Problems
Source Object: Problems
Overview and Usage: The "Problems" source object is essential in healthcare systems for tracking and managing patient health issues, diagnoses, and conditions. It provides a comprehensive view of a patient's medical problems and their associated details. Here's a breakdown of the key components:
- Code: A unique identifier for the problem or diagnosis code.
- Code Set: The code set used for the problem code (e.g., ICD-10, SNOMED CT).
- Name: The name or description of the problem or diagnosis.
- Problem ID: A unique identifier for the problem or diagnosis record.
- Events: Information related to events associated with the problem, including start date, best match ICD-10 code, deactivation date, and more.
- Start Date: The date when the problem or diagnosis was first identified.
- Best Match ICD-10 Code: The ICD-10 code that best matches the problem or diagnosis.
- Deactivation Date and User: The date when the problem was deactivated and the user responsible.
- Last Modified By and Date Time: The user who last modified the problem and the date and time of the modification.
- Most Recent Diagnosis Note: The note associated with the most recent diagnosis event.
- Created By and Date: The user who created the event and the date of creation.
- Diagnosis: Information about the diagnosis associated with the event.
- Code: The diagnosis code.
- Code Set: The code set for the diagnosis code.
- Name: The name or description of the diagnosis.
- Encounter Date: The date when the diagnosis event occurred during an encounter.
- End Date: The date when the event concluded.
- Event Type: The type of event related to the problem or diagnosis.
- Laterality: Information about the laterality of the problem or diagnosis.
- Note: Additional notes related to the event.
- Onset Date: The date when the problem or diagnosis first began.
- Source: The source or cause of the problem or diagnosis.
- Status: The status of the event (e.g., resolved, ongoing).
- SNOMED Code: The SNOMED CT code associated with the problem.
- Note: Additional notes or comments related to the problem or diagnosis.
- Status: The status of the problem (e.g., active, resolved).
- Laterality: Information about the laterality of the problem or diagnosis.
- Start Date: The date when the problem or diagnosis was first identified.
- PATIENT FACING CALL: An indication of whether the problem or diagnosis is associated with patient-facing communication.
- THIRD PARTY USERNAME: The username of the third party involved in the management of the problem or diagnosis.
The "Problems" source object is vital for maintaining a comprehensive and accurate patient health record, enabling healthcare providers to diagnose, treat, and monitor patient conditions effectively.
Mapping Table
Data Field | Example Value | Source Data Field Description | Source Field Data Type | Source Data Field Cardinality | Mapped FHIR++ Resource | Mapped FHIR Data Field | Augmented Mapping | Associated Coding System | Associated FHIR Data Field Extension | Mapping Context |
---|---|---|---|---|---|---|---|---|---|---|
code | - | Problem code | String | 1..1 | Condition | code.coding[1].code | - | - | - | Top Level |
codeset | - | Problem codeset (SNOMED, ICD9, ICD10, etc) | String | 0..1 | Condition | code.coding[1].system | - | Snomed,ICD10,ICD9 | - | Top Level |
name | - | Problem name | String | 0..1 | Condition | code.coding[1].display | - | - | - | Top Level |
problemid | - | athena ID for this problem | Integer | 1..1 | Condition | id | - | - | - | Top Level |
events | - | List of start and stop events for this problem, which can occur multiple times. | Object | 0..* | ClinicalImpression | - | - | - | - | Contained |
events.startdate | - | The date this problem event started or was restarted. Uses the onsetdate if available, otherwise uses the date the problem was entered into the system. | String | 0..1 | ClinicalImpression | effectivePeriod.start | - | - | - | Contained |
bestmatchicd10code | - | If this was added from the chart or from an encounter without a selected ICD10 code, and if the primary codeset is SNOMED, then this contains the best matching ICD10 code mapped. Because SNOMED to ICD10 is a many to many map, this will tend to give the most generic diagnosis. | String | 0..1 | Condition | code.coding[2].code | system = ICD10 | ICD10 | - | Top Level |
deactivateddate | - | Date of problem deactivation. | String | 0..1 | Condition | abatement.abatementDateTime | - | - | - | Top Level |
deactivateduser | - | The name of the user who deactivated the problem. | String | 0..1 | Condition | extension[*].valueString | - | - | deactivated-user | Top Level |
lastmodifiedby | - | The username of the user who last modified this problem. | String | 0..1 | Condition | extension[*].valueString | - | - | last-modified-by | Top Level |
lastmodifieddatetime | - | The date the problem was last modified. Currently only date precision. | String | 0..1 | Condition | extension[*].valueString | - | - | last-modified-datetime | Top Level |
mostrecentdiagnosisnote | - | The data will be displayed when the showdiagnosisinfo flag is set to true | String | 0..1 | Condition | note[1].text | - | - | - | Top Level |
events.createdby | - | The name of the user who entered this problem. | String | 0..1 | ClinicalImpression | assessor.reference | - | - | - | Contained |
events.createddate | - | The date that the user entered this problem. | String | 0..1 | ClinicalImpression | date | - | - | - | Contained |
events.diagnosis | - | List of encounter diagnoses that triggered this problem. | Object | 0..* | ClinicalImpression | - | - | - | - | Contained |
events.diagnosis.code | - | Diagnosis code | String | 0..1 | ClinicalImpression | finding[].itemCodeableConcept.coding[].code | - | - | - | Contained |
events.diagnosis.codeset | - | Diagnosis codeset (SNOMED, ICD9, ICD10, etc) | String | 0..1 | ClinicalImpression | finding[].itemCodeableConcept.coding[].system | - | Snomed,ICD10,ICD9 | - | Contained |
events.diagnosis.name | - | Diagnosis name. Might be different than problem name. | String | 0..1 | ClinicalImpression | finding[].itemCodeableConcept.coding[].display | - | - | - | Contained |
events.encounterdate | - | The date of the encounter where a diagnosis matching this problem was used. | String | 0..1 | ClinicalImpression | extension[*].valueString | - | - | encounter-date | Contained |
events.enddate | - | The date this problem event ended or was hidden | String | 0..1 | ClinicalImpression | effectivePeriod.end | - | - | - | Contained |
events.eventtype | - | The type of this event: START, END, HIDDEN, REACTIVATED, or ENCOUNTER | String | 0..1 | ClinicalImpression | extension[*].valueString | - | - | event-type | Contained |
events.laterality | - | The laterality of this problem. Can be null, LEFT, RIGHT, or BILATERAL. | String | 0..1 | ClinicalImpression | extension[*].valueString | - | - | laterality | Contained |
events.note | - | The note attached to this event. | String | 0..1 | ClinicalImpression | note.text | - | - | - | Contained |
events.onsetdate | - | The specified onset date for this problem, as entered by the practice. If available this is more accurate than the start date. | String | 0..1 | ClinicalImpression | extension[*].valueString | - | - | on-set-date | Contained |
events.source | - | The source of this event: ENCOUNTER or HISTORY | String | 0..1 | ClinicalImpression | extension[*].valueString | - | - | source | Contained |
events.status | - | The status of this problem event: CHRONIC or ACUTE | String | 0..1 | ClinicalImpression | extension[*].valueString | - | - | status | Contained |
snomedcode | - | snomed code | Integer | 1..1 | Condition | code.coding[*].code | system=http://snomed.info/sct | Snomed | - | Top Level |
note | - | The note to be attached to this problem. | String | 0..1 | Condition | note[0].text | - | - | - | Top Level |
status | - | Whether the problem is chronic or acute. | String | 0..1 | Condition | clinicalStatus.extensions[*].valueString | - | - | problem-status | Top Level |
laterality | - | Update the laterality of this problem. Can be null, LEFT, RIGHT, or BILATERAL. | String | 0..1 | Condition | extensions[*].valueString | - | - | - | Top Level |
startdate | - | The onset date to be updated for this problem in MM/DD/YYYY format. | String | 0..1 | Condition | onsetDateTime | - | - | - | Top Level |
PATIENTFACINGCALL | - | When 'true' is passed we will collect relevant data and store in our database. | Boolean | 0..1 | Condition | extensions[*].valueBoolean | - | - | patient-facing-call | Top Level |
THIRDPARTYUSERNAME | - | User name of the patient in the third party application. | String | 0..1 | Condition | extensions[*].valueString | - | - | third-party-user-name | Top Level |