HL7 FHIR Implementation Guide: Transversal Clinical Core
1.0.0 - STU1

This page is part of the HL7 Belgium FHIR Implementation Guide - Core clinical profiles - transversal (v1.0.0: Trial Use) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: BeProblem

Official URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-problem Version: 1.0.0
Active as of 2021-01-10 Maturity Level: 1 Responsible: eHealth Platform Realm: BE Computable Name: BeProblem

Belgian federal profile. Initially based on the functional description of the NIHDI. Defines a patient’s known problem, a diagnostic or antecedent that deserves attention.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

This structure is derived from Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..*ConditionDetailed information about conditions, problems or diagnoses
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... be-ext-problem-origin-type S0..1codeBeExtProblemOriginType
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-problem-origin-type
Binding: Problem Origin Type (required)
... identifier S0..*IdentifierExternal Ids for this condition
... verificationStatus S0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: Problem Category (extensible)
... code S1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Code (extensible)
... bodySite S0..*CodeableConceptAnatomical location, if relevant
Binding: Body Site (required)
.... be-ext-laterality 0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
... subject S1..1Reference(BePatient)Who has the condition?
... encounter S0..1Reference(Encounter)Encounter created as part of
... onset[x] S0..1dateTime, Age, Period, Range, stringEstimated or actual date, date-time, or age
... abatement[x] S0..1dateTime, Age, Period, Range, stringWhen in resolution/remission
... recordedDate S1..1dateTimeDate record was first recorded
... recorder S1..1Reference(BePractitioner | BePractitionerRole | BePatient)Who recorded the condition
... asserter 0..1Reference(RelatedPerson | BePractitioner | BePractitionerRole | BePatient)Person who asserts this condition
... note S0..*AnnotationAdditional information about the Condition

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*ConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... be-ext-problem-origin-type S0..1codeBeExtProblemOriginType
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-problem-origin-type
Binding: Problem Origin Type (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: Problem Category (extensible)
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code SΣ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Code (extensible)
... bodySite SΣ0..*CodeableConceptAnatomical location, if relevant
Binding: Body Site (required)
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... be-ext-laterality 0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(BePatient)Who has the condition?
... encounter SΣ0..1Reference(Encounter)Encounter created as part of
... onset[x] SΣ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] SI0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate SΣ1..1dateTimeDate record was first recorded
... recorder SΣ1..1Reference(BePractitioner | BePractitionerRole | BePatient)Who recorded the condition
... asserter Σ0..1Reference(RelatedPerson | BePractitioner | BePractitionerRole | BePatient)Person who asserts this condition
... stage I0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary I0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment I0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type 0..1CodeableConceptKind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence I0..*BackboneElementSupporting evidence
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note S0..*AnnotationAdditional information about the Condition

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*ConditionDetailed information about conditions, problems or diagnoses
... be-ext-problem-origin-type 0..1codeBeExtProblemOriginType
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-problem-origin-type
Binding: Problem Origin Type (required)
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!ΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... category 1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: Problem Category (extensible)
... code Σ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Code (extensible)
... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
Binding: Body Site (required)
... subject Σ1..1Reference(BePatient)Who has the condition?
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... onset[x] Σ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate Σ1..1dateTimeDate record was first recorded
... recorder Σ1..1Reference(BePractitioner | BePractitionerRole | BePatient)Who recorded the condition
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Differential View

This structure is derived from Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..*ConditionDetailed information about conditions, problems or diagnoses
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... be-ext-problem-origin-type S0..1codeBeExtProblemOriginType
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-problem-origin-type
Binding: Problem Origin Type (required)
... identifier S0..*IdentifierExternal Ids for this condition
... verificationStatus S0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: Problem Category (extensible)
... code S1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Code (extensible)
... bodySite S0..*CodeableConceptAnatomical location, if relevant
Binding: Body Site (required)
.... be-ext-laterality 0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
... subject S1..1Reference(BePatient)Who has the condition?
... encounter S0..1Reference(Encounter)Encounter created as part of
... onset[x] S0..1dateTime, Age, Period, Range, stringEstimated or actual date, date-time, or age
... abatement[x] S0..1dateTime, Age, Period, Range, stringWhen in resolution/remission
... recordedDate S1..1dateTimeDate record was first recorded
... recorder S1..1Reference(BePractitioner | BePractitionerRole | BePatient)Who recorded the condition
... asserter 0..1Reference(RelatedPerson | BePractitioner | BePractitionerRole | BePatient)Person who asserts this condition
... note S0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*ConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... be-ext-problem-origin-type S0..1codeBeExtProblemOriginType
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-problem-origin-type
Binding: Problem Origin Type (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: Problem Category (extensible)
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code SΣ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Code (extensible)
... bodySite SΣ0..*CodeableConceptAnatomical location, if relevant
Binding: Body Site (required)
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... be-ext-laterality 0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(BePatient)Who has the condition?
... encounter SΣ0..1Reference(Encounter)Encounter created as part of
... onset[x] SΣ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] SI0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate SΣ1..1dateTimeDate record was first recorded
... recorder SΣ1..1Reference(BePractitioner | BePractitionerRole | BePatient)Who recorded the condition
... asserter Σ0..1Reference(RelatedPerson | BePractitioner | BePractitionerRole | BePatient)Person who asserts this condition
... stage I0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary I0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment I0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type 0..1CodeableConceptKind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence I0..*BackboneElementSupporting evidence
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note S0..*AnnotationAdditional information about the Condition

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
Condition.languagepreferredCommonLanguages
Max Binding: AllLanguages
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleBeVSProblemCategory
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.codeextensibleBeVSProblemCode
Condition.bodySiterequiredBeVSBodySite
Condition.stage.summaryexampleConditionStage
Condition.stage.typeexampleConditionStageType
Condition.evidence.codeexampleManifestationAndSymptomCodes

Constraints

IdGradePathDetailsRequirements
con-3Best PracticeConditionCondition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
: clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorConditionIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6Best PracticeConditionA resource should have narrative for robust management
: text.`div`.exists()
ele-1errorCondition.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.extension:ProblemOriginTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.extension:ProblemOriginTypeMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.clinicalStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.verificationStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.severityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.bodySite.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.bodySite.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.bodySite.extension:lateralityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.bodySite.extension:lateralityMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.bodySite.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.bodySite.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.onset[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.abatement[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.recordedDateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.asserterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
ele-1errorCondition.stageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.stage.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.stage.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.stage.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.stage.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.stage.summaryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.stage.assessmentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.stage.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
ele-1errorCondition.evidenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.evidence.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.evidence.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.evidence.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCondition.evidence.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCondition.evidence.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.evidence.detailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCondition.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())