CA Core+ v1.1.0 DFT-preBallot
1.1.0-DFT-preBallot 
DFT-preBallot - The specification is a DFT-preBallot version of CA Core+ for collecting community feedback. For a full list of available versions, see the Directory of published versions
Condition (CA-Core)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/Condition
Examples
example-condition-ca-core, example-condition-ca-core2
Description
This profile applies constraints to the Condition resource for CA Core+ to support recording clinical conditions and health concerns in the pan-Canadian context.
References to this resource
AppointmentCACore, CommunicationCACore, EncounterCACore, FamilyMemberHistoryCACore, ImmunizationCACore
CFMM: 2
Resource Content
| ConditionCACore (Condition) | C | Condition | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| clinicalStatus | O Σ ?! C | 0..1 | CodeableConceptBinding |
| verificationStatus | Σ ?! C | 0..1 | CodeableConceptBinding |
| category | 0..* | CodeableConceptCACoreBinding | |
| severity | 0..1 | CodeableConceptCACoreBinding | |
| code | O Σ | 0..1 | CodeableConceptCACoreBinding |
| bodySite | Σ | 0..* | CodeableConceptCACoreBinding |
| subject | Σ | 1..1 | Reference(PatientCACore | Group) |
| encounter | Σ | 0..1 | Reference(EncounterCACore) |
| onset[x] | O Σ | 0..1 | |
| onsetAge | Age | ||
| onsetPeriod | Period | ||
| onsetRange | Range | ||
| onsetString | string | ||
| onsetDateTime | Σ | 0..1 | dateTime |
| abatement[x] | C | 0..1 | |
| abatementDateTime | dateTime | ||
| abatementAge | Age | ||
| abatementPeriod | Period | ||
| abatementRange | Range | ||
| abatementString | string | ||
| recordedDate | Σ | 0..1 | dateTime |
| recorder | Σ | 0..1 | Reference(PractitionerCACore | PractitionerRoleCACore | PatientCACore | RelatedPerson) |
| asserter | Σ | 0..1 | Reference(PractitionerCACore | PractitionerRoleCACore | PatientCACore | RelatedPerson) |
| stage | C | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| summary | C | 0..1 | CodeableConcept |
| assessment | C | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) |
| type | 0..1 | CodeableConcept | |
| evidence | C | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| code | Σ C | 0..* | CodeableConcept |
| detail | Σ C | 0..* | Reference(Resource) |
| note | 0..* | Annotation |
| ConditionCACore (Condition) | C | Condition | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| clinicalStatus | O Σ ?! C | 0..1 | CodeableConceptBinding |
| verificationStatus | Σ ?! C | 0..1 | CodeableConceptBinding |
| category | 0..* | CodeableConceptCACoreBinding | |
| severity | 0..1 | CodeableConceptCACoreBinding | |
| code | O Σ | 0..1 | CodeableConceptCACoreBinding |
| bodySite | Σ | 0..* | CodeableConceptCACoreBinding |
| subject | Σ | 1..1 | Reference(PatientCACore | Group) |
| encounter | Σ | 0..1 | Reference(EncounterCACore) |
| onset[x] | O Σ | 0..1 | |
| onsetAge | Age | ||
| onsetPeriod | Period | ||
| onsetRange | Range | ||
| onsetString | string | ||
| onsetDateTime | Σ | 0..1 | dateTime |
| abatement[x] | C | 0..1 | |
| abatementDateTime | dateTime | ||
| abatementAge | Age | ||
| abatementPeriod | Period | ||
| abatementRange | Range | ||
| abatementString | string | ||
| recordedDate | Σ | 0..1 | dateTime |
| recorder | Σ | 0..1 | Reference(PractitionerCACore | PractitionerRoleCACore | PatientCACore | RelatedPerson) |
| asserter | Σ | 0..1 | Reference(PractitionerCACore | PractitionerRoleCACore | PatientCACore | RelatedPerson) |
| stage | C | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| summary | C | 0..1 | CodeableConcept |
| assessment | C | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) |
| type | 0..1 | CodeableConcept | |
| evidence | C | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| code | Σ C | 0..* | CodeableConcept |
| detail | Σ C | 0..* | Reference(Resource) |
| note | 0..* | Annotation |
</extension>
</telecom>
</telecom>
</contact>
<description value="This profile applies constraints to the Condition resource for CA Core+ to support recording clinical conditions and health concerns in the pan-Canadian context." />
</jurisdiction>
<copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
</mapping>
<definition value="A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern." />
</base>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis." />
</extension>
<human value="Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item" />
<expression value="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()" />
<xpath value="exists(f:clinicalStatus) or exists(f:verificationStatus/f:coding/f:code/@value='entered-in-error') or not(exists(category[@value='problem-list-item']))" />
</constraint>
<human value="If condition is abated, then clinicalStatus must be either inactive, resolved, or remission" />
<expression value="abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()" />
<xpath value="not(exists(*[starts-with(local-name(.), 'abatement')])) or exists(f:clinicalStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-clinical' and f:code/@value=('resolved', 'remission', 'inactive')])" />
</constraint>
<human value="Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error" />
<expression value="verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()" />
<xpath value="not(exists(f:verificationStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-ver-status' and f:code/@value='entered-in-error'])) or not(exists(f:clinicalStatus))" />
</constraint>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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" />
<expression value="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()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
</constraint>
</mapping>
</mapping>
<map value="< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)" />
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
</base>
</type>
</constraint>
</element>
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
</element>
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
</base>
</type>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
<definition value="Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server." />
<comment value="This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number." />
<requirements value="Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<comment value="The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the status contains codes that mark the condition as no longer active." />
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
<map value="Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value" />
</mapping>
</mapping>
</element>
<comment value="verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\nThe data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid." />
</extension>
<description value="The verification status to support or decline the clinical status of the condition or diagnosis." />
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
<map value="Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value" />
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</extension>
</extension>
</extension>
</extension>
</extension>
<description value="A subjective assessment of the severity of the condition as evaluated by the clinician." />
</binding>
</mapping>
</mapping>
</mapping>
<map value="Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value" />
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</binding>
</mapping>
</mapping>
<map value="code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS\n<< 420134006 |Propensity to adverse reactions| MINUS \n<< 473010000 |Hypersensitivity condition| MINUS \n<< 79899007 |Drug interaction| MINUS\n<< 69449002 |Drug action| MINUS \n<< 441742003 |Evaluation finding| MINUS \n<< 307824009 |Administrative status| MINUS \n<< 385356007 |Tumor stage finding|) \nOR < 413350009 |Finding with explicit context|\nOR < 272379006 |Event|" />
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</extension>
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode" />
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The Encounter during which this Condition was created or to which the creation of this record is tightly associated." />
<comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known"." />
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/encounter-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</discriminator>
</slicing>
<definition value="Estimated or actual date or date-time the condition began, in the opinion of the clinician." />
<comment value="onsetDateTime is the preferred datatype for this element. Systems receiving are expected to process and store the onsetDateTime. Other types may be used depending on context." />
</base>
</type>
</type>
</type>
</type>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
<map value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value" />
</mapping>
</element>
<definition value="Estimated or actual date or date-time the condition began, in the opinion of the clinician." />
<comment value="onsetDateTime is constrained in IPS and PS-CA and is likely the most practical element to be captured in a given system." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
<map value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value" />
</mapping>
</element>
<definition value="The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate." />
<comment value="There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated." />
</base>
</type>
</type>
</type>
</type>
</type>
</constraint>
</mapping>
<map value=".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed" />
</mapping>
</element>
<definition value="The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Clinical stage or grade of a condition. May include formal severity assessments." />
</base>
</type>
</constraint>
</constraint>
<map value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]" />
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<definition value="A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Reference to a formal record of the evidence on which the staging assessment is based." />
</base>
</type>
</constraint>
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
<description value="Codes describing the kind of condition staging (e.g. clinical or pathological)." />
</binding>
<map value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]" />
</mapping>
</element>
<definition value="Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition." />
<comment value="The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis." />
</base>
</type>
</constraint>
</mapping>
</mapping>
<map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value" />
</mapping>
</element>
</snapshot>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</mapping>
</element>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</element>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
</extension>
</extension>
</extension>
</binding>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</binding>
</mapping>
</element>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode" />
</binding>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</mapping>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/encounter-ca-core" />
</type>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</discriminator>
</slicing>
<comment value="onsetDateTime is the preferred datatype for this element. Systems receiving are expected to process and store the onsetDateTime. Other types may be used depending on context." />
</element>
<comment value="onsetDateTime is constrained in IPS and PS-CA and is likely the most practical element to be captured in a given system." />
</type>
</element>
</mapping>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</element>
</differential>
</StructureDefinition>
{
],
{
{
},
{
}
]
}
],
"description": "This profile applies constraints to the Condition resource for CA Core+ to support recording clinical conditions and health concerns in the pan-Canadian context.",
],
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
}
],
{
"definition": "A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.",
},
{
{
},
{
"valueMarkdown": "Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis."
}
],
"human": "Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item",
"expression": "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()",
"xpath": "exists(f:clinicalStatus) or exists(f:verificationStatus/f:coding/f:code/@value='entered-in-error') or not(exists(category[@value='problem-list-item']))"
},
{
"human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
"expression": "abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()",
"xpath": "not(exists(*[starts-with(local-name(.), 'abatement')])) or exists(f:clinicalStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-clinical' and f:code/@value=('resolved', 'remission', 'inactive')])"
},
{
"human": "Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error",
"expression": "verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()",
"xpath": "not(exists(f:verificationStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-ver-status' and f:code/@value='entered-in-error'])) or not(exists(f:clinicalStatus))"
},
{
},
{
"human": "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",
"expression": "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()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
}
],
{
},
{
},
{
"map": "< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)"
},
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
},
],
{
}
],
},
{
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
},
{
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
"definition": "Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.",
"comment": "This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.",
"requirements": "Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"comment": "The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.",
},
],
"con-3",
"con-4",
"con-5"
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.",
{
}
],
},
{
},
{
},
{
},
{
},
{
"map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
},
{
}
]
},
{
"comment": "verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\nThe data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.",
},
],
"con-3",
"con-5"
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
{
}
],
"description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
},
{
},
{
},
{
},
{
},
{
"map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
},
{
}
]
},
{
{
},
{
}
],
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
},
{
{
},
{
},
{
}
],
}
],
"description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
},
{
},
{
},
{
},
{
"map": "Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"severity\"].value"
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"type"
],
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
},
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
}
],
}
],
},
{
},
{
},
{
"map": "code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS\n<< 420134006 |Propensity to adverse reactions| MINUS \n<< 473010000 |Hypersensitivity condition| MINUS \n<< 79899007 |Drug interaction| MINUS\n<< 69449002 |Drug action| MINUS \n<< 441742003 |Evaluation finding| MINUS \n<< 307824009 |Administrative status| MINUS \n<< 385356007 |Tumor stage finding|) \nOR < 413350009 |Finding with explicit context|\nOR < 272379006 |Event|"
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"patient"
],
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The Encounter during which this Condition was created or to which the creation of this record is tightly associated.",
"comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/encounter-ca-core"
]
}
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
"definition": "Estimated or actual date or date-time the condition began, in the opinion of the clinician.",
"comment": "onsetDateTime is the preferred datatype for this element. Systems receiving are expected to process and store the onsetDateTime. Other types may be used depending on context.",
},
{
},
{
},
{
},
{
},
{
}
],
{
}
],
{
},
{
},
{
},
{
"map": ".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age at onset\"].value"
}
]
},
{
"definition": "Estimated or actual date or date-time the condition began, in the opinion of the clinician.",
"comment": "onsetDateTime is constrained in IPS and PS-CA and is likely the most practical element to be captured in a given system.",
},
],
{
}
],
{
},
{
},
{
},
{
"map": ".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age at onset\"].value"
}
]
},
{
"definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
"comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.",
},
{
},
{
},
{
},
{
},
{
}
],
"con-4"
],
{
}
],
{
},
{
"map": ".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"age at remission\"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed"
}
]
},
{
"definition": "The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.",
},
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
{
}
],
{
},
{
}
]
},
{
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
{
}
],
{
},
{
},
{
}
]
},
{
},
],
{
},
{
}
],
{
"map": "./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"stage/grade\"]"
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"definition": "A simple summary of the stage such as \"Stage 3\". The determination of the stage is disease-specific.",
},
],
"con-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
}
]
},
{
"definition": "Reference to a formal record of the evidence on which the staging assessment is based.",
},
{
"http://hl7.org/fhir/StructureDefinition/ClinicalImpression",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/Observation"
]
}
],
"con-1"
],
{
}
],
]
},
{
},
],
{
}
],
{
}
],
},
{
"map": "./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"stage type\"]"
}
]
},
{
"definition": "Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.",
"comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
},
],
{
},
{
}
],
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
"con-2"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
}
]
},
{
},
],
"con-2"
],
{
}
],
]
},
{
"definition": "Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.",
},
],
{
}
],
{
},
{
},
{
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
}
]
},
{
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
{
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
}
],
}
],
}
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
}
],
}
],
},
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
}
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/encounter-ca-core"
]
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
"comment": "onsetDateTime is the preferred datatype for this element. Systems receiving are expected to process and store the onsetDateTime. Other types may be used depending on context."
},
{
"comment": "onsetDateTime is constrained in IPS and PS-CA and is likely the most practical element to be captured in a given system.",
]
},
{
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
]
}
]
}
}
Terminology bindings
| Path | Conformance | ValueSet |
|---|---|---|
| Condition.severity | preferred | https://fhir.infoway-inforoute.ca/ValueSet/severitycode |
| Condition.code | preferred | https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode |
| Condition.bodySite | preferred | https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode |
Additional Terminology Bindings
These bindings may be used in lieu of the primary bindings in the table above.
| Path | Conformance | AdditionalValueSet |
|---|---|---|
| Condition.severity | candidate | http://hl7.org/fhir/ValueSet/condition-severity |
| Condition.code | candidate | http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-problems-uv-ips |
Mappings to CACDI
The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.
| FHIR Profile Element | CACDI Element(s) |
|---|---|
| Condition | Patient Health Concern |
| Condition.clinicalStatus | Patient Health Concern.Patient Health Concern Clinical Status Code |
| Condition.code | Patient Health Concern.Health Concern Code |
| Condition.subject | Patient |
| Condition.recordedDate | Patient Health Concern.Patient Health Concern Diagnosis Date Time |