PatientMedicalCondition

Reference data entity for medical conditions and diagnoses with standardized coding. Provides a catalog of conditions using ICD-10, ICD-11, or SNOMED-CT codes for consistent documentation across healthcare systems.

Overview

PatientMedicalCondition defines medical conditions that can be assigned to patients. Each condition is identified by a standardized code from recognized medical coding systems (ICD-10, SNOMED-CT), categorized by type (chronic, acute, infectious), and includes human-readable descriptions. This reference data ensures consistent condition documentation, enables interoperability, and supports clinical analytics.

Key Concepts

Medical Coding Systems

Conditions are coded using standard terminologies:

Condition Categories

The category field groups conditions by clinical type:

By Duration

• chronic - Long-term conditions requiring ongoing management (diabetes, hypertension)
• acute - Short-term conditions that resolve (pneumonia, fractures)

By Cause/Nature

• infectious - Caused by pathogens (COVID-19, tuberculosis)
• genetic - Inherited conditions (cystic fibrosis, sickle cell)
• autoimmune - Immune system attacking own tissue (lupus, rheumatoid arthritis)
• metabolic - Metabolism disorders (diabetes, thyroid conditions)

By Body System

• cardiovascular - Heart and blood vessel conditions
• respiratory - Lung and airway conditions
• neurological - Brain and nervous system conditions
• mental-health - Psychiatric and psychological conditions
• other - Conditions not fitting above categories

Condition Identification

Each condition record contains:

• code - Standardized code (e.g., "E11.9" for Type 2 Diabetes)
• system - Which coding system the code belongs to
• label - Human-readable condition name
• description - Additional clinical details

Use Cases

Problem List Documentation

When adding to patient's problem list:

1. Search conditions by label or code
2. Select matching condition from reference
3. Link to patient with status and dates
4. Associate with PatientConditionStatus for tracking

Clinical Decision Support

For automated alerts and recommendations:

1. Query patient's active conditions by code
2. Check for drug-condition interactions
3. Apply condition-specific clinical rules
4. Generate appropriate care recommendations

Billing and Claims

When coding for reimbursement:

1. Select conditions with ICD-10 codes
2. Ensure code specificity requirements met
3. Link conditions to encounters and procedures
4. Submit accurate diagnosis codes on claims

Analytics and Reporting

For population health:

1. Query conditions by category
2. Identify patients with chronic conditions
3. Track disease prevalence trends
4. Generate quality measure reports

Interoperability

When exchanging patient data:

1. Use standard codes (ICD-10, SNOMED-CT)
2. Include both code and coding system
3. Map between systems if needed
4. Ensure receiving system can interpret codes

Related Entities

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