Skip to content

Health Concerns

Overview

Health Concerns addresses to the Condition HL7® FHIR® resource. 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) v1 ‘Problems’ and ‘Health Concerns’ requirements and SDOH ‘Problems/Health Concerns’ 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 status of the condition*
  • a category
  • a code that identifies the condition
  • a patient

Each Condition must support:

  • a verification status

Profile specific implementation guidance:

  • The US Core Condition Category 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 V1 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.

Must support elements, mandatory and optional search parameters

Condition must support these elements:

  • clinicalStatus
  • verificationStatus
  • category
  • code
  • subject

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]

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 search parameters:

GET [base url]/Condition?patient={Type/}[id]&category={system|}[code]

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]&...}

The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.

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 Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header Type Required/Optional Value
Authorization string required 'Bearer'

RESPONSES

Code Description Comment
200 OK The request was processed successfully
400 Bad request Invalid request parameters or FHIR operation outcome resource returned
401 Unauthorized This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404 no Route matched with those values The request was able to communicate with a given server, but the server could not find what was requested
500 Internal Server Error The 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.kodjin.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb&status=active' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Condition by Patient and clinical-status

Get Condition by combination patient and clinical-status

METHOD GET

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 Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header Type Required/Optional Value
Authorization string required 'Bearer'

RESPONSES

Code Description Comment
200 OK The request was processed successfully
400 Bad request Invalid request parameters or FHIR operation outcome resource returned
401 Unauthorized This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404 no Route matched with those values The request was able to communicate with a given server, but the server could not find what was requested
500 Internal Server Error The 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.kodjin.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'

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 Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header Type Required/Optional Value
Authorization string required 'Bearer'

RESPONSES

Code Description Comment
200 OK The request was processed successfully
400 Bad request Invalid request parameters or FHIR operation outcome resource returned
401 Unauthorized This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404 no Route matched with those values The request was able to communicate with a given server, but the server could not find what was requested
500 Internal Server Error The 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.kodjin.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'

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 Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header Type Required/Optional Value
Authorization string required 'Bearer'

RESPONSES

Code Description Comment
200 OK The request was processed successfully
400 Bad request Invalid request parameters or FHIR operation outcome resource returned
401 Unauthorized This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404 no Route matched with those values The request was able to communicate with a given server, but the server could not find what was requested
500 Internal Server Error The 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.kodjin.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&code=http://snomed.info/sct|442311008' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

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 Authentication and Authorization process. Goto Authentication and Authorization for further details.

Header Type Required/Optional Value
Authorization string required 'Bearer'

RESPONSES

Code Description Comment
200 OK The request was processed successfully
400 Bad request Invalid request parameters or FHIR operation outcome resource returned
401 Unauthorized This code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404 no Route matched with those values The request was able to communicate with a given server, but the server could not find what was requested
500 Internal Server Error The 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.kodjin.com/fhir/Condition?patient=Patient/05b87542-b50e-4f19-8a87-2da2e6959bfb2&onset-date=ge2020-10-12' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'