Finnish Base Profiles
2.0.0 - release

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## Resource Profile: FI Base Reason for Care (encounter-diagnosis and reason for visit)

Official URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-reason-for-care | Version: 2.0.0
Active as of 2025-10-05 | Computable Name: FiBaseReasonForCare

This is the Finnish base profile for the encounter-diagnosis and (nurse asserted) reason for visit Conditions.

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

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

- Use of `problem-list-item` for long term diagnosis (Pitkäaikaisdiagnoosi or Pysyvä diagnoosi)? The conceptual mapping is not staightforward.
- THL Tietosisältö 10 Tiedon lähde. Should this be an extension?
- THL Tietosisältö 15 Diagnoosin päättymisen toteajan nimi.
- THL Tietosisältö 17 Diagnoosin päättymisen syy.
- THL Tietosisältö 18 Diagnoosin päättymisen syyn tarkenne.
- THL Tietosisältö 20 Diagnoosin päättymisen toteajan palveluyksikkö.
- THL Tietosisältö 22 Episodin nimi.
- THL Tietosisältö 7 Diagnoosin tai käyntisyyn varmuusaste. This could perhaps be mapped to verificationStatus codes.
- THL Tietosisältö 9 Diagnoosin tai käyntisyyn episoditunnus.

Feedback on all of the above is most welcome for further development of this profile. </div> #### Links * [*Suomalainen tautien kirjaamisen ohjekirja*](https://thl.fi/documents/10531/124365/Opas%202012%2017.pdf), the national guide for the use of ICD-10.

Usages:

- Examples for this Profile: Condition/id-for-diagnosis-1, Condition/id-for-diagnosis-2 and Condition/id-for-diagnosis-3

### Formal Views of Profile Content

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

- 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) | Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:primaryCondition |  | 0..1 | Coding | Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:permanence |  | 0..1 | Coding | Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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 ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:endocrinologicalDisorder |  | 0..1 | Coding | Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:conditionCausedByMedication |  | 0..1 | Coding | Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:conditionExternalCause |  | 0..1 | Coding | External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:conditionCategorizationOfAccident |  | 0..1 | Coding | Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:causeOfAdverseEffect |  | 0..1 | Coding | Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
clinicalStatus | ?!Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. ele-1: All FHIR elements must have a @value or children
verificationStatus | ?!Σ C | 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. ele-1: All FHIR elements must have a @value or children
subject | Σ | 1..1 | Reference(FI Base Patient(2.0.0)) | Who has the condition? ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1` From the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1` From the FHIR Standard

#### Constraints

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

This structure is derived from FiBaseCondition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | FiBaseCondition(2.0.0) | 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) | Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
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 | ?!Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!Σ C | 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)) | 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 con-1: Stage SHALL have summary or assessment
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 con-2: evidence SHALL have code or details
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 | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Condition.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1` From the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1` From the FHIR Standard
Condition.category | extensible | ConditionCategoryCodes `http://hl7.org/fhir/ValueSet/condition-category` From the FHIR Standard
Condition.severity | preferred | Condition/DiagnosisSeverity `http://hl7.org/fhir/ValueSet/condition-severity` From the FHIR Standard
Condition.code | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
Condition.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard
Condition.stage.summary | example | ConditionStage `http://hl7.org/fhir/ValueSet/condition-stage` From the FHIR Standard
Condition.stage.type | example | ConditionStageType `http://hl7.org/fhir/ValueSet/condition-stage-type` From the FHIR Standard
Condition.evidence.code | example | ManifestationAndSymptomCodes `http://hl7.org/fhir/ValueSet/manifestation-or-symptom` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
con-1 | error | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() |
con-2 | error | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() |
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

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | FiBaseCondition(2.0.0) | Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:primaryCondition |  | 0..1 | Coding | Primary condition for encounter URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-primary ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:permanence |  | 0..1 | Coding | Permanence of condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-permanence ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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 ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:endocrinologicalDisorder |  | 0..1 | Coding | Endocrinological disorder URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-endocrinological-disorder ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:conditionCausedByMedication |  | 0..1 | Coding | Medication that caused this condition URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-caused-by-medication ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:conditionExternalCause |  | 0..1 | Coding | External cause for diagnosis URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-external-cause ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:conditionCategorizationOfAccident |  | 0..1 | Coding | Categorization of the type of accident URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-categorization-of-accident ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:causeOfAdverseEffect |  | 0..1 | Coding | Cause of an adverse effect URL: https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/condition-cause-of-adverse-effect ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
clinicalStatus | ?!Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. ele-1: All FHIR elements must have a @value or children
verificationStatus | ?!Σ C | 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. ele-1: All FHIR elements must have a @value or children
subject | Σ | 1..1 | Reference(FI Base Patient(2.0.0)) | Who has the condition? ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1` From the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1` From the FHIR Standard

#### Constraints

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

Differential View

This structure is derived from FiBaseCondition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  | 0..* | FiBaseCondition(2.0.0) | 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) | Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
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 | ?!Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!Σ C | 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)) | 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 con-1: Stage SHALL have summary or assessment
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 con-2: evidence SHALL have code or details
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 | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Condition.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Condition.clinicalStatus | required | ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1` From the FHIR Standard
Condition.verificationStatus | required | ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1` From the FHIR Standard
Condition.category | extensible | ConditionCategoryCodes `http://hl7.org/fhir/ValueSet/condition-category` From the FHIR Standard
Condition.severity | preferred | Condition/DiagnosisSeverity `http://hl7.org/fhir/ValueSet/condition-severity` From the FHIR Standard
Condition.code | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
Condition.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard
Condition.stage.summary | example | ConditionStage `http://hl7.org/fhir/ValueSet/condition-stage` From the FHIR Standard
Condition.stage.type | example | ConditionStageType `http://hl7.org/fhir/ValueSet/condition-stage-type` From the FHIR Standard
Condition.evidence.code | example | ManifestationAndSymptomCodes `http://hl7.org/fhir/ValueSet/manifestation-or-symptom` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
con-1 | error | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() |
con-2 | error | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() |
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

Other representations of profile: CSV, Excel, Schematron