Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Zib Pregnancy - Detailed Descriptions

Draft as of 2024-04-09

Definitions for the zib-Pregnancy resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Condition
Definition

Root concept of the Pregnancy information model. This root concept contains all data elements of the Pregnancy information model.

ShortPregnancy
Alternate NamesZwangerschap
2. Condition.code
4. Condition.code.coding
Control1..?
SlicingThis element introduces a set of slices on Condition.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ code
  • 6. Condition.code.coding:PregnancyObservable
    Slice NamePregnancyObservable
    Control1..1
    8. Condition.code.coding:PregnancyObservable.system
    Control1..?
    Fixed Valuehttp://snomed.info/sct
    10. Condition.code.coding:PregnancyObservable.code
    Control1..?
    Fixed Value364320009
    12. Condition.code.coding:PregnancyObservable.display
    Default ValuePregnancy observable
    14. Condition.note
    Definition

    Comment on the pregnancy.

    Control0..1

    Guidance on how to interpret the contents of this table can be found here

    0. Condition
    Definition

    Root concept of the Pregnancy information model. This root concept contains all data elements of the Pregnancy information model.


    A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

    ShortPregnancyDetailed information about conditions, problems or diagnoses
    Control0..*
    Alternate NamesConcern, Probleem, Zwangerschap
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
    dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
    con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')
    con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error (verificationStatus='entered-in-error' or clinicalStatus.exists())
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
    dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
    con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')
    con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error (verificationStatus='entered-in-error' or clinicalStatus.exists())
    2. Condition.implicitRules
    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.

    ShortA set of rules under which this content was created
    Comments

    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.

    This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

    Control0..1
    Typeuri
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    4. Condition.modifierExtension
    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. Usually modifier elements provide negation or qualification. In order 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.

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Alternate Namesextensions, user content
    6. Condition.clinicalStatus
    Definition

    The problem status describes the condition of the problem: <ol> <li>Active problems are problems of which the patient experiences symptoms or for which evidence exists.</li> <li>Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore..</li> </ol>


    The clinical status of the condition.

    ShortProblemStatusactive | recurrence | inactive | remission | resolved
    Comments

    A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/ProbleemStatusCodelijst-to-Condition-Clinical-Status-Codes) is available that maps ProblemStatusCodelist to the condition-clinical valueset.


    This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.

    Control10..1
    This element is affected by the following invariants: con-3, con-4
    BindingThe codes SHALL be taken from Condition Clinical Status Codeshttp://hl7.org/fhir/ValueSet/condition-clinical
    (required to http://hl7.org/fhir/ValueSet/condition-clinical)

    The clinical status of the condition or diagnosis.

    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate NamesProbleemStatus
    8. Condition.clinicalStatus.extension:ProblemStatusCodelist
    Slice NameProblemStatusCodelist
    Definition

    Describes the condition of the problem, use this extension to include the original ZIB code

    Shortclinicalstatus
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
    Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Probleemstatus
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Condition.clinicalStatus.extension:ProblemStatusCodelist.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
    12. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]
    Definition

    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortValue of extension
    Control10..1
    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 14. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

      ShortValue of extension
      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see ProbleemStatusCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.2--20171231000000)

      ProbleemStatusCodelijst

      TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      16. Condition.verificationStatus
      Definition

      Clinical status of the problem or the diagnosis.


      The verification status to support the clinical status of the condition.

      ShortVerificationStatusprovisional | differential | confirmed | refuted | entered-in-error | unknown
      Comments

      A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/VerificatieStatusCodelijst-to-ConditionVerificationStatus) is available.


      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.

      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.

      Control0..1
      This element is affected by the following invariants: con-3
      BindingThe codes SHALL be taken from ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status
      (required to http://hl7.org/fhir/ValueSet/condition-ver-status)

      The verification status to support or decline the clinical status of the condition or diagnosis.

      Typecode
      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesVerificatieStatus
      Default Valueunknown
      18. Condition.verificationStatus.extension:VerificatieStatusCodelijst
      Slice NameVerificatieStatusCodelijst
      Definition

      Describes the verification status of the problem, use this extension to include the original ZIB code

      ShortVerificationstatus
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
      Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., VerificatieStatusCodelijst
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      20. Condition.verificationStatus.extension:VerificatieStatusCodelijst.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
      22. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]
      Definition

      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

      ShortValue of extension
      Control10..1
      TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      SlicingThis element introduces a set of slices on Condition.verificationStatus.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 24. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]:valueCodeableConcept
        Slice NamevalueCodeableConcept
        Definition

        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

        ShortValue of extension
        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from For codes, see VerificatieStatusCodelijst
        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.4--20171231000000)

        VerificatieStatusCodelijst

        TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        26. Condition.code
        Definition

        The problem name defines the problem. Depending on the setting, different code systems can be used. The ProblemNameCodelist provides an overview of the possible code systems.


        Identification of the condition, problem or diagnosis.

        ShortProblemNameIdentification of the condition, problem or diagnosis
        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see ProbleemNaamCodelijsthttp://hl7.org/fhir/ValueSet/condition-code
        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.3--20171231000000)

        The problem name defines the problem.


        Identification of the condition or diagnosis.

        TypeCodeableConcept
        Summarytrue
        Requirements

        0..1 to account for primarily narrative only resources.

        Alternate Namestype, ProbleemNaam
        28. Condition.code.coding
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control10..*
        TypeCoding
        Summarytrue
        Requirements

        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

        SlicingThis element introduces a set of slices on Condition.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ code
        • 30. Condition.code.coding:PregnancyObservable
          Slice NamePregnancyObservable
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control10..1*
          TypeCoding
          Summarytrue
          Requirements

          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

          32. Condition.code.coding:PregnancyObservable.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

          Control10..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be unambiguous about the source of the definition of the symbol.

          Fixed Valuehttp://snomed.info/sct
          34. Condition.code.coding:PregnancyObservable.code
          Definition

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          ShortSymbol in syntax defined by the system
          Control10..1
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to refer to a particular code in the system.

          Fixed Value364320009
          36. Condition.code.coding:PregnancyObservable.display
          Definition

          A representation of the meaning of the code in the system, following the rules of the system.

          ShortRepresentation defined by the system
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

          38. Condition.subject
          Definition

          Indicates the patient or group who the condition record is associated with.

          ShortWho has the condition?
          Control1..1
          TypeReference(nl-core-patient, Patient, Group)
          Summarytrue
          Requirements

          Group is typically used for veterinary or public health use cases.

          Alternate Namespatient
          40. Condition.onset[x]
          Definition

          Estimated or actual date or date-time the condition began, in the opinion of the clinician.

          ShortEstimated or actual date, date-time, or age
          Comments

          Age is generally used when the patient reports an age at which the Condition began to occur.

          Control0..1
          TypePeriod, dateTime, string, Range, Age
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Summarytrue
          SlicingThis element introduces a set of slices on Condition.onset[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 42. Condition.onset[x]:onsetPeriod
            Slice NameonsetPeriod
            Definition

            Estimated or actual date or date-time the condition began, in the opinion of the clinician.

            ShortEstimated or actual date, date-time, or age
            Comments

            Age is generally used when the patient reports an age at which the Condition began to occur.

            Control0..1
            TypePeriod, dateTime, string, Range, Age
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Summarytrue
            44. Condition.note
            Definition

            Comment on the pregnancy.


            Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

            ShortCommentAdditional information about the Condition
            Control0..1*
            TypeAnnotation
            Alternate NamesToelichting

            Guidance on how to interpret the contents of this table can be found here

            0. Condition
            Definition

            Root concept of the Pregnancy information model. This root concept contains all data elements of the Pregnancy information model.

            ShortPregnancy
            Control0..*
            Alternate NamesConcern, Probleem, Zwangerschap
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
            dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
            con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive')
            con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error (verificationStatus='entered-in-error' or clinicalStatus.exists())
            2. Condition.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            4. Condition.meta
            Definition

            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Summarytrue
            6. Condition.implicitRules
            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.

            ShortA set of rules under which this content was created
            Comments

            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.

            This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

            Control0..1
            Typeuri
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            8. Condition.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            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).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Common Languages
            (extensible to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            10. Condition.text
            Definition

            A human-readable narrative that contains a summary of the resource, and may 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.

            ShortText summary of the resource, for human interpretation
            Comments

            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 in formation is added later.

            Control0..1
            This element is affected by the following invariants: dom-1
            TypeNarrative
            Alternate Namesnarrative, html, xhtml, display
            12. Condition.contained
            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.

            ShortContained, inline Resources
            Comments

            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.

            Control0..*
            TypeResource
            Alternate Namesinline resources, anonymous resources, contained resources
            14. Condition.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

            ShortAdditional Content defined by implementations
            Comments

            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.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            16. Condition.modifierExtension
            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. Usually modifier elements provide negation or qualification. In order 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.

            ShortExtensions that cannot be ignored
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Alternate Namesextensions, user content
            18. Condition.identifier
            Definition

            This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

            ShortExternal Ids for this condition
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Summarytrue
            Requirements

            Need to allow connection to a wider workflow.

            20. Condition.clinicalStatus
            Definition

            The problem status describes the condition of the problem: <ol> <li>Active problems are problems of which the patient experiences symptoms or for which evidence exists.</li> <li>Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore..</li> </ol>

            ShortProblemStatus
            Comments

            A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/ProbleemStatusCodelijst-to-Condition-Clinical-Status-Codes) is available that maps ProblemStatusCodelist to the condition-clinical valueset.

            Control1..1
            This element is affected by the following invariants: con-3, con-4
            BindingThe codes SHALL be taken from Condition Clinical Status Codes
            (required to http://hl7.org/fhir/ValueSet/condition-clinical)

            The clinical status of the condition or diagnosis.

            Typecode
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate NamesProbleemStatus
            22. Condition.clinicalStatus.id
            Definition

            unique id for the element within a resource (for internal references)

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            24. Condition.clinicalStatus.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 26. Condition.clinicalStatus.extension:ProblemStatusCodelist
              Slice NameProblemStatusCodelist
              Definition

              Describes the condition of the problem, use this extension to include the original ZIB code

              Shortclinicalstatus
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
              Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Probleemstatus
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              28. Condition.clinicalStatus.extension:ProblemStatusCodelist.id
              Definition

              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              30. Condition.clinicalStatus.extension:ProblemStatusCodelist.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

              ShortAdditional Content defined by implementations
              Comments

              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.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 32. Condition.clinicalStatus.extension:ProblemStatusCodelist.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                34. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control1..1
                TypeCodeableConcept
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 36. Condition.clinicalStatus.extension:ProblemStatusCodelist.value[x]:valueCodeableConcept
                  Slice NamevalueCodeableConcept
                  Definition

                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                  ShortValue of extension
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from ProbleemStatusCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.2--20171231000000)

                  ProbleemStatusCodelijst

                  TypeCodeableConcept
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  38. Condition.clinicalStatus.value
                  Definition

                  Primitive value for code

                  ShortPrimitive value for code
                  Control0..1
                  Typecode
                  XML FormatIn the XML format, this property is represented as an attribute.
                  40. Condition.verificationStatus
                  Definition

                  Clinical status of the problem or the diagnosis.

                  ShortVerificationStatus
                  Comments

                  A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/VerificatieStatusCodelijst-to-ConditionVerificationStatus) is available.

                  Control0..1
                  This element is affected by the following invariants: con-3
                  BindingThe codes SHALL be taken from ConditionVerificationStatus
                  (required to http://hl7.org/fhir/ValueSet/condition-ver-status)

                  The verification status to support or decline the clinical status of the condition or diagnosis.

                  Typecode
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Alternate NamesVerificatieStatus
                  Default Valueunknown
                  42. Condition.verificationStatus.id
                  Definition

                  unique id for the element within a resource (for internal references)

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  44. Condition.verificationStatus.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  SlicingThis element introduces a set of slices on Condition.verificationStatus.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 46. Condition.verificationStatus.extension:VerificatieStatusCodelijst
                    Slice NameVerificatieStatusCodelijst
                    Definition

                    Describes the verification status of the problem, use this extension to include the original ZIB code

                    ShortVerificationstatus
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                    Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., VerificatieStatusCodelijst
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    48. Condition.verificationStatus.extension:VerificatieStatusCodelijst.id
                    Definition

                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    50. Condition.verificationStatus.extension:VerificatieStatusCodelijst.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                    ShortAdditional Content defined by implementations
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Alternate Namesextensions, user content
                    SlicingThis element introduces a set of slices on Condition.verificationStatus.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 52. Condition.verificationStatus.extension:VerificatieStatusCodelijst.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                      54. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]
                      Definition

                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                      ShortValue of extension
                      Control1..1
                      TypeCodeableConcept
                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                      SlicingThis element introduces a set of slices on Condition.verificationStatus.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 56. Condition.verificationStatus.extension:VerificatieStatusCodelijst.value[x]:valueCodeableConcept
                        Slice NamevalueCodeableConcept
                        Definition

                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                        ShortValue of extension
                        Control1..1
                        BindingUnless not suitable, these codes SHALL be taken from VerificatieStatusCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.4--20171231000000)

                        VerificatieStatusCodelijst

                        TypeCodeableConcept
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        58. Condition.verificationStatus.value
                        Definition

                        Primitive value for code

                        ShortPrimitive value for code
                        Control0..1
                        Typecode
                        XML FormatIn the XML format, this property is represented as an attribute.
                        60. Condition.category
                        Definition

                        The type of problem; see the profile description.

                        ShortProblemType
                        Comments

                        The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

                        Control0..*
                        BindingUnless not suitable, these codes SHALL be taken from ProbleemTypeCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.1--20171231000000)

                        The type of problem.

                        TypeCodeableConcept
                        Alternate NamesProbleemType
                        62. Condition.severity
                        Definition

                        A subjective assessment of the severity of the condition as evaluated by the clinician.

                        ShortSubjective severity of condition
                        Comments

                        Coding of the severity with a terminology is preferred, where possible.

                        Control0..1
                        BindingThe codes SHOULD be taken from Condition/Diagnosis Severity
                        (preferred to http://hl7.org/fhir/ValueSet/condition-severity)

                        A subjective assessment of the severity of the condition as evaluated by the clinician.

                        TypeCodeableConcept
                        64. Condition.code
                        Definition

                        The problem name defines the problem. Depending on the setting, different code systems can be used. The ProblemNameCodelist provides an overview of the possible code systems.

                        ShortProblemName
                        Control1..1
                        BindingUnless not suitable, these codes SHALL be taken from ProbleemNaamCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.3--20171231000000)

                        The problem name defines the problem.

                        TypeCodeableConcept
                        Summarytrue
                        Requirements

                        0..1 to account for primarily narrative only resources.

                        Alternate Namestype, ProbleemNaam
                        66. Condition.code.id
                        Definition

                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        Shortxml:id (or equivalent in JSON)
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        68. Condition.code.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                        ShortAdditional Content defined by implementations
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Alternate Namesextensions, user content
                        SlicingThis element introduces a set of slices on Condition.code.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 70. Condition.code.coding
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          Comments

                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                          Control1..*
                          TypeCoding
                          Summarytrue
                          Requirements

                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                          SlicingThis element introduces a set of slices on Condition.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ code
                          • 72. Condition.code.coding:PregnancyObservable
                            Slice NamePregnancyObservable
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                            Control1..1
                            TypeCoding
                            Summarytrue
                            Requirements

                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                            74. Condition.code.coding:PregnancyObservable.id
                            Definition

                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            Shortxml:id (or equivalent in JSON)
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            76. Condition.code.coding:PregnancyObservable.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                            ShortAdditional Content defined by implementations
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Alternate Namesextensions, user content
                            SlicingThis element introduces a set of slices on Condition.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 78. Condition.code.coding:PregnancyObservable.system
                              Definition

                              The identification of the code system that defines the meaning of the symbol in the code.

                              ShortIdentity of the terminology system
                              Comments

                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                              Control1..1
                              Typeuri
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to be unambiguous about the source of the definition of the symbol.

                              Fixed Valuehttp://snomed.info/sct
                              80. Condition.code.coding:PregnancyObservable.version
                              Definition

                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                              ShortVersion of the system - if relevant
                              Comments

                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                              NoteThis is a business versionId, not a resource version id (see discussion)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              82. Condition.code.coding:PregnancyObservable.code
                              Definition

                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                              ShortSymbol in syntax defined by the system
                              Control1..1
                              Typecode
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to refer to a particular code in the system.

                              Fixed Value364320009
                              84. Condition.code.coding:PregnancyObservable.display
                              Definition

                              A representation of the meaning of the code in the system, following the rules of the system.

                              ShortRepresentation defined by the system
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                              86. Condition.code.coding:PregnancyObservable.userSelected
                              Definition

                              Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                              ShortIf this coding was chosen directly by the user
                              Comments

                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                              Control0..1
                              Typeboolean
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                              88. Condition.code.text
                              Definition

                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                              ShortPlain text representation of the concept
                              Comments

                              Very often the text is the same as a displayName of one of the codings.

                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                              90. Condition.bodySite
                              Definition

                              Anatomical location which is the focus of the procedure.

                              ShortProblemAnatomicalLocation
                              Comments

                              Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both.

                              Control0..*
                              BindingUnless not suitable, these codes SHALL be taken from ProbleemAnatomischeLocatieCodelijst
                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.5--20171231000000)

                              ProbleemAnatomischeLocatieCodelijst

                              TypeCodeableConcept
                              Summarytrue
                              Alternate NamesProbleemAnatomischeLocatie
                              92. Condition.bodySite.id
                              Definition

                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              94. Condition.bodySite.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..*
                              TypeExtension
                              SlicingThis element introduces a set of slices on Condition.bodySite.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 96. Condition.bodySite.extension:Laterality
                                Slice NameLaterality
                                Definition

                                Laterality adds information about body side to the anatomic location, e.g. left

                                ShortProblemLaterality
                                Control0..1
                                TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
                                Alternate NamesProbleemLateraliteit
                                98. Condition.bodySite.extension:Laterality.id
                                Definition

                                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                Shortxml:id (or equivalent in JSON)
                                Control0..1
                                Typestring
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                XML FormatIn the XML format, this property is represented as an attribute.
                                100. Condition.bodySite.extension:Laterality.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                ShortAdditional Content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Alternate Namesextensions, user content
                                SlicingThis element introduces a set of slices on Condition.bodySite.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 102. Condition.bodySite.extension:Laterality.url
                                  Definition

                                  Source of the definition for the extension code - a logical name or a URL.

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                  Control1..1
                                  Typeuri
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
                                  104. Condition.bodySite.extension:Laterality.value[x]
                                  Definition

                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                  ShortValue of extension
                                  Control0..1
                                  TypeCodeableConcept
                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                  SlicingThis element introduces a set of slices on Condition.bodySite.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 106. Condition.bodySite.extension:Laterality.value[x]:valueCodeableConcept
                                    Slice NamevalueCodeableConcept
                                    Definition

                                    Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

                                    ShortBodySite qualifier
                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from ProbleemLateraliteitCodelijst
                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.1.6--20171231000000)

                                    ProblemLateralityCodelist

                                    TypeCodeableConcept
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    108. Condition.bodySite.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control0..*
                                    TypeCoding
                                    Summarytrue
                                    Requirements

                                    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                    110. Condition.bodySite.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    112. Condition.subject
                                    Definition

                                    Indicates the patient or group who the condition record is associated with.

                                    ShortWho has the condition?
                                    Control1..1
                                    TypeReference(nl-core-patient)
                                    Summarytrue
                                    Requirements

                                    Group is typically used for veterinary or public health use cases.

                                    Alternate Namespatient
                                    114. Condition.context
                                    Definition

                                    Encounter during which the condition was first asserted.

                                    ShortEncounter or episode when condition first asserted
                                    Comments

                                    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".

                                    Control0..1
                                    TypeReference(HCIM Encounter, nl-core-episodeofcare)
                                    Summarytrue
                                    Alternate Namesencounter
                                    116. Condition.onset[x]
                                    Definition

                                    Estimated or actual date or date-time the condition began, in the opinion of the clinician.

                                    ShortEstimated or actual date, date-time, or age
                                    Comments

                                    Age is generally used when the patient reports an age at which the Condition began to occur.

                                    Control0..1
                                    TypePeriod
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    Summarytrue
                                    SlicingThis element introduces a set of slices on Condition.onset[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 118. Condition.onset[x]:onsetPeriod
                                      Slice NameonsetPeriod
                                      Definition

                                      Estimated or actual date or date-time the condition began, in the opinion of the clinician.

                                      ShortEstimated or actual date, date-time, or age
                                      Comments

                                      Age is generally used when the patient reports an age at which the Condition began to occur.

                                      Control0..1
                                      TypePeriod
                                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                                      Summarytrue
                                      120. Condition.onset[x]:onsetPeriod.id
                                      Definition

                                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      Shortxml:id (or equivalent in JSON)
                                      Control0..1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      122. Condition.onset[x]:onsetPeriod.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                      ShortAdditional Content defined by implementations
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Alternate Namesextensions, user content
                                      SlicingThis element introduces a set of slices on Condition.onset[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 124. Condition.onset[x]:onsetPeriod.start
                                        Definition

                                        Start of the disorder to which the problem applies. Especially in symptoms in which it takes longer for the final diagnosis, it is important to know not only the date of the diagnosis, but also how long the patient has had the disorder. A ‘vague’ date, such as only the year or the month and the year, is permitted.

                                        ShortProblemStartDate
                                        Comments

                                        If the low element is missing, the meaning is that the low boundary is not known.

                                        Control0..1
                                        This element is affected by the following invariants: per-1
                                        TypedateTime
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Alternate NamesProbleemBeginDatum
                                        126. Condition.onset[x]:onsetPeriod.end
                                        Definition

                                        Date on which the disorder to which the problem applies, is considered not to be present anymore.This datum needs not to be the same as the date of the change in problem status. A ‘vague’ date, such as only the year or the month and the year, is permitted.

                                        ShortProblemEndDate
                                        Comments

                                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

                                        Control0..1
                                        This element is affected by the following invariants: per-1
                                        TypedateTime
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Alternate NamesProbleemEindDatum
                                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                        128. Condition.abatement[x]
                                        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.

                                        ShortIf/when in resolution/remission
                                        Comments

                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: con-4
                                        TypeChoice of: dateTime, Age, boolean, Period, Range, string
                                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        130. Condition.assertedDate
                                        Definition

                                        The date on which the existance of the Condition was first asserted or acknowledged.

                                        ShortDate record was believed accurate
                                        Comments

                                        The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.

                                        Control0..1
                                        TypedateTime
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        132. Condition.asserter
                                        Definition

                                        Individual who is making the condition statement.

                                        ShortPerson who asserts this condition
                                        Control0..1
                                        TypeReference(nl-core-relatedperson, nl-core-patient, nl-core-practitioner)
                                        Summarytrue
                                        134. Condition.asserter.id
                                        Definition

                                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        Shortxml:id (or equivalent in JSON)
                                        Control0..1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        136. Condition.asserter.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..*
                                        TypeExtension
                                        SlicingThis element introduces a set of slices on Condition.asserter.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 138. Condition.asserter.extension:practitionerRole
                                          Slice NamepractitionerRole
                                          Definition

                                          Optional Extension Element - found in all resources.

                                          ShortOptional Extensions Element
                                          Control0..1
                                          TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                          140. Condition.asserter.reference
                                          Definition

                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                          ShortLiteral reference, Relative, internal or absolute URL
                                          Comments

                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                          Control0..1
                                          This element is affected by the following invariants: ref-1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          142. Condition.asserter.identifier
                                          Definition

                                          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                          ShortLogical reference, when literal reference is not known
                                          Comments

                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..1
                                          TypeIdentifier
                                          Summarytrue
                                          144. Condition.asserter.display
                                          Definition

                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                          ShortText alternative for the resource
                                          Comments

                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                          Control0..1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          146. Condition.stage
                                          Definition

                                          Clinical stage or grade of a condition. May include formal severity assessments.

                                          ShortStage/grade, usually assessed formally
                                          Control0..1
                                          TypeBackboneElement
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                          con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
                                          148. Condition.stage.id
                                          Definition

                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          Shortxml:id (or equivalent in JSON)
                                          Control0..1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          150. Condition.stage.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                          ShortAdditional Content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Alternate Namesextensions, user content
                                          152. Condition.stage.modifierExtension
                                          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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                                          ShortExtensions that cannot be ignored
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                          Summarytrue
                                          Alternate Namesextensions, user content, modifiers
                                          154. Condition.stage.summary
                                          Definition

                                          A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

                                          ShortSimple summary (disease specific)
                                          Control0..1
                                          This element is affected by the following invariants: con-1
                                          BindingFor example codes, see Condition Stage
                                          (example to http://hl7.org/fhir/ValueSet/condition-stage)

                                          Codes describing condition stages (e.g. Cancer stages).

                                          TypeCodeableConcept
                                          156. Condition.stage.assessment
                                          Definition

                                          Reference to a formal record of the evidence on which the staging assessment is based.

                                          ShortFormal record of assessment
                                          Control0..*
                                          This element is affected by the following invariants: con-1
                                          TypeReference(ClinicalImpression, DiagnosticReport, Observation)
                                          158. Condition.evidence
                                          Definition

                                          Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.

                                          ShortSupporting evidence
                                          Comments

                                          The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

                                          Control0..*
                                          TypeBackboneElement
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                          con-2: evidence SHALL have code or details (code.exists() or detail.exists())
                                          160. Condition.evidence.id
                                          Definition

                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          Shortxml:id (or equivalent in JSON)
                                          Control0..1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          162. Condition.evidence.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                          ShortAdditional Content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Alternate Namesextensions, user content
                                          164. Condition.evidence.modifierExtension
                                          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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                                          ShortExtensions that cannot be ignored
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                          Summarytrue
                                          Alternate Namesextensions, user content, modifiers
                                          166. Condition.evidence.code
                                          Definition

                                          A manifestation or symptom that led to the recording of this condition.

                                          ShortManifestation/symptom
                                          Control0..*
                                          This element is affected by the following invariants: con-2
                                          BindingFor example codes, see Manifestation and Symptom Codes
                                          (example to http://hl7.org/fhir/ValueSet/manifestation-or-symptom)

                                          Codes that describe the manifestation or symptoms of a condition.

                                          TypeCodeableConcept
                                          Summarytrue
                                          168. Condition.evidence.detail
                                          Definition

                                          Links to other relevant information, including pathology reports.

                                          ShortSupporting information found elsewhere
                                          Control0..*
                                          This element is affected by the following invariants: con-2
                                          TypeReference(Resource)
                                          Summarytrue
                                          170. Condition.note
                                          Definition

                                          Comment on the pregnancy.

                                          ShortComment
                                          Control0..1
                                          TypeAnnotation
                                          Alternate NamesToelichting