HealthReferenceVerificationStatus

Reference data entity for verification status of medical diagnoses. Tracks the clinical certainty level from initial suspicion through confirmation or refutation.

Overview

HealthReferenceVerificationStatus defines the progression of diagnostic certainty in clinical practice. Diagnoses move from unconfirmed or provisional (initial assessment) through differential diagnosis (multiple possibilities) to confirmed (verified) or refuted (ruled out). This enables tracking of diagnostic confidence and supports appropriate clinical decision-making based on certainty level.

Key Concepts

Diagnostic Certainty Progression

Diagnoses typically progress through stages:

UNCONFIRMED → PROVISIONAL → DIFFERENTIAL → CONFIRMED
                                        ↘ REFUTED

Status Definitions

Code	Label	Clinical Meaning
`UNCONFIRMED`	Unconfirmed	Suspected but not yet assessed
`PROVISIONAL`	Provisional	Working diagnosis based on initial evaluation
`DIFFERENTIAL`	Differential	One of several possibilities being considered
`CONFIRMED`	Confirmed	Diagnosis verified through testing or clinical course
`REFUTED`	Refuted	Diagnosis ruled out based on evidence

Clinical Workflow

Initial Assessment

Patient presents with symptoms
Provider forms initial impression → PROVISIONAL
Multiple possibilities → DIFFERENTIAL

Diagnostic Workup

Order confirmatory tests
Review results
Consult specialists if needed

Confirmation

Test results support diagnosis → CONFIRMED
Evidence rules out diagnosis → REFUTED

Status Implications

Status	Treatment Approach	Documentation
Unconfirmed	Hold treatment, gather data	Suspected diagnosis
Provisional	May start empiric treatment	Working diagnosis
Differential	Consider multiple treatment paths	DDx list
Confirmed	Definitive treatment	Final diagnosis
Refuted	Exclude from consideration	Ruled out

Use Cases

Problem List Management

When managing patient diagnoses:

Add new diagnosis as provisional or differential
Update to confirmed when verified
Mark as refuted if ruled out
Filter active list by confirmed diagnoses

Clinical Documentation

For encounter notes:

Document assessment with verification status
Track status changes with timestamps
Record evidence supporting status change
Maintain history of diagnostic reasoning

Billing and Coding

For claims accuracy:

Distinguish confirmed vs suspected diagnoses
Apply appropriate diagnosis modifiers
Ensure coding matches clinical certainty
Avoid billing for refuted diagnoses

Quality Reporting

For diagnostic accuracy metrics:

Track time to confirmation
Monitor diagnostic revision rates
Analyze refuted diagnosis patterns
Report confirmed diagnosis distribution

Clinical Decision Support

For evidence-based alerts:

Tailor recommendations by verification status
Prompt for confirmatory testing if provisional
Suggest differential workup
Alert when diagnosis remains unconfirmed

Related Entities

Entity	Relationship	Description
Diagnosis	Referenced by	Diagnosis records with verification status

Standard Values

Code	Label	Description
`UNCONFIRMED`	Unconfirmed	Provisional diagnosis pending further assessment or confirmation
`PROVISIONAL`	Provisional	Working diagnosis based on initial clinical assessment
`DIFFERENTIAL`	Differential	One of several possible diagnoses being actively considered
`CONFIRMED`	Confirmed	Diagnosis verified through testing, imaging, or clinical course
`REFUTED`	Refuted	Diagnosis ruled out based on clinical evidence or test results

3 properties

Schema

Properties

Property	Type	Mode	Description	Required
code	string	stored	Unique code identifying the verification status Example: `"CONFIRMED"`	Required
label	string	stored	Human-readable name of the status Example: `"Confirmed"`	Required
description	string	stored	Description of the verification status	Optional

Examples

Example 1

{
  "@type": "HealthReferenceVerificationStatus",
  "code": "UNCONFIRMED",
  "label": "Unconfirmed",
  "description": "Provisional diagnosis pending confirmation"
}

Example 2

{
  "@type": "HealthReferenceVerificationStatus",
  "code": "PROVISIONAL",
  "label": "Provisional",
  "description": "Working diagnosis based on initial assessment"
}

Example 3

{
  "@type": "HealthReferenceVerificationStatus",
  "code": "DIFFERENTIAL",
  "label": "Differential",
  "description": "One of several possible diagnoses being considered"
}

Example 4

{
  "@type": "HealthReferenceVerificationStatus",
  "code": "CONFIRMED",
  "label": "Confirmed",
  "description": "Diagnosis has been verified and confirmed"
}

Example 5

{
  "@type": "HealthReferenceVerificationStatus",
  "code": "REFUTED",
  "label": "Refuted",
  "description": "Diagnosis has been ruled out"
}