KjConditionCriticalMedicalCondition profile

The KjConditionCriticalMedicalCondition profile is used for medical condition alert about a patient.

To filter out this specific Condition type from all other Conditions, for e.g. privacy reasons, you can use the query parameter 'criticalInfoType' as described in the documentation for endpoints.

Profile elements

Note that for all FHIR elements which has coding, e.g. code.coding and category.coding, we prefer coding.display to always be set for completeness sake as well as coding.code and coding.system.

https://simplifier.net/kjernejournalr4/kjconditioncriticalmedicalcondition

Element Norwegian Text Description Comment
id Record id Id + meta.versionId is the unique identifier.
meta.versionId Record version id
clinicalStatus See below Used for Status, see below. Values can be active | inactive
verificationStatus See below Used for Status, see below. Values can be confirmed | refuted | entered-in-error
category.coding.code Kritisk medisinsk tilstand 5=Kritisk medisinsk tilstand Type of critical information.
code.coding Diagnose Clinical code for the condition, problem or diagnosis. Additional codings may be added, if any, with extra information. I.e. related information from Absoluttliste for ICD-10 code (not userSelected).
code.coding.userSelected If this coding was chosen directly by the user. If more than one coding, userSelected shall indicate the main coding. See code example below.
code.coding.extension Extensions for extra information for this type of critical medical condition:
http://nhn.no/kj/fhir/StructureDefinition/CodeInfoText - Code description text
http://nhn.no/kj/fhir/StructureDefinition/UrlMoreInformation - URL to information		 These extensions is linked to the code and will not be stored in write operations.
See code example below.
code.text Spesifisering Text if no proper code is found.
subject Pasient Who has the condition.
onset Tidspunkt for hendelse Estimated or actual date, date-time, or age.
recordedDate Tidspunkt for første registrering Date record was first recorded.
recorder Hvem som gjorde første registrering Who recorded this condition first. Must always reference the original recorder of the resource. Use PractitionerRole contained reference.
evidence.code Begrunnelse for registrering Critical medical condition reason.
note Kommentar Note.
extension.sourceOfInformation Kilde Source of information.
extension.updater Hvem som gjorde endring Who changed this version of the resource. Use PractitionerRole contained reference.
extension.updatedDateTime Tidspunkt endring When this version of the resource was changed.

Status

The status which the critical information record is in.

Status Norwegian Text Element Values Comment
Active Aktiv clinicalStatus=active and verificationStatus=confirmed Use when the registration is active.
Refuted Avkreftet clinicalStatus=inactive and verificationStatus=refuted Use when the registration is refuted.
Deleted Slettet clinicalStatus=null and verificationStatus=entered-in-error When an erroneous registration. Use the REST delete endpoint.
Inactive Inaktiv clinicalStatus=inactive and verificationStatus=confirmed Use to remove a duplicate registration.

Example

Critical medical condition, coding ICD-10

{
  "resourceType": "Condition",
  "id": "1480f4a0-0e23-41f5-9c9f-5dd2e2580dc8",
  "meta": {
    "versionId": "2",
    "lastUpdated": "2021-04-26T11:15:17.955+02:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjConditionCriticalMedicalCondition" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "updaterRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200068"
      },
      "display": "Skansen, Karl"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.101",
        "value": "983544622"
      },
      "display": "HELSEDIREKTORATET"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  }, {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.101",
        "value": "998570328"
      },
      "display": "Munkholmen Legesenter"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjUpdater",
    "valueReference": {
      "reference": "#updaterRef"
    }
  }, {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjUpdatedDateTime",
    "valueDateTime": "2021-04-26T11:15:17+02:00"
  }, {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "7",
      "display": "Opplyst av ansvarlig behandler"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
      "code": "confirmed",
      "display": "Confirmed"
    } ]
  },
  "category": [ {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SubcategoriesOfCriticalInformation",
      "code": "5",
      "display": "Kritisk medisinsk tilstand"
    } ]
  } ],
  "code": {
    "coding": [
      {
        "system": "http://nhn.no/kj/fhir/CodeSystem/ICD-10",
        "code": "Q874",
        "display": "Marfans syndrom",
        "userSelected": true
      },
      {
        "extension": [
          {
            "url": "http://nhn.no/kj/fhir/StructureDefinition/CodeInfoText",
            "valueReference": {
              "reference": "Medfødt bindevevssykdom med svekkelse av kollagen. Kan bl.a medføre forandringer i hjerte-karsystemet. Økt risiko for utvidelse av og ruptur av hovedpulsåren og løse øyelinser."
            }
          },
          {
            "url": "http://nhn.no/kj/fhir/StructureDefinition/UrlMoreInformation",
            "valueReference": {
              "reference": "http://www.helsebiblioteket.no/sok?q=Marfans+syndrom"
            }
          }
        ],
        "system": "http://nhn.no/kj/fhir/CodeSystem/CriticalMedicalConditionAbsoluteList",
        "code": "4",
        "display": "Marfans syndrom",
        "userSelected": false
      }
    ]
  },
  "subject": {
    "reference": "Patient/01035500126"
  },
  "onsetDateTime": "2021-04-15T00:00:00+02:00",
  "recordedDate": "2021-04-06T15:56:35+02:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "evidence": [ {
    "code": [ {
      "text": "Akutt bakteriell rhinosinusitt (ABRS) "
    } ]
  } ],
  "note": [ {
    "text": "Operert x 5 på Rikshospitalet"
  } ]
}

Critical medical condition, coding CriticalMedicalConditionAbsoluteList

{
  "resourceType": "Condition",
  "id": "9c4cb870-98ec-485b-af65-885a4e157e0a",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2021-03-14T12:12:54.364+01:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjConditionCriticalMedicalCondition" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Fos Perez, Jack"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.101",
        "value": "100100223"
      },
      "display": "Andeby Legevakt"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "2",
      "display": "Observert av registrerende helsepersonell"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
      "code": "confirmed",
      "display": "Confirmed"
    } ]
  },
  "category": [ {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SubcategoriesOfCriticalInformation",
      "code": "5",
      "display": "Kritisk medisinsk tilstand"
    } ]
  } ],
  "code": {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/CriticalMedicalConditionAbsoluteList",
      "code": "78",
      "display": "Påvist genetisk avvik i CYP-metabolismen: CYP2D6 *3/*3"
    } ]
  },
  "subject": {
    "reference": "Patient/13116900216"
  },
  "onsetDateTime": "2017-03-14T00:00:00+01:00",
  "recordedDate": "2021-03-14T12:12:54+01:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "evidence": [ {
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CriticalMedicalConditionReason",
        "code": "8",
        "display": "Diagnosen omfattes av definisjonen av kritisk tilstand"
      } ]
    } ]
  } ],
  "note": [ {
    "text": "Pasienten har påvist ingen metabolisme og lavere dosebehov av legemidler som brytes ned av dette enzymet. For f.eks. tamoksifen, kodein og tramadol gir denne genotypen redusert effekt.\nPrøven er analysert ved Senter for Psykofarmakologi, Diakonhjemmet."
  } ]
}

Coding extension for additional information

  "code": {
    "coding": [ {
      "extension": [ {
        "url": "http://nhn.no/kj/fhir/StructureDefinition/UrlMoreInformation",
        "valueReference": {
          "reference": "http://www.helsebiblioteket.no/sok?q=Marfans+syndrom"
        }
      }, {
        "url": "http://nhn.no/kj/fhir/StructureDefinition/CodeInfoText",
        "valueReference": {
          "reference": "Medfødt bindevevssykdom med svekkelse av kollagen. Kan bl.a medføre forandringer i hjerte-karsystemet. Økt risiko for utvidelse av og ruptur av hovedpulsåren og løse øyelinser."
        }
      } ],
      "system": "http://nhn.no/kj/fhir/CodeSystem/CriticalMedicalConditionAbsoluteList",
      "code": "4",
      "display": "Marfans syndrom"
    } ]