This Finnish base profile for the Reason for Care Condition resource is still very early in development, and implementer feedback is appreciated in many aspects. There are many TODO parts intentionally left in this draft version. See also the foreseen further development needs below.

Scope and Usage

This profile describes Diagnosis -based conditions and Finnish kayntisyy. These are Condition resources that are asserted by a healthcare professional and directly related to encounters. This profile does not describe how to communicate problem-list-item -level conditions.

THL has a data model for Finnish diagnosis (including käyntisyy) in code server: THL/Tietosisältö - Diagnoosit (“THL specification”).

For high level documentation, see Tiedonhallintapalvelun periaatteet ja toiminnallinen määrittely 2021, versio 1.2.

This profile SHOULD NOT be used to describe reason given by patient for requesting/acquiring healthcare service. Finnish tulosyy.

Separating between Diagnosis -based conditions and Finnish käyntisyy

Reason for care may be a diagnosis asserted by a clinician / medical doctor or some other reason for visit that is asserted by an nurse or some other healthcare professional.

A reason for care condition needs to be categorized to make the distinction between clinician asserted diagnosis and other käyntisyy conditions. When reason for care is a clinician asserted diagnosis it MUST contain another category code encounter-diagnosis. When condition is not asserted by a clincian it MUST NOT contain encounter-diagnosis category code.

Categories match to THL specification in following way:

• when additionally encounter-diagnosis is present –> This is a diagnosis and is not a käyntisyy
  • In THL specification, codeId 23: Käyntisyy has value False
• when encounter-diagnosis is not present –> This is a käyntisyy
  • In THL specification, codeId 23: Käyntisyy has value True

Diagnosis Code Systems

When using Finnish ICD-10 it’s usage has special rules. These are described below. For reference and detailed specifications, see Potilastiedon arkiston Kertomus ja lomakkeet version 5.11 or later.

Diagnosis code (reason)

code SHALL only contain the reason code.

When using Finnish ICD-10, the code MUST NOT contain special characters (+,&,# after the code indicate reason). Pre-built pairs (like E85.9+I68.0) SHALL be broken down to constituent parts and the code part indicating reason (in case of E85.9+I68.0, Koodi1 field) used here.

In THL specification, this data is codeId 1: Diagnoosi.

In THL specification, there is another codeId 6: “ICD-10 -vastaavuuskoodi ICPC-koodille”. This MAY be in code (it’s the same code, but coded in another code system, so repetition of code is ok). Other codes, like symptom and accident type SHOULD NOT be repetitions of code.

More than one code may be used in code (in code’s repetitions of coding). code itself cannot be repeated. Currently ICD-10, ICPC2 are supported by THL, in near future ICD-11, SNOMED and ORPHA will become supported too). Additional codes may be expressed by repeating coding. Other codes like sympton SHOULD not be communicated via code, repetitions should represent the same concept (see CodeableConcept datatype specification).

Here’s a valid example of repeating code.coding (code is not repeating, but coding has repetitions expressing the same information in two code systems):

  "code" : {
    "coding" : [
      {
        "system" : "1.2.246.537.6.1.1999",
        "code" : "H36.03",
        "display" : "Proliferatiivinen diabeettinen retinopatia"
      },
      {
        "system" : "1.2.246.537.6.31.2007",
        "code" : "F83",
        "display" : "Retinopatia, verkkokalvon rappeuma"
      }
    ],
    "text" : "..."
  }

Symptom code

Symptom code SHOULD be communicated via evidence.

When using Finnish ICD-10, code MUST NOT contain special characters (+ after the code and * before code indicates symptom). Pre-built pairs (like E85.9+I68.0) code . SHALL be broken down to constituent parts and the code part indicating symptom (in case of in case of E85.9+I68.0, Koodi2 field) used here.

For example:

"evidence" : [
    {
      "code" : [
        {
          "coding" : [
            {
              "system" : "1.2.246.537.6.1.1999",
              "code" : "E11.3",
              "display" : "Aikuistyypin diabetes diabeteksen silmäkomplikaatiot"
            }
          ]
        }
      ]
    }
  ]

In THL specification, this data is codeId 26: Diagnoosin tai käyntisyyn oirekoodi.

When name differs from code.display

Medical doctor may make some adjustments to the name of the diagnosis. code.display MUST be the original name from the codesystem and code.text MAY contain adjusted name for the diagnosis.

In THL specification, this data is codeId 21: Diagnoosin tai käyntisyyn nimi.

Primary/main diagnosis (or käyntisyy)

Extension primaryCondition is used to express whether this is the primary/main condition for encounter.

Extension is a code from terminology “AR/YDIN - Diagnoosin /toimenpiteen ensisijaisuus” (1.2.246.537.5.40005.2003).

In THL specification, this data is codeId 2: Diagnoosin tai käyntisyyn ensisijaisuus.

Permanence (finnish “pysyvyys”)

Extension permanence is used to express the condition is permanent or not.

Extension is a code from terminology “AR/YDIN - Pysyvyys” (1.2.246.537.5.40003.2003).

This information has some relation to clinicalStatus, but “AR/YDIN - Pysyvyys” can’t be mapped to clinicalStatus codes (doing so would redefine clinicalStatus).

In THL specification, this data is codeId 8: Diagnoosin pysyvyys.

Onset

Standard onset SHOULD be used.

In THL specification, this data is codeId 12: Diagnoosin tai käyntisyyn toteamispäivä.

Abatement

Standard abatement MAY be used.

In THL specification, this data is codeId 16: Diagnoosin päättymispäivä.

Asserter

Standard asserter MAY be used.

When asserter references a Practitioner, it can provide information for codeId 11: Toteajan nimi in THL specification. When asserter references a PractitionerRole, it can provide information for both codeId 11: Toteajan nimi and codeId 19: Toteajan palveluyksikkö.

Type of physical exercise during which injury occurred

Extension physicalExcercise.

TODO add example.

In THL specification, this data is codeId: 24 Tapaturman liikuntalaji.

Endocrinological disorder

Extension endocrinologicalDisorder.

TODO add example.

In THL specification, this data is codeId: 27 Endokrinologisen häiriön koodi.

Medication that caused this condition

Extension conditionCausedByMedication

In THL specification, this data is codeId: 28 Aiheuttajan ATC-koodi

External cause for diagnosis

Extension conditionExternalCause

In THL specification, this data is codeId: 3 Diagnoosin ulkoinen syy

Categorization of the type of accident

Extension conditionCategorizationOfAccident

In THL specification, this data is codeId: 4 Diagnoosin tapaturmatyyppi

Cause of an adverse effect

Extension causeOfAdverseEffect

In THL specification, this data is codeId: 5 Haittavaikutuksen aiheuttaja

Further development needs

Finnish diagnosis has some data that is not yet modeled in this profile. There is more modeling and mapping work to be done. Following list contains most relevant parts that need work:

• Use of problem-list-item for long term diagnosis (“Pitkäaikaisdiagnoosi” or “Pysyvä diagnoosi” in finnish)? The conceptual mapping is not staightforward.
• THL Tietosisältö 10 Tiedon lähde
  • extension?
• THL Tietosisältö 15 Diagnoosin päättymisen toteajan nimi
• THL Tietosisältö 17 Diagnoosin päättymisen syy
• THL Tietosisältö 18 Diagnoosin päättymisen syyn tarkenne
• THL Tietosisältö 20 Diagnoosin päättymisen toteajan palveluyksikkö
• THL Tietosisältö 22 Episodin nimi
• THL Tietosisältö 7 Diagnoosin tai käyntisyyn varmuusaste
  • map to verificationStatus codes?
• THL Tietosisältö 9 Diagnoosin tai käyntisyyn episoditunnus

Links

• Suomalainen tautien kirjaamisen ohjekirja national guide for the use if ICD-10.

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

This structure is derived from FiBaseCondition

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	FiBaseCondition	Detailed information about conditions, problems or diagnoses
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
causeOfAdverseEffect		0..1	Coding	Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	FiBaseCondition	Detailed information about conditions, problems or diagnoses
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
causeOfAdverseEffect		0..1	Coding	Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | 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	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
subject	SΣ	1..1	Reference(FI Base Patient)	Who has the condition?
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.code	example	Condition/Problem/DiagnosisCodes

Constraints

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

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	FiBaseCondition	Detailed information about conditions, problems or diagnoses
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
causeOfAdverseEffect		0..1	Coding	Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | 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	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject	SΣ	1..1	Reference(FI Base Patient)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
onset[x]	Σ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	C	0..1		When in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	Σ	0..1	dateTime	Date record was first recorded
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Supporting evidence
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.severity	preferred	Condition/DiagnosisSeverity
Condition.code	example	Condition/Problem/DiagnosisCodes
Condition.bodySite	example	SNOMEDCTBodyStructures
Condition.stage.summary	example	ConditionStage
Condition.stage.type	example	ConditionStageType
Condition.evidence.code	example	ManifestationAndSymptomCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
con-1	error	Condition.stage	Stage SHALL have summary or assessment : summary.exists() or assessment.exists()
con-2	error	Condition.evidence	evidence SHALL have code or details : code.exists() or detail.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from FiBaseCondition

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	FiBaseCondition	Detailed information about conditions, problems or diagnoses
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
causeOfAdverseEffect		0..1	Coding	Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	FiBaseCondition	Detailed information about conditions, problems or diagnoses
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
causeOfAdverseEffect		0..1	Coding	Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | 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	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
subject	SΣ	1..1	Reference(FI Base Patient)	Who has the condition?
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.code	example	Condition/Problem/DiagnosisCodes

Constraints

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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	FiBaseCondition	Detailed information about conditions, problems or diagnoses
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
causeOfAdverseEffect		0..1	Coding	Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	0..1	CodeableConcept	unconfirmed | 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	S	0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject	SΣ	1..1	Reference(FI Base Patient)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
onset[x]	Σ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	C	0..1		When in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	Σ	0..1	dateTime	Date record was first recorded
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Supporting evidence
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes
Condition.verificationStatus	required	ConditionVerificationStatus
Condition.category	extensible	ConditionCategoryCodes
Condition.severity	preferred	Condition/DiagnosisSeverity
Condition.code	example	Condition/Problem/DiagnosisCodes
Condition.bodySite	example	SNOMEDCTBodyStructures
Condition.stage.summary	example	ConditionStage
Condition.stage.type	example	ConditionStageType
Condition.evidence.code	example	ManifestationAndSymptomCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
con-1	error	Condition.stage	Stage SHALL have summary or assessment : summary.exists() or assessment.exists()
con-2	error	Condition.evidence	evidence SHALL have code or details : code.exists() or detail.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from FiBaseCondition

Summary

Extensions

This structure refers to these extensions:

• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
• https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect