOMED CT).extension(snomedCTDescriptionID)
Definition The SNOMED CT Description ID for the display.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.relationship.coding(SNOMED CT).system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.relationship.coding(SNOMED CT).code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.relationship.coding(SNOMED CT).display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.relationship.coding(SNOMED CT).userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.relationship.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
FamilyMemberHistory.gender
Definition Administrative Gender - the gender that the relative is considered to have for administration and record keeping purposes.
Cardinality 0..1
Binding CareConnectAdministrativeGender1.html: The gender of a person used for administrative purposes. (required)
Type Code
Requirements Not all relationship codes imply gender and the relative's gender can be relevant for risk assessments.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
FamilyMemberHistory.born[x]
Definition The actual or approximate date of birth of the relative.
Cardinality 0..1
Type Period | Date | String
Requirements Allows calculation of the relative's age.
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
Invariants Affect this element

per-1: If present, start SHALL have a lower value than end (xpath: not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)) severity: error
Mappings v2: DR

rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

rim: player[classCode=LIV, determinerCode=INSTANCE]. birthDate (could be URG)
FamilyMemberHistory.age[x]
Definition The actual or approximate age of the relative at the time the family member history is recorded.
Cardinality 0..1
Type Quantity ( Age ) | Range | String
Requirements While age can be calculated from date of birth, sometimes recording age directly is more natureal for clinicians.
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants Affect this element

qty-3: If a code for the unit is present, the system SHALL also be present (xpath: not(exists(f:code)) or exists(f:system)) severity: error

age-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. If value is present, it SHALL be positive. (xpath: (f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org') and not(contains(f:value/@value, '-'))) severity: error
Mappings v2: SN (see also Range) or CQ

rim: PQ, IVL<PQ>, MO, CO, depending on the values

rim: participation[typeCode=SBJ].act[classCode=OBS,moodCode=EVN, code="age"].value
FamilyMemberHistory.deceased[x]
Definition Deceased flag or the actual or approximate age of the relative at the time of death for the family member history record.
Cardinality 0..1
Type Boolean | Quantity ( Age ) | Range | Date | String
[x] Note See Choice of Data Types for further information about how to use [x]
Mappings rim: player[classCode=LIV, determinerCode=INSTANCE].deceasedInd, deceasedDate (could be URG) For age, you'd hang an observation off the role
FamilyMemberHistory.note
Definition This property allows a non condition-specific note to the made about the related person. Ideally, the note would be in the condition property, but this is not always possible.
Cardinality 0..1
Type Annotation
Summary True
Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Mappings rim: Act

rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value
FamilyMemberHistory.note.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.note.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.note.author[x]
Definition The individual responsible for making the annotation.
Cardinality 0..1
Type Reference ( Practitioner | Patient | RelatedPerson ) | String
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

rim: Act.participant[typeCode=AUT].role
FamilyMemberHistory.note.time
Definition Indicates when this particular annotation was made.
Cardinality 0..1
Type dateTime
Summary True
Mappings rim: Act.effectiveTime
FamilyMemberHistory.note.text
Definition The text of the annotation.
Cardinality 1..1
Type String
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings rim: Act.text
FamilyMemberHistory.condition
Definition The significant Conditions (or condition) that the family member had. This is a repeating section to allow a system to represent more than one condition per resource, though there is nothing stopping multiple resources - one per condition.
Cardinality 0..*
Type BackboneElement
Comments If none of the conditions listed have an outcome of "death" specified, that indicates that none of the specified conditions are known to have been the primary cause of death.
Mappings rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION, value<Diagnosis]
FamilyMemberHistory.condition.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.modifierExtension
Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content; modifiers
Modifier True
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.code
Definition The actual condition specified. Could be a coded condition (like MI or Diabetes) or a less specific string like 'cancer' depending on how much is known about the condition and the capabilities of the creating system.
Cardinality 1..1
Binding ValuesetConditionCode.html: Identification of the Condition or diagnosis. (example)
Type CodeableConcept
Summary True
Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rim: .value
FamilyMemberHistory.condition.code.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.code.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.code.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Slicing This element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: system
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.condition.code.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.code.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.code.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.condition.code.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
FamilyMemberHistory.condition.code.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.condition.code.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.condition.code.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.condition.code.coding(SNOMED CT)
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.condition.code.coding(SNOMED CT).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.code.coding(SNOMED CT).extension(snomedCTDescriptionID)
Definition The SNOMED CT Description ID for the display.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.code.coding(SNOMED CT).system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.condition.code.coding(SNOMED CT).code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.condition.code.coding(SNOMED CT).display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.condition.code.coding(SNOMED CT).userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.condition.code.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
FamilyMemberHistory.condition.outcome
Definition Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relation.
Cardinality 0..1
Binding ValuesetConditionOutcome.html: The result of the condition for the patient; e.g. death, permanent disability, temporary disability, etc. (example)
Type CodeableConcept
Summary True
Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Mappings v2: CE/CNE/CWE

rim: CD

orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rim: outboundRelationship[typeCode=OUTC)].target[classCode=OBS, moodCode=EVN, code=ActCode#ASSERTION].value
FamilyMemberHistory.condition.outcome.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.outcome.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.outcome.coding
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Slicing This element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: system
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.condition.outcome.coding.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.outcome.coding.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.outcome.coding.system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 0..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.condition.outcome.coding.version
Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality 0..1
Type String
Summary True
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Mappings v2: C*E.7

rim: ./codeSystemVersion

orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
FamilyMemberHistory.condition.outcome.coding.code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 0..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.condition.outcome.coding.display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 0..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.condition.outcome.coding.userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.condition.outcome.coding(SNOMED CT)
Definition A reference to a code defined by a terminology system.
Cardinality 0..*
Type Coding
Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Summary True
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.
Mappings v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

rim: CV

orim: fhir:Coding rdfs:subClassOf dt:CDCoding

v2: C*E.1-8, C*E.10-22

rim: union(., ./translation)

orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
FamilyMemberHistory.condition.outcome.coding(SNOMED CT).id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.outcome.coding(SNOMED CT).extension(snomedCTDescriptionID)
Definition The SNOMED CT Description ID for the display.
Cardinality 0..1
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.outcome.coding(SNOMED CT).system
Definition The identification of the code system that defines the meaning of the symbol in the code.
Cardinality 1..1
Type Uri
Requirements Need to be unambiguous about the source of the definition of the symbol.
Summary True
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Mappings v2: C*E.3

rim: ./codeSystem

orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
FamilyMemberHistory.condition.outcome.coding(SNOMED CT).code
Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality 1..1
Type Code
Requirements Need to refer to a particular code in the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.1

rim: ./code

orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
FamilyMemberHistory.condition.outcome.coding(SNOMED CT).display
Definition A representation of the meaning of the code in the system, following the rules of the system.
Cardinality 1..1
Type String
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings v2: C*E.2 - but note this is not well followed

rim: CV.displayName

orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
FamilyMemberHistory.condition.outcome.coding(SNOMED CT).userSelected
Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality 0..1
Type Boolean
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Summary True
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Mappings v2: Sometimes implied by being first

rim: CD.codingRationale

orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
FamilyMemberHistory.condition.outcome.text
Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality 0..1
Type String
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Summary True
Comments Very often the text is the same as a displayName of one of the codings.
Mappings v2: C*E.9. But note many systems use C*E.2 for this

rim: ./originalText[mediaType/code="text/plain"]/data

orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
FamilyMemberHistory.condition.onset[x]
Definition Either the age of onset, range of approximate age or descriptive string can be recorded. For conditions with multiple occurrences, this describes the first known occurrence.
Cardinality 0..1
Type Quantity ( Age ) | Range | Period | String
Requirements Age of onset of a condition in relatives is predictive of risk for the patient.
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants Affect this element

qty-3: If a code for the unit is present, the system SHALL also be present (xpath: not(exists(f:code)) or exists(f:system)) severity: error

age-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. If value is present, it SHALL be positive. (xpath: (f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org') and not(contains(f:value/@value, '-'))) severity: error
Mappings v2: SN (see also Range) or CQ

rim: PQ, IVL<PQ>, MO, CO, depending on the values

rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="Subject Age at measurement", value<Diagnosis].value[@xsi:typeCode='TS' or 'IVL_TS'] Use originalText for string
FamilyMemberHistory.condition.note
Definition An area where general notes can be placed about this specific condition.
Cardinality 0..1
Type Annotation
Summary True
Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Mappings rim: Act

rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=ActCode#ANNGEN].value
FamilyMemberHistory.condition.note.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
FamilyMemberHistory.condition.note.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
FamilyMemberHistory.condition.note.author[x]
Definition The individual responsible for making the annotation.
Cardinality 0..1
Type Reference ( RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1 ) | String
[x] Note See Choice of Data Types for further information about how to use [x]
Summary True
Invariants Affect this element

ref-1: SHALL have a local reference if the resource is provided inline (xpath: not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])) severity: error
Mappings rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

rim: Act.participant[typeCode=AUT].role
FamilyMemberHistory.condition.note.time
Definition Indicates when this particular annotation was made.
Cardinality 0..1
Type dateTime
Summary True
Mappings rim: Act.effectiveTime
FamilyMemberHistory.condition.note.text
Definition The text of the annotation.
Cardinality 1..1
Type String
Summary True
Comments Note that FHIR strings may not exceed 1MB in size
Mappings rim: Act.text

Bindings

Path Definition Type Reference
FamilyMemberHistory.language The base language in which the resource is written. required http://tools.ietf.org/html/bcp47.html
FamilyMemberHistory.identifier.use The purpose of this identifier. required http://hl7.org/fhir/DSTU2/valueset-identifier-use.html
FamilyMemberHistory.identifier.type A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. extensible http://hl7.org/fhir/DSTU2/valueset-identifier-type.html
FamilyMemberHistory.status A code specifying a state of a Family Member History record. required http://hl7.org/fhir/DSTU2/valueset-history-status.html
FamilyMemberHistory.relationship The type of relationship this person has to the patient (father, mother, brother etc.). example http://hl7.org/fhir/DSTU2/v3/FamilyMember/index.html
FamilyMemberHistory.gender Administrative Gender - the gender that the relative is considered to have for administration and record keeping purposes. required https://fhir.hl7.org.uk/ValueSet/CareConnect-AdministrativeGender-1.html
FamilyMemberHistory.condition.code The actual condition specified. Could be a coded condition (like MI or Diabetes) or a less specific string like 'cancer' depending on how much is known about the condition and the capabilities of the creating system. example http://hl7.org/fhir/DSTU2/valueset-condition-code.html
FamilyMemberHistory.condition.outcome Indicates what happened as a result of this condition. If the condition resulted in death, deceased date is captured on the relation. example http://hl7.org/fhir/DSTU2/valueset-condition-outcome.html

Structure definition: encounter-associatedEncounter

Name: encounter-associatedEncounter URL: http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter
Version: 1.0.0 Constrained type: Extension Constrained URL: http://hl7.org/fhir/extensibility.html#extension Status: draft
Description: This encounter occurs within the scope of the referenced encounter.
Published by: Created date: 28/02/17 Last updated: 06/06/17 Kind: Datatype
FHIR Version: DSTU2 DisplayName: Abstract: No Context type: resource
Use context: AllergyIntolerance, FamilyMemberHistory
Copyright © Health Level Seven, Inc. - FHIR WG
Name Flags Card. Type Description/Constraints
Extension I 0..* Profile
An associated encounter reference
Constraint (ele-1): All FHIR elements must have a @value or children
id I 0..1 Id
xml:id (or equivalent in JSON)
extension I 0..* Extension
Additional Content defined by implementations
url I 1..1 Uri
Identifies The Meaning Of The Extension
valueReference I 0..1 Reference ( Encounter )
Associated Encounter: This encounter occurs within the scope of the referenced encounter.
Name Flags Card. Type Description/Constraints
Extension 0..* Profile
An associated encounter reference
url 1..1 Uri
valueReference 0..1 Reference ( Encounter )
Associated Encounter: This encounter occurs within the scope of the referenced encounter.

Details

Extension
Definition An associated encounter reference.
Cardinality 0..*
Type Profile
Invariants Affect this element

ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div) severity: error
Extension.id
Definition unique id for the element within a resource (for internal references).
Cardinality 0..1
Type Id
Comments RFC 4122
Extension.extension
Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality 0..*
Type Extension
Alternate Names extensions; user content
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension.url
Definition Source of the definition for the extension code - a logical name or a URL.
Cardinality 1..1
Type Uri
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.
Extension.valueReference
Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
Cardinality 0..1
Type Reference ( Encounter )