Implementation Guide CH VACD
2.0.0 - STU 2
Implementation Guide CH VACD
2.0.0 - STU 2
This page is part of the CH VACD (R4) (v2.0.0: STU 2) based on FHIR R4. . For a full list of available versions, see the Directory of published versions 
| Defining URL: | http://fhir.ch/ig/ch-vacd/StructureDefinition/ch-vacd-recommendation-medical-problems |
| Version: | 2.0.0 |
| Name: | CHVACDRecommendationMedicalProblems |
| Title: | CH VACD Recommendation Medical Problems Profile |
| Status: | Draft as of 2022-02-11 02:45:16+0100 |
| Definition: | Definition of the medical problems part for recommendation request and response documents. |
| Publisher: | HL7 Switzerland |
| Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://fhir.ch/ig/ch-vacd/StructureDefinition/ch-vacd-recommendation-medical-problems
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from CHVACDRecommendationCondition
This structure is derived from CHVACDRecommendationCondition
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Condition | 0..* | CHVACDRecommendationCondition | CH VACD Medical Problem Condition | |
  code | 1..1 | CodeableConcept | Condition code Binding: SwissRisksForImmunizations (extensible): The code for medical problems (exposition and medical risks) for immunization. | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | I | 0..* | CHVACDRecommendationCondition | CH VACD Medical Problem Condition |
  id | Σ | 0..1 | string | Logical id of this artifact |
 meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
 Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
 ch-vacd-ext-cross-reference | 0..1 | (Complex) | Reference to related resource URL: http://fhir.ch/ig/ch-vacd/StructureDefinition/ch-vacd-ext-cross-reference | |
| ch-vacd-ext-merging-conflict-entry-reference | 0..* | (Complex) | Reference to related resource URL: http://fhir.ch/ig/ch-vacd/StructureDefinition/ch-vacd-ext-merging-conflict-entry-reference | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | External Ids for this condition |
| clinicalStatus | ?!ΣI | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. |
| verificationStatus | ?!ΣI | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis. |
| category | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. | |
| severity | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician. | |
| code | Σ | 1..1 | CodeableConcept | Condition code Binding: SwissRisksForImmunizations (extensible): The code for medical problems (exposition and medical risks) for immunization. |
| bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
 subject | Σ | 1..1 | Reference(CH VACD Recommendation Patient Profile) | Patient |
  onset[x] | Σ | 0..1 | Estimated or actual date, date-time, or age | |
 onsetDateTime | dateTime | |||
| onsetAge | Age | |||
| onsetPeriod | Period | |||
| onsetRange | Range | |||
| onsetString | string | |||
| abatement[x] | I | 0..1 | When in resolution/remission | |
| abatementDateTime | dateTime | |||
| abatementAge | Age | |||
| abatementPeriod | Period | |||
| abatementRange | Range | |||
| abatementString | string | |||
| recordedDate | Σ | 1..1 | dateTime | Condition recordedDate |
| recorder | Σ | 0..1 | Reference(CH VACD Recommendation PractitionerRole Profile | CH VACD Recommendation Patient Profile | RelatedPerson) | Who recorded the condition |
| asserter | Σ | 0..1 | Reference(CH VACD Recommendation PractitionerRole Profile) | Person who asserts this condition |
| stage | I | 0..* | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| summary | I | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages). |
| assessment | I | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment |
| type | 0..1 | CodeableConcept | Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological). | |
| evidence | I | 0..* | BackboneElement | Supporting evidence con-2: evidence SHALL have code or details |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition. |
| detail | ΣI | 0..* | Reference(Resource) | Supporting information found elsewhere |
| note | 0..* | Annotation | Additional information about the Condition | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | I | 0..* | CHVACDRecommendationCondition | CH VACD Medical Problem Condition |
| Documentation for this format | ||||
This structure is derived from CHVACDRecommendationCondition
Differential View
This structure is derived from CHVACDRecommendationCondition
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | 0..* | CHVACDRecommendationCondition | CH VACD Medical Problem Condition | |
| code | 1..1 | CodeableConcept | Condition code Binding: SwissRisksForImmunizations (extensible): The code for medical problems (exposition and medical risks) for immunization. | |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Condition | I | 0..* | CHVACDRecommendationCondition | CH VACD Medical Problem Condition |
| id | Σ | 0..1 | string | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| ch-vacd-ext-cross-reference | 0..1 | (Complex) | Reference to related resource URL: http://fhir.ch/ig/ch-vacd/StructureDefinition/ch-vacd-ext-cross-reference | |
| ch-vacd-ext-merging-conflict-entry-reference | 0..* | (Complex) | Reference to related resource URL: http://fhir.ch/ig/ch-vacd/StructureDefinition/ch-vacd-ext-merging-conflict-entry-reference | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | External Ids for this condition |
| clinicalStatus | ?!ΣI | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. |
| verificationStatus | ?!ΣI | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis. |
| category | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. | |
| severity | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician. | |
| code | Σ | 1..1 | CodeableConcept | Condition code Binding: SwissRisksForImmunizations (extensible): The code for medical problems (exposition and medical risks) for immunization. |
| bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
| subject | Σ | 1..1 | Reference(CH VACD Recommendation Patient Profile) | Patient |
| onset[x] | Σ | 0..1 | Estimated or actual date, date-time, or age | |
| onsetDateTime | dateTime | |||
| onsetAge | Age | |||
| onsetPeriod | Period | |||
| onsetRange | Range | |||
| onsetString | string | |||
| abatement[x] | I | 0..1 | When in resolution/remission | |
| abatementDateTime | dateTime | |||
| abatementAge | Age | |||
| abatementPeriod | Period | |||
| abatementRange | Range | |||
| abatementString | string | |||
| recordedDate | Σ | 1..1 | dateTime | Condition recordedDate |
| recorder | Σ | 0..1 | Reference(CH VACD Recommendation PractitionerRole Profile | CH VACD Recommendation Patient Profile | RelatedPerson) | Who recorded the condition |
| asserter | Σ | 0..1 | Reference(CH VACD Recommendation PractitionerRole Profile) | Person who asserts this condition |
| stage | I | 0..* | BackboneElement | Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| summary | I | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages). |
| assessment | I | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment |
| type | 0..1 | CodeableConcept | Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological). | |
| evidence | I | 0..* | BackboneElement | Supporting evidence con-2: evidence SHALL have code or details |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | ΣI | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition. |
| detail | ΣI | 0..* | Reference(Resource) | Supporting information found elsewhere |
| note | 0..* | Annotation | Additional information about the Condition | |
| Documentation for this format | ||||
Other representations of profile: CSV, Excel, Schematron
| Path | Conformance | ValueSet |
| Condition.language | preferred | CommonLanguages Max Binding: AllLanguages |
| Condition.clinicalStatus | required | ConditionClinicalStatusCodes |
| Condition.verificationStatus | required | ConditionVerificationStatus |
| Condition.category | extensible | ConditionCategoryCodes |
| Condition.severity | preferred | Condition/DiagnosisSeverity |
| Condition.code | extensible | SwissRisksForImmunizations |
| Condition.bodySite | example | SNOMEDCTBodyStructures |
| Condition.stage.summary | example | ConditionStage |
| Condition.stage.type | example | ConditionStageType |
| Condition.evidence.code | example | ManifestationAndSymptomCodes |
| Id | Grade | Path | Details | Requirements |
| con-3 | Best Practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item : clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty() | |
| con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists() | |
| con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty() | |
| dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Condition | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | Condition | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | Best Practice | Condition | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | Condition.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.extension:relatesTo | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.extension:relatesTo | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.extension:conflict | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.extension:conflict | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.clinicalStatus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.verificationStatus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.severity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.bodySite | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.onset[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.abatement[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.recordedDate | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.recorder | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.asserter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| con-1 | error | Condition.stage | Stage SHALL have summary or assessment : summary.exists() or assessment.exists() | |
| ele-1 | error | Condition.stage | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.stage.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.stage.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.stage.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.stage.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.stage.summary | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.stage.assessment | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.stage.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| con-2 | error | Condition.evidence | evidence SHALL have code or details : code.exists() or detail.exists() | |
| ele-1 | error | Condition.evidence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.evidence.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.evidence.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.evidence.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | Condition.evidence.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | error | Condition.evidence.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.evidence.detail | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | error | Condition.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |