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 a symptom 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" : "urn:oid:1.2.246.537.6.1",
        "version" : "1999",
        "code" : "H36.03",
        "display" : "Proliferatiivinen diabeettinen retinopatia"
      },
      {
        "system" : "urn:oid:1.2.246.537.6.31",
        "version" : "2007",
        "code" : "F83",
        "display" : "Retinopatia, verkkokalvon rappeuma"
      }
    ],
    "text" : "..."
  }

Symptom code

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

Symptom code SHOULD be communicated via evidence.

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

For example:

"evidence" : [
    {
      "code" : [
        {
          "coding" : [
            {
              "system" : "urn:oid:1.2.246.537.6.1",
              "version" : "1999",
              "code" : "E11.3",
              "display" : "Aikuistyypin diabetes diabeteksen silmäkomplikaatiot"
            }
          ]
        }
      ]
    }
  ]

Name of diagnosis

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

A practitioner may make some adjustments to the name of the diagnosis. code.coding.display SHALL still be the original name from the codesystem and code.text MAY contain an adjusted name for the diagnosis.

Primary diagnosis (käyntisyy)

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

Extension primaryCondition is used to express whether this diagnosis is the primary condition for why the encounter takes place.

The extension SHALL have a code from "AR/YDIN - Diagnoosin /toimenpiteen ensisijaisuus" (oid 1.2.246.537.5.40005).

Permanence (pysyvyys)

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

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

The extension SHALL have a code from "AR/YDIN - Pysyvyys" (oid 1.2.246.537.5.40003).

This information has some relation to clinicalStatus, but "AR/YDIN - Pysyvyys" cannot be mapped to clinicalStatus codes (doing so would redefine clinicalStatus).

Onset

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

Standard onset SHOULD be used.

Abatement

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

Standard abatement MAY be used.

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

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

Extension physicalExcercise is used.

Endocrinological disorder

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

Extension endocrinologicalDisorder is used.

Medication that caused this condition

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

Extension conditionCausedByMedication is used.

External cause for diagnosis

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

Extension conditionExternalCause is used.

Categorization of the type of accident

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

Extension conditionCategorizationOfAccident is used.

Cause of an adverse effect

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

Extension causeOfAdverseEffect is used.

Further development needs

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	FiBaseCondition(2.0.0-ci)	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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
extension:primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
extension:permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
extension:physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
extension:endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
extension:conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
extension:conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
extension:conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
extension: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	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!ΣC	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.
subject	Σ	1..1	Reference(FI Base Patient(2.0.0-ci))	Who has the condition?
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.

Constraints

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

This structure is derived from FiBaseCondition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition		0..*	FiBaseCondition(2.0.0-ci)	Detailed information about conditions, problems or diagnoses
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
extension:permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
extension:physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
extension:endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
extension:conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
extension:conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
extension:conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
extension: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    Filter: Bindings Constraints Obligations
Condition	C	0..*	FiBaseCondition(2.0.0-ci)	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
extension:permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
extension:physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
extension:endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
extension:conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
extension:conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
extension:conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
extension: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	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!ΣC	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		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	Σ	0..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	Σ	1..1	Reference(FI Base Patient(2.0.0-ci))	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 Constraints: con-1
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 Constraints: con-2
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	Status	Usage	ValueSet	Version	Source
Condition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Condition.stage.summary	Base	example	Condition Stage	📍4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📍4.0.1	FHIR Std.
Condition.evidence.code	Base	example	Manifestation and Symptom Codes	📍4.0.1	FHIR Std.

Constraints

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

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	FiBaseCondition(2.0.0-ci)	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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
extension:primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
extension:permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
extension:physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
extension:endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
extension:conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
extension:conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
extension:conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
extension: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	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!ΣC	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.
subject	Σ	1..1	Reference(FI Base Patient(2.0.0-ci))	Who has the condition?
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.

Constraints

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

Differential View

This structure is derived from FiBaseCondition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition		0..*	FiBaseCondition(2.0.0-ci)	Detailed information about conditions, problems or diagnoses
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
extension:permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
extension:physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
extension:endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
extension:conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
extension:conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
extension:conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
extension: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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	FiBaseCondition(2.0.0-ci)	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:primaryCondition		0..1	Coding	Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary
extension:permanence		0..1	Coding	Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence
extension:physicalExcercise		0..1	Coding	Type of physical exercise during which injury occurred. URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-physical-excercise
extension:endocrinologicalDisorder		0..1	Coding	Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder
extension:conditionCausedByMedication		0..1	Coding	Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication
extension:conditionExternalCause		0..1	Coding	External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause
extension:conditionCategorizationOfAccident		0..1	Coding	Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident
extension: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	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!ΣC	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		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	Σ	0..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	Σ	1..1	Reference(FI Base Patient(2.0.0-ci))	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 Constraints: con-1
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 Constraints: con-2
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	Status	Usage	ValueSet	Version	Source
Condition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Condition.stage.summary	Base	example	Condition Stage	📍4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📍4.0.1	FHIR Std.
Condition.evidence.code	Base	example	Manifestation and Symptom Codes	📍4.0.1	FHIR Std.

Constraints

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

This structure is derived from 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