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Overview

Health Concerns Information addresses: The US Core Condition Problems and Health Concerns Profile is based upon the core FHIR Condition Resource and meets the US Core Data for Interoperability (USCDI) v3 SDOH Assessment, Health Status/Assessments and Problems requirements. To promote interoperability and adoption through common implementation, this profile defines constraints and extensions on the Condition resource for the minimal set of data to record, search, and fetch information about a condition, diagnosis, or other event, situation, issue, or clinical concept that is documented and categorized as a problem or health concern including information about a Social Determinants of Health-related condition. Health concerns are also returned as part of the Condition resource and represent other concerns a patient may have such as financial or social risks. Each Condition has next elements:
  • a category code of “problem-list-item” or “health-concern”
  • a code that identifies the condition
  • a patient
Each Condition must support:
  • a clinical status of the condition (e.g., active or resolved)
  • a verification status
  • additional health status/assessment categories
  • a date of diagnosis
  • abatement date (in other words, date of resolution or remission)
  • a date when recorded
Profile specific implementation guidance:
  • The US Core Problem or Health Concern Codes support the separate types of conditions so API consumers can separate health concerns, problems, and encounter diagnoses.
  • The 2015 Certification rule requires the use of SNOMED CT for problem list entries. Following the rules for extensible binding to coded data types, ICD or other local codes can be used as translations to SNOMED CT.
  • The US Core Condition Code supports ICD-9-CM for historical purposes only. ICD-10-CM is available and may be used as the primary code for current encounter diagnoses.
  • To search for an encounter diagnosis, query for Conditions that reference the Encounter of interest and have a category of encounter-diagnosis.
This resource conforms to USCDI V3 profile for Condition - refers to US Core Condition Problems and Health Concerns Profile. Condition response will be provided in JSON (refers to Capability Statement) format as per FHIR standard R4 version.
USCore Data ElementFHIR Resource Field
statusCondition.status
categoryCondition.category (us-core/sdoh)
codeCondition.code (ICD-10-CM/Snomed)
patientCondition.subject

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Must support elements, mandatory and optional search parameters

Conditionmust support these elements:
  • assertedDate
  • clinicalStatus
  • verificationStatus
  • category
    • category:us-core
    • category:screening-assessment
  • code
  • subject
  • onsetDateTime
  • abatementDateTime
  • recordedDate
The following search parameters and search parameter combinations SHALL be supported: The syntax used to describe the interactions is described here. SHALL support searching for all conditions including problems, health concerns, and encounter diagnosis for a patient using the patient search parameter: GET [base]/Condition?patient={Type/}[id] SHALL support searching using the combination of the patient and category search parameters: GET [base url]/Condition?patient={Type/}[id]&category={system|}[code] The following search parameter combinations SHOULD be supported: SHOULD support searching using the combination of the patient and clinical-status search parameters: GET [base url]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission SHOULD support searching using the combination of the patient and category and clinical-status search parameters: GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission SHOULD support searching using the combination of the patient and category and encounter search parameters: GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id] SHOULD support searching using the combination of the patient and code search parameters: GET [base url]/Condition?patient={Type/}[id]&code={system|}[code] SHOULD support searching using the combination of the patient and onset-date search parameters:
  • including support for these onset-date comparators: gt,lt,ge,le
  • including optional support for AND search on onset-date (e.g.onset-date=[date]&onset-date=[date]]&…)
GET [base url]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...} SHOULD support searching using the combination of the patient and asserted-date search parameters:
  • including support for these asserted-date comparators: gt,lt,ge,le
  • including optional support for AND search on asserted-date (e.g.asserted-date=[date]&asserted-date=[date]]&…) GET [base url]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}
SHOULD support searching using the combination of the patient and recorded-date search parameters:
  • including support for these recorded-date comparators: gt,lt,ge,le
  • including optional support for AND search on recorded-date (e.g.recorded-date=[date]&recorded-date=[date]]&…) GET [base url]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}
SHOULD support searching using the combination of the patient and abatement-date search parameters:
  • including support for these abatement-date comparators: gt,lt,ge,le
  • including optional support for AND search on abatement-date (e.g.abatement-date=[date]&abatement-date=[date]]&…) GET [base url]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.

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Condition by Patient

Get Condition by patient METHOD GET 
GET [base url]/Condition?patient={Type/}[id]
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s id HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLES: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&status=active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient and category

Get Condition by combination patient and category METHOD GET 
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s id {system|} - http://hl7.org/fhir/us/core/CodeSystem/condition-category [code] - health-concern optionally: code could take a value from the list: [code] - problem-list-item [code] - encounter-diagnosis [code] - health-concern HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient and clinical-status

Get Condition by combination patient and clinical-status METHOD GET Notes: Fetches a bundle of all Condition resources for the specified patient and all “active” statuses (active,relapse,remission). This will exclude diagnoses and health concerns without a clinicalStatus specified. 
GET [base url]/Condition?patient={Type/}[id]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s id HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient, category and clinical-status

Get Condition by combination patient, category and clinical-status METHOD GET Notes: Fetches a bundle of all Condition resources for the specified patient, category, and all “active” statuses (active, relapse, remission). This will exclude diagnoses and health concerns without a clinicalStatus specified. 
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s id {system|} - http://hl7.org/fhir/us/core/CodeSystem/condition-category [code] - health-concern optionally: code could take a value from the list: [code] - problem-list-item [code] - encounter-diagnosis [code] - health-concern HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern&clinical-status=http://terminology.hl7.org/CodeSystem/condition-clinical|active,http://terminology.hl7.org/CodeSystem/condition-clinical|recurrance,http://terminology.hl7.org/CodeSystem/condition-clinical|remission' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient, category and encounter

Get Condition by combination patient, category and encounter METHOD GET Notes: Fetches a bundle of all Condition resources for the specified patient, category, and encounter. This is particularly useful for retrieving encounter-specific diagnoses. 
GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]&encounter={Type/}[id]
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s id {system|} - http://hl7.org/fhir/us/core/CodeSystem/condition-category [code] - health-concern optionally: code could take a value from the list: [code] - problem-list-item [code] - encounter-diagnosis [code] - health-concern [id] - Encounter’s id HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|encounter-diagnosis&encounter=Encounter/12345' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient and code

Get Condition by combination patient and code METHOD GET 
GET [base url]/Condition?patient={Type/}[id]&code={system|}[code]
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s Id {system|} - The system for the observation, e.g. http://snomed.info/sct [code] - code for observation in the system, e.g. 442311008 HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&code=http://snomed.info/sct|442311008' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient and onset-date

Get Condition by combination patient and onset-date METHOD GET 
GET [base]/Condition?patient={Type/}[id]&onset-date={gt|lt|ge|le}[date]{&onset-date={gt|lt|ge|le}[date]&...}
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s Id [date] - Filter’s date {gt|lt|ge|le} - Search modifier gr or lt or ge or le. Specification how to search by date in FHIR HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&onset-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient and asserted-date

Get Condition by combination patient and asserted-date METHOD GET 
GET [base]/Condition?patient={Type/}[id]&asserted-date={gt|lt|ge|le}[date]{&asserted-date={gt|lt|ge|le}[date]&...}
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s Id [date] - Filter’s date {gt|lt|ge|le} - Search modifier gt or lt or ge or le. Specification how to search by date in FHIR HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&asserted-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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Condition by Patient and recorded-date

Get Condition by combination patient and recorded-date METHOD GET 
GET [base]/Condition?patient={Type/}[id]&recorded-date={gt|lt|ge|le}[date]{&recorded-date={gt|lt|ge|le}[date]&...}
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s Id [date] - Filter’s date {gt|lt|ge|le} - Search modifier gt or lt or ge or le. Specification how to search by date in FHIR HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&recorded-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

​
Condition by Patient and abatement-date

Get Condition by combination patient and abatement-date METHOD GET 
GET [base]/Condition?patient={Type/}[id]&abatement-date={gt|lt|ge|le}[date]{&abatement-date={gt|lt|ge|le}[date]&...}
PARAMS [base url] - FHIR base url {Type/} - optional parameter for reference type [id] - Patient’s Id [date] - Filter’s date {gt|lt|ge|le} - Search modifier gt or lt or ge or le. Specification how to search by date in FHIR HEADERS The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
HeaderTypeRequired/OptionalValue
AuthorizationstringrequiredBearer <token>
RESPONSES
CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404No route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn’t know how to handle
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome. EXAMPLE: 
curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&abatement-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'