# condition

Data diagnosis pasien dapat dikirimkan menggunakan *resource* `Condition`. Informasi diagnosis yang dimiliki pasien dilaporkan menggunakan kode ICD-10. Satu *payload* `Condition` hanya dapat digunakan untuk melaporkan 1 kode ICD-10. Sehingga apabila pasien memiliki 2 diagnosis, maka dikirimkan 2 *payload* `Condition` dengan 2 kode ICD-10 yang berbeda.

## condition**.identifier**

Berisi satu atau lebih daftar data mengenai informasi terkait kode atau nomor internal sub lokasi yang dimiliki oleh lokasi induk yang setiap datanya direpresentasikan dengan tipe data Identifier.

<table><thead><tr><th width="405">Elemen</th><th>Nilai Elemen</th></tr></thead><tbody><tr><td><h4 id="observation-identifier-use">condition.identifier[i].use</h4></td><td>Berisi data dengan tipe data <code>code</code>, yang nilainya mengacu pada data terminologi <a href="http://hl7.org/fhir/identifier-use">IdentifierUse</a>.</td></tr><tr><td>condition.identifier[i].system</td><td><a href="http://sys-ids.kemkes.go.id/condition/%7B%7Borganization-ihs-number%7D%7D">http://sys-ids.kemkes.go.id/condition/{{organization-ihs-number}}</a> dengan <code>{organization-ihs-number}</code> adalah ID organisasi induk yang didapatkan dari master sarana indeks.</td></tr><tr><td>condition.identifier[i].value</td><td>Berisi kode atau ID lokal yang disimpan di sistem internal masing-masing organisasi.</td></tr></tbody></table>

### condition.identifier\[i].use <a href="#observation-identifier-use" id="observation-identifier-use"></a>

| Code      | Display   | Definition                                                                                                                                                                                                                                           |
| --------- | --------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| usual     | Usual     | The identifier recommended for display and use in real-world interactions which should be used when such identifier is different from the "official" identifier.                                                                                     |
| official  | Official  | The identifier considered to be most trusted for the identification of this item. Sometimes also known as "primary" and "main". The determination of "official" is subjective and implementation guides often provide additional guidelines for use. |
| temp      | Temp      | A temporary identifier.                                                                                                                                                                                                                              |
| secondary | Secondary | An identifier that was assigned in secondary use - it serves to identify the object in a relative context, but cannot be consistently assigned to the same object again in a different context.                                                      |
| old       | Old       | The identifier id no longer considered valid, but may be relevant for search purposes. E.g. Changes to identifier schemes, account merges, etc.                                                                                                      |

{% code title="Contoh data condition.identifier" %}

```json
[
  {
    "system": "http://sys-ids.kemkes.go.id/condition/10000004",
    "use": "official",
    "value": "5234342"
  }
]
```

{% endcode %}

## Condition.clinicalStatus <a href="#condition-clinicalstatus" id="condition-clinicalstatus"></a>

Berisi informasi mengenai status klinis dari kondisi pasien dengan tipe data `CodeableConcept`.

### Condition.clinicalStatus.coding <a href="#condition-clinicalstatus-coding" id="condition-clinicalstatus-coding"></a>

Berisi satu atau lebih data kode status klinis dari kondisi pasien dengan tipe data `Coding`, yang nilainya mengacu pada data terminologi [ConditionClinicalStatusCodes](http://terminology.hl7.org/CodeSystem/condition-clinical).

| Code       | Display    | Definition                                                                                                                                                 |
| ---------- | ---------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------- |
| active     | Active     | The subject is currently experiencing the condition or situation, there is evidence of the condition or situation, or considered to be a significant risk. |
| recurrence | Recurrence | The subject is experiencing a reoccurence or repeating of a previously resolved condition or situation, e.g. urinary tract infection, food insecurity.     |
| relapse    | Relapse    | The subject is experiencing a return of a condition or situation after a period of improvement or remission, e.g. relapse of cancer, alcoholism.           |
| inactive   | Inactive   | The subject is no longer experiencing the condition or situation and there is no longer evidence or appreciable risk of the condition or situation.        |
| remission  | Remission  | The subject is not presently experiencing the condition or situation, but there is a risk of the condition or situation returning.                         |
| resolved   | Resolved   | The subject is not presently experiencing the condition or situation and there is a negligible perceived risk of the condition or situation returning.     |

{% code title="Contoh Condition.clinicalStatus.coding " %}

```json
[
  {
    "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
    "code": "active",
    "display": "Active"
  }
]
```

{% endcode %}

## Condition.severity <a href="#condition-severity" id="condition-severity"></a>

Berisi data penilaian subjektif dari tingkat keparahan kondisi yang dievaluasi oleh dokter dengan tipe data `CodeableConcept`.

### Condition.severity.coding <a href="#condition-severity-coding" id="condition-severity-coding"></a>

Berisi satu atau lebih data penilaian subjektif dari tingkat keparahan kondisi yang dievaluasi oleh dokter dengan tipe data `Coding`, yang nilainya mengacu pada data terminologi [SNOMED CT](https://hl7.org/FHIR/codesystem-snomedct.html).&#x20;

| Condition.severity.coding.system                 | Condition.severity.coding.code                                                      | Condition.severity.coding.display |
| ------------------------------------------------ | ----------------------------------------------------------------------------------- | --------------------------------- |
| [http://snomed.info/sct](http://www.snomed.org/) | [24484000](http://browser.ihtsdotools.org/?perspective=full\&conceptId1=24484000)   | Severe                            |
| [http://snomed.info/sct](http://www.snomed.org/) | [6736007](http://browser.ihtsdotools.org/?perspective=full\&conceptId1=6736007)     | Moderate                          |
| [http://snomed.info/sct](http://www.snomed.org/) | [255604002](http://browser.ihtsdotools.org/?perspective=full\&conceptId1=255604002) | Mild                              |
| [http://snomed.info/sct](http://www.snomed.org/) | 442452003                                                                           | Life threatening severity         |

## Condition.code <a href="#condition-code" id="condition-code"></a>

Berisi kode diagnosis dengan tipe data `CodeableConcept`, yang nilainya mengacu pada dua data terminologi:

1. [ICD-10 tahun 2010](https://icd.who.int/browse10/2010/en#/) -> untuk melaporkan terkait diagnosis pasien saat kunjungan
2. Kode Terminology Kemkes -> untuk melaporkan kondisi saat meninggalkan rumah sakit
3. SNOMED CT -> Digunakan untuk melaporkan keluhan utama, kondisi pasien, temuan pemeriksaan klinis.

{% tabs %}
{% tab title="ICD - 10 tahun 2010" %}
**Ketentuan pengguanan Kode ICD-10 versi 2010:**

* Digunakan ketika melaporkan terkait diagnosis pasien saat kunjungan.
* Dengan detail elemen dan elemen sebagai berikut

| Condition.code.coding.system  | <http://hl7.org/fhir/sid/icd-10>                                                       |
| ----------------------------- | -------------------------------------------------------------------------------------- |
| Condition.code.coding.code    | Kode ICD-10, contoh: C47.0                                                             |
| Condition.code.coding.display | Deksripsi ICD-10, contoh: Malignant neoplasm, peripheral nerves of head, face and neck |
| {% endtab %}                  |                                                                                        |

{% tab title="SNOMED CT" %}
SNOMED CT

Digunakan untuk melaporkan kondisi saat meninggalkan rumah sakit.&#x20;

Berikut adalah pemetaan perubahan kode Istilah klinis yang tercantum pada Dokumen Lampiran Terminologi versi 1.1 terhadap kode SNOMED-CT yang sepadan.

| FHIR Path                     | Versi 1.1                                                                                                             | Versi 2.0                    |
| ----------------------------- | --------------------------------------------------------------------------------------------------------------------- | ---------------------------- |
| Condition.code.coding.system  | [http://terminology.kemkes.go.id/CodeSystem/clinical-term](https://terminology.kemkes.go.id/CodeSystem/clinical-term) | <http://snomed.info/sct>     |
| Condition.code.coding.code    | MN000001                                                                                                              | 359746009                    |
| Condition.code.coding.display | Stabil                                                                                                                | Patient's condition stable   |
| Condition.code.coding.system  | [http://terminology.kemkes.go.id/CodeSystem/clinical-term](https://terminology.kemkes.go.id/CodeSystem/clinical-term) | <http://snomed.info/sct>     |
| Condition.code.coding.code    | MN000002                                                                                                              | 162668006                    |
| Condition.code.coding.display | Tidak stabil                                                                                                          | Patient's condition unstable |
| Condition.code.coding.system  | [http://terminology.kemkes.go.id/CodeSystem/clinical-term](https://terminology.kemkes.go.id/CodeSystem/clinical-term) | <http://snomed.info/sct>     |
| Condition.code.coding.code    | MN000003                                                                                                              | 268910001                    |
| Condition.code.coding.display | Perbaikan                                                                                                             | Patient's condition improved |

**Digunakan untuk melaporkan keluhan utama, kondisi pasien, temuan pemeriksaan klinis.**

Ruang lingkup kode SNOMED CT yang dapat dipakai :&#x20;

**`Expression Constraint Language (ECL) Query: < 404684003 |Clinical finding (finding)|`**

**Lampiran Terminologi Condition.code untuk Keluhan Utama**

{% embed url="<https://docs.google.com/spreadsheets/d/1o8n8pIEGWRRR1ylSq2WdadpgYBj5a2oba3Pgmg7b1pM/edit?usp=sharing>" %}

**Digunakan untuk melaporkan Riwayat Penyakit Pribadi maupun Riwayat Penyakit yang berasal dari Keluarga.** Ruang lingkup kode SNOMED CT yang dapat dipakai :&#x20;

1. **Riwayat Pribadi** → Expression Constraint Language (ECL) Query : < 417662000 | History of clinical finding in subject (situation) | OR < 443508001 | No history of clinical finding in subject (situation) |
2. **Riwayat Keluarga** → Expression Constraint Language (ECL) Query : < 416471007 | Family history of clinical finding (situation) | OR < 160266009 | No family history of clinical finding (situation) |

Untuk contoh kode SNOMED-CT yang dapat digunakan dalam pelaporan keluhan utama dapat melihat dalam link berikut:

**Lampiran Terminologi Condition.code untuk Riwayat Penyakit**

{% embed url="<https://docs.google.com/spreadsheets/d/1K91P8K-e_iB4kk6nFIMphYv64bme4gxma7a_J_EzUDk/edit?usp=sharing>" %}

<br>
{% endtab %}

{% tab title="Kode Terminology Kemkes" %}
Digunakan ketika melaporkan terkait topografi dan morfologi pada use case Kanker. Lampiran kode topografi dapat dilihat pada link berikut [Topography (ICD-O)](https://docs.google.com/spreadsheets/d/1orVFJ6EpFGbJ12pSWDCodsKO-lfmJEOxKwAKGBzEykE/edit#gid=0) dan kode morfologi pada link berikut [Morphology (ICD-O-3 2nd Revision)](https://docs.google.com/spreadsheets/d/1owHD-6k3dR5oMda8wNV_ceyayg0HFy6zlt6oYAObrB8/edit#gid=0).

* Format pengisian kode topografi:

| Elemen                        | Nilai Elemen                                                  |
| ----------------------------- | ------------------------------------------------------------- |
| Condition.code.coding.system  | <http://terminology.kemkes.go.id/CodeSystem/icd-o-topography> |
| Condition.code.coding.code    | C10.1                                                         |
| Condition.code.coding.display | Anterior surface of epiglottis                                |

* Format pengisian kode morfologi:

| Elemen                        | Nilai Elemen                                                  |
| ----------------------------- | ------------------------------------------------------------- |
| Condition.code.coding.system  | <http://terminology.kemkes.go.id/CodeSystem/icd-o-morphology> |
| Condition.code.coding.code    | 8010/3                                                        |
| Condition.code.coding.display | Epithelial tumor, malignant                                   |

**Link Dokumen Terminologi**

<table data-view="cards"><thead><tr><th></th><th data-hidden data-card-target data-type="content-ref"></th></tr></thead><tbody><tr><td> <strong>Topography (ICD-O)</strong></td><td><a href="https://docs.google.com/spreadsheets/d/1orVFJ6EpFGbJ12pSWDCodsKO-lfmJEOxKwAKGBzEykE/edit?usp=sharing">https://docs.google.com/spreadsheets/d/1orVFJ6EpFGbJ12pSWDCodsKO-lfmJEOxKwAKGBzEykE/edit?usp=sharing</a></td></tr><tr><td><strong>Morphology (ICD-O-3 2nd Revision)</strong></td><td><a href="https://docs.google.com/spreadsheets/d/1owHD-6k3dR5oMda8wNV_ceyayg0HFy6zlt6oYAObrB8/edit?usp=sharing">https://docs.google.com/spreadsheets/d/1owHD-6k3dR5oMda8wNV_ceyayg0HFy6zlt6oYAObrB8/edit?usp=sharing</a></td></tr></tbody></table>
{% endtab %}
{% endtabs %}

## Condition.category\[i]

Berisi satu atau lebih kategori kondisi apakah problem atau keluhan yang dirasakan pasien atau diagnosis pasien dengan tipe data `CodeableConcept`.

### Condition.category\[i].coding

Berisi satu atau lebih data kode kategori kondisi apakah problem atau keluhan yang dirasakan pasien (diagnosis pasien) dengan tipe data `Coding`, yang nilainya mengacu pada data terminologi [ConditionCategoryCodes](http://terminology.hl7.org/CodeSystem/condition-category).

| Condition.category\[i].coding.system                                                                                  | Condition.category\[i].coding.code                                                                                      | Condition.category\[i].coding.display | Keterangan                                                                                                                        |
| --------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------- | ------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------- |
| [http://terminology.hl7.org/CodeSystem/condition-category](http://hl7.org/fhir/R4/codesystem-condition-category.html) | [problem-list-item](http://hl7.org/fhir/R4/codesystem-condition-category.html#condition-category-problem-list-item)     | Problem List Item                     | Daftar keluhan/masalah yang dapat dikelola waktu ke waktu dan dapat diungkapkan oleh tenaga kesehatan, pasien, atau orang terkait |
| [http://terminology.hl7.org/CodeSystem/condition-category](http://hl7.org/fhir/R4/codesystem-condition-category.html) | [encounter-diagnosis](http://hl7.org/fhir/R4/codesystem-condition-category.html#condition-category-encounter-diagnosis) | Encounter Diagnosis                   | Diagnosis pasien pada waktu tertentu dalam kunjungan                                                                              |

<br>