HL7 - REFACTORED

18.8.125 PRB - Problem Detail Segment (12.4.2)

NOTE: This segment will be taken over by the Orders and Observations Work Group.

The problem detail segment contains the data necessary to add, update, correct, and delete the problems of a given individual.

HL7 Attribute Table - PRB - Problem Details

Segment (new)
(base framework)
Segment (new)
(w/o profiles)
Segment (new)
(w/ profiles)
Segment (classic)
(w/ profiles)
Segment (classic)
(w/o profiles)
FHIR
Structure Definition
v2.xml
XSD

Base Framework
	Seq#	Data Element	Description	Flags	Implement	Cardinality	Length	C.LEN	Vocabulary	Data Type
PRB
	1	00816	Action Code		SHALL	[1..1]	[2..2]		univ: SegmentActionCode (CD) hl7VS-segmentActionCode (VS) segmentAction (CS)	ID Coded Value for HL7 Defined Tables
	2	00817	Action Date/Time		SHOULD	[1..1]				DTM Date/Time
	3	00838	Problem ID		SHOULD	[1..1]				CWE Coded with Exceptions
	4	00839	Problem Instance ID		SHOULD	[1..1]				EI Entity Identifier
	5	00820	Episode of Care ID		MAY	[0..1]				EI Entity Identifier
	6	00841	Problem List Priority		MAY	[0..1]				NM Numeric
	7	00842	Problem Established Date/Time		MAY	[0..1]				DTM Date/Time
	8	00843	Anticipated Problem Resolution Date/Time		MAY	[0..1]				DTM Date/Time
	9	00844	Actual Problem Resolution Date/Time		MAY	[0..1]				DTM Date/Time
	10	00845	Problem Classification		MAY	[0..1]				CWE Coded with Exceptions
	11	00846	Problem Management Discipline		MAY	[0..*]				CWE Coded with Exceptions
	12	00847	Problem Persistence		MAY	[0..1]				CWE Coded with Exceptions
	13	00848	Problem Confirmation Status		MAY	[0..1]				CWE Coded with Exceptions
	14	00849	Problem Life Cycle Status		MAY	[0..1]				CWE Coded with Exceptions
	15	00850	Problem Life Cycle Status Date/Time		MAY	[0..1]				DTM Date/Time
	16	00851	Problem Date of Onset		MAY	[0..1]				DTM Date/Time
	17	00852	Problem Onset Text	= Truncation not allowed!	MAY	[0..1]		80		ST String Data
	18	00853	Problem Ranking		MAY	[0..1]				CWE Coded with Exceptions
	19	00854	Certainty of Problem		MAY	[0..1]				CWE Coded with Exceptions
	20	00855	Probability of Problem (0-1)	= Truncation allowed.	MAY	[0..1]		4		NM Numeric
	21	00856	Individual Awareness of Problem		MAY	[0..1]				CWE Coded with Exceptions
	22	00857	Problem Prognosis		MAY	[0..1]				CWE Coded with Exceptions
	23	00858	Individual Awareness of Prognosis		MAY	[0..1]				CWE Coded with Exceptions
	24	00859	Family/Significant Other Awareness of Problem/Prognosis	= Truncation not allowed!	MAY	[0..1]		200		ST String Data
	25	00823	Security/Sensitivity		MAY	[0..1]				CWE Coded with Exceptions
	26	02234	Problem Severity		MAY	[0..1]			ProblemSeverity (CD)	CWE Coded with Exceptions
	27	02235	Problem Perspective		MAY	[0..1]			ProblemPerspective (CD)	CWE Coded with Exceptions
	28	02237	Mood Code	C Condition defined for this element	MAY	[0..1]			univ: MoodCodes (CD) hl7VS-moodCodes (VS) actMood (CS)	CNE Coded with No Exceptions

Conditions/Invariants

The root for the expression is on the segment.

Seq.	Referenced Elements	Introduction	Invariant	Comment
1		?

	Seq#	Data Element	Description	Flags	Implement	Cardinality	Length	C.LEN	Vocabulary	Data Type
PRB
	1	00816	Action Code		SHALL	[1..1]	[2..2]		univ: SegmentActionCode (CD) hl7VS-segmentActionCode (VS) segmentAction (CS)	ID Coded Value for HL7 Defined Tables
	2	00817	Action Date/Time		SHALL	[1..1]				DTM Date/Time
	3	00838	Problem ID		SHALL	[1..1]				CWE Coded with Exceptions
	4	00839	Problem Instance ID		SHALL	[1..1]				EI Entity Identifier
	5	00820	Episode of Care ID		MAY	[0..1]				EI Entity Identifier
	6	00841	Problem List Priority		MAY	[0..1]				NM Numeric
	7	00842	Problem Established Date/Time		MAY	[0..1]				DTM Date/Time
	8	00843	Anticipated Problem Resolution Date/Time		MAY	[0..1]				DTM Date/Time
	9	00844	Actual Problem Resolution Date/Time		MAY	[0..1]				DTM Date/Time
	10	00845	Problem Classification		MAY	[0..1]				CWE Coded with Exceptions
	11	00846	Problem Management Discipline		MAY	[0..*]				CWE Coded with Exceptions
	12	00847	Problem Persistence		MAY	[0..1]				CWE Coded with Exceptions
	13	00848	Problem Confirmation Status		MAY	[0..1]				CWE Coded with Exceptions
	14	00849	Problem Life Cycle Status		MAY	[0..1]				CWE Coded with Exceptions
	15	00850	Problem Life Cycle Status Date/Time		MAY	[0..1]				DTM Date/Time
	16	00851	Problem Date of Onset		MAY	[0..1]				DTM Date/Time
	17	00852	Problem Onset Text	= Truncation not allowed!	MAY	[0..1]		80		ST String Data
	18	00853	Problem Ranking		MAY	[0..1]				CWE Coded with Exceptions
	19	00854	Certainty of Problem		MAY	[0..1]				CWE Coded with Exceptions
	20	00855	Probability of Problem (0-1)	= Truncation allowed.	MAY	[0..1]		4		NM Numeric
	21	00856	Individual Awareness of Problem		MAY	[0..1]				CWE Coded with Exceptions
	22	00857	Problem Prognosis		MAY	[0..1]				CWE Coded with Exceptions
	23	00858	Individual Awareness of Prognosis		MAY	[0..1]				CWE Coded with Exceptions
	24	00859	Family/Significant Other Awareness of Problem/Prognosis	= Truncation not allowed!	MAY	[0..1]		200		ST String Data
	25	00823	Security/Sensitivity		MAY	[0..1]				CWE Coded with Exceptions
	26	02234	Problem Severity		MAY	[0..1]			ProblemSeverity (CD)	CWE Coded with Exceptions
	27	02235	Problem Perspective		MAY	[0..1]			ProblemPerspective (CD)	CWE Coded with Exceptions
	28	02237	Mood Code	C Condition defined for this element	MAY	[0..1]			univ: MoodCodes (CD) hl7VS-moodCodes (VS) actMood (CS)	CNE Coded with No Exceptions

Base Framework											Base Standard Profile
	Seq#	Data Element	Description	Flags	Implement	Cardinality	Length	C.LEN	Vocabulary	Data Type	Implement	Vocabulary
PRB
	1	00816	Action Code		SHALL	[1..1]	[2..2]		univ: SegmentActionCode (CD) hl7VS-segmentActionCode (VS) segmentAction (CS)	ID Coded Value for HL7 Defined Tables	SHALL
	2	00817	Action Date/Time		SHOULD	[1..1]				DTM Date/Time	SHALL
	3	00838	Problem ID		SHOULD	[1..1]				CWE Coded with Exceptions	SHALL
	4	00839	Problem Instance ID		SHOULD	[1..1]				EI Entity Identifier	SHALL
	5	00820	Episode of Care ID		MAY	[0..1]				EI Entity Identifier	MAY
	6	00841	Problem List Priority		MAY	[0..1]				NM Numeric	MAY
	7	00842	Problem Established Date/Time		MAY	[0..1]				DTM Date/Time	MAY
	8	00843	Anticipated Problem Resolution Date/Time		MAY	[0..1]				DTM Date/Time	MAY
	9	00844	Actual Problem Resolution Date/Time		MAY	[0..1]				DTM Date/Time	MAY
	10	00845	Problem Classification		MAY	[0..1]				CWE Coded with Exceptions	MAY
	11	00846	Problem Management Discipline		MAY	[0..*]				CWE Coded with Exceptions	MAY
	12	00847	Problem Persistence		MAY	[0..1]				CWE Coded with Exceptions	MAY
	13	00848	Problem Confirmation Status		MAY	[0..1]				CWE Coded with Exceptions	MAY
	14	00849	Problem Life Cycle Status		MAY	[0..1]				CWE Coded with Exceptions	MAY
	15	00850	Problem Life Cycle Status Date/Time		MAY	[0..1]				DTM Date/Time	MAY
	16	00851	Problem Date of Onset		MAY	[0..1]				DTM Date/Time	MAY
	17	00852	Problem Onset Text	= Truncation not allowed!	MAY	[0..1]		80		ST String Data	MAY
	18	00853	Problem Ranking		MAY	[0..1]				CWE Coded with Exceptions	MAY
	19	00854	Certainty of Problem		MAY	[0..1]				CWE Coded with Exceptions	MAY
	20	00855	Probability of Problem (0-1)	= Truncation allowed.	MAY	[0..1]		4		NM Numeric	MAY
	21	00856	Individual Awareness of Problem		MAY	[0..1]				CWE Coded with Exceptions	MAY
	22	00857	Problem Prognosis		MAY	[0..1]				CWE Coded with Exceptions	MAY
	23	00858	Individual Awareness of Prognosis		MAY	[0..1]				CWE Coded with Exceptions	MAY
	24	00859	Family/Significant Other Awareness of Problem/Prognosis	= Truncation not allowed!	MAY	[0..1]		200		ST String Data	MAY
	25	00823	Security/Sensitivity		MAY	[0..1]				CWE Coded with Exceptions	MAY
	26	02234	Problem Severity		MAY	[0..1]			ProblemSeverity (CD)	CWE Coded with Exceptions	MAY
	27	02235	Problem Perspective		MAY	[0..1]			ProblemPerspective (CD)	CWE Coded with Exceptions	MAY
	28	02237	Mood Code	C Condition defined for this element	MAY	[0..1]			univ: MoodCodes (CD) hl7VS-moodCodes (VS) actMood (CS)	CNE Coded with No Exceptions	MAY

Base Framework											Base Standard Profile
	Seq#	Data Element	Description	Flags	Optionality	Repetition	Length	C.LEN	Table	Data Type	Optionality	Table
PRB
	1	00816	Action Code		O		[2..2]		(0206)	ID Coded Value for HL7 Defined Tables	R
	2	00817	Action Date/Time		O					DTM Date/Time	R
	3	00838	Problem ID		O					CWE Coded with Exceptions	R
	4	00839	Problem Instance ID		O					EI Entity Identifier	R
	5	00820	Episode of Care ID		O					EI Entity Identifier
	6	00841	Problem List Priority		O					NM Numeric
	7	00842	Problem Established Date/Time		O					DTM Date/Time
	8	00843	Anticipated Problem Resolution Date/Time		O					DTM Date/Time
	9	00844	Actual Problem Resolution Date/Time		O					DTM Date/Time
	10	00845	Problem Classification		O					CWE Coded with Exceptions
	11	00846	Problem Management Discipline		O	Y				CWE Coded with Exceptions
	12	00847	Problem Persistence		O					CWE Coded with Exceptions
	13	00848	Problem Confirmation Status		O					CWE Coded with Exceptions
	14	00849	Problem Life Cycle Status		O					CWE Coded with Exceptions
	15	00850	Problem Life Cycle Status Date/Time		O					DTM Date/Time
	16	00851	Problem Date of Onset		O					DTM Date/Time
	17	00852	Problem Onset Text		O			80=		ST String Data
	18	00853	Problem Ranking		O					CWE Coded with Exceptions
	19	00854	Certainty of Problem		O					CWE Coded with Exceptions
	20	00855	Probability of Problem (0-1)		O			4#		NM Numeric
	21	00856	Individual Awareness of Problem		O					CWE Coded with Exceptions
	22	00857	Problem Prognosis		O					CWE Coded with Exceptions
	23	00858	Individual Awareness of Prognosis		O					CWE Coded with Exceptions
	24	00859	Family/Significant Other Awareness of Problem/Prognosis		O			200=		ST String Data
	25	00823	Security/Sensitivity		O					CWE Coded with Exceptions
	26	02234	Problem Severity		O					CWE Coded with Exceptions		(0836)
	27	02235	Problem Perspective		O					CWE Coded with Exceptions		(0838)
	28	02237	Mood Code	C Condition defined for this element	O					CNE Coded with No Exceptions		(0725)

	Seq#	Data Element	Description	Optionality	Repetition	Length	C.LEN	Table	Data Type
PRB
	1	00816	Action Code	R		[2..2]		(0206)	ID Coded Value for HL7 Defined Tables
	2	00817	Action Date/Time	R					DTM Date/Time
	3	00838	Problem ID	R					CWE Coded with Exceptions
	4	00839	Problem Instance ID	R					EI Entity Identifier
	5	00820	Episode of Care ID	O					EI Entity Identifier
	6	00841	Problem List Priority	O					NM Numeric
	7	00842	Problem Established Date/Time	O					DTM Date/Time
	8	00843	Anticipated Problem Resolution Date/Time	O					DTM Date/Time
	9	00844	Actual Problem Resolution Date/Time	O					DTM Date/Time
	10	00845	Problem Classification	O					CWE Coded with Exceptions
	11	00846	Problem Management Discipline	O	Y				CWE Coded with Exceptions
	12	00847	Problem Persistence	O					CWE Coded with Exceptions
	13	00848	Problem Confirmation Status	O					CWE Coded with Exceptions
	14	00849	Problem Life Cycle Status	O					CWE Coded with Exceptions
	15	00850	Problem Life Cycle Status Date/Time	O					DTM Date/Time
	16	00851	Problem Date of Onset	O					DTM Date/Time
	17	00852	Problem Onset Text	O			80=		ST String Data
	18	00853	Problem Ranking	O					CWE Coded with Exceptions
	19	00854	Certainty of Problem	O					CWE Coded with Exceptions
	20	00855	Probability of Problem (0-1)	O			4#		NM Numeric
	21	00856	Individual Awareness of Problem	O					CWE Coded with Exceptions
	22	00857	Problem Prognosis	O					CWE Coded with Exceptions
	23	00858	Individual Awareness of Prognosis	O					CWE Coded with Exceptions
	24	00859	Family/Significant Other Awareness of Problem/Prognosis	O			200=		ST String Data
	25	00823	Security/Sensitivity	O					CWE Coded with Exceptions
	26	02234	Problem Severity	O				(0836)	CWE Coded with Exceptions
	27	02235	Problem Perspective	O				(0838)	CWE Coded with Exceptions
	28	02237	Mood Code	C				(0725)	CNE Coded with No Exceptions

The business and/or application must assume the responsibility for maintaining knowledge about data ownership, versioning, and/or audit trail control (for purposes of data integrity). It is also their responsibility to represent the appropriate version of that data.

18.8.125.1 PRB Field Definitions (12.4.2.0)

18.8.125.2 PRB-1 Action Code (ID) 00816 (12.4.2.1)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 - Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

18.8.125.3 PRB-2 Action Date/Time (DTM) 00817 (12.4.2.2)

Definition: This field contains the date/time that the operation represented by the action code was performed.

18.8.125.4 PRB-3 Problem ID (CWE) 00838 (12.4.2.3)

Definition: This field identifies the problem. This is the identifier from an institution's master list of problems.

18.8.125.5 PRB-4 Problem Instance ID (EI) 00839 (12.4.2.4)

Definition: This field contains the identifier assigned by an initiating system to an instance of a problem.

Note: It is required that this value remain unique over time. This instance ID identifies a specific instance for a specific patient and is unique across all patients. See entity ID data type description in Chapter 2.

18.8.125.6 PRB-5 Episode of Care ID (EI) 00820 (12.4.2.5)

Definition: This field uniquely identifies the episode of care to which this problem applies. (See note under "Ongoing issues.")

Note: It is required that this field be unique over time.

18.8.125.7 PRB-6 Problem List Priority (NM) 00841 (12.4.2.6)

Definition: This field prioritizes this problem on a list that is maintained for the individual.

18.8.125.8 PRB-7 Problem Established Date/Time (DTM) 00842 (12.4.2.7)

Definition: This field contains the date/time when the corresponding problem was initially identified by the caregiver.

18.8.125.9 PRB-8 Anticipated Problem Resolution Date/Time (DTM) 00843 (12.4.2.8)

Definition: This field contains the estimated date/time for resolving the stated problem.

18.8.125.10 PRB-9 Actual Problem Resolution Date/Time (DTM) 00844 (12.4.2.9)

Definition: This field contains the date/time that the problem was actually resolved.

18.8.125.11 PRB-10 Problem Classification (CWE) 00845 (12.4.2.10)

Definition: This field indicates the kind of problem. This field can be used to categorize problems so that they may be managed and viewed independently within different applications (e.g., admission, final, post-operative, pre-operative, outpatient, discharge, etc.).

18.8.125.12 PRB-11 Problem Management Discipline (CWE) 00846 (12.4.2.11)

Definition: This field indicates the category of caregiver with responsibility for managing this specific problem (e.g., care team, nursing, medicine, respiratory therapy, occupational therapy, dietary, etc.). This is a repeating field to allow identification of all disciplines that may have the responsibility for this problem.

18.8.125.13 PRB-12 Problem Persistence (CWE) 00847 (12.4.2.12)

Definition: This field contains the perseverance of a problem (e.g., acute, chronic, etc.).

18.8.125.14 PRB-13 Problem Confirmation Status (CWE) 00848 (12.4.2.13)

Definition: This field contains the verification status of a problem (e.g., confirmed, differential, provisional, rule-out, etc.).

18.8.125.15 PRB-14 Problem Life Cycle Status (CWE) 00849 (12.4.2.14)

Definition: This field contains the current status of the problem at this particular date/time (e.g., active, active-improving, active-stable, active-worsening, inactive, resolved, etc.).

18.8.125.16 PRB-15 Problem Life Cycle Status Date/Time (DTM) 00850 (12.4.2.15)

Definition: This field indicates the effective date/time of the current problem life cycle status.

18.8.125.17 PRB-16 Problem Date of Onset (DTM) 00851 (12.4.2.16)

Definition: This field contains the date/time when the problem began.

18.8.125.18 PRB-17 Problem Onset Text (ST) 00852 (12.4.2.17)

Definition: This field allows for a textual representation of the time when the problem began.

18.8.125.19 PRB-18 Problem Ranking (CWE) 00853 (12.4.2.18)

Definition: This field contains a user-defined prioritization of a problem (e.g., numeric ranking, or the use of words such as "primary," "secondary," etc.).

18.8.125.20 PRB-19 Certainty of Problem (CWE) 00854 (12.4.2.19)

Definition: This field contains a qualitative representation of the certainty of a problem (e.g., HI - high, LO - low, ME - medium, etc.).

18.8.125.21 PRB-20 Probability of Problem (0-1) (NM) 00855 (12.4.2.20)

Definition: This field contains a quantitative or numeric representation of the certainty that the problem exists for this patient. This field has a valid range of 0 to 1. For example, a healthcare provider may be 75% (.75) sure that the problem has been correctly identified.

Note: We have provided for two different representations of the certainty of the problem due to varying representations in applications.

18.8.125.22 PRB-21 Individual Awareness of Problem (CWE) 00856 (12.4.2.21)

Definition: This field contains the individual's comprehension of the problem (e.g., full, marginal, partial, etc.).

18.8.125.23 PRB-22 Problem Prognosis (CWE) 00857 (12.4.2.22)

Definition: This field contains the prognosis for the individual's problem (e.g., good, poor, etc.).

18.8.125.24 PRB-23 Individual Awareness of Prognosis (CWE) 00858 (12.4.2.23)

Definition: This field contains the individual's comprehension of the prognosis for the problem (e.g., full, marginal, partial, etc.).

18.8.125.25 PRB-24 Family/Significant Other Awareness of Problem/Prognosis (ST) 00859 (12.4.2.24)

Definition: This field indicates the individual's family or significant other's comprehension of the actual problem/prognosis.

18.8.125.26 PRB-25 Security/Sensitivity (CWE) 00823 (12.4.2.25)

Definition: This field contains information about the level of security and/or sensitivity surrounding the problem (e.g., highly sensitive, not sensitive, sensitive, etc.).

18.8.125.27 PRB-26 Problem Severity (CWE) 02234 (12.4.2.26)

Definition: This field indicates the severity of the Problem. Refer to User-defined Table 0836- Problem Severity in Chapter 2C, Code Tables, for suggested values.

18.8.125.28 PRB-27 Problem Perspective (CWE) 02235 (12.4.2.27)

Definition: This field indicates from whose perspective this problem was identified. Refer to User-defined Table 0838 - Problem Perspective in Chapter 2C, Code Tables, for suggested values.

18.8.125.29 PRB-28 Mood Code (CNE) 02237 (12.4.2.28)

Definition: This field indicates the Mood of the Problem. It allows expression of the context of the problem.

Note: As Mood Code changes the meaning of the segment it must only be used in new messages as of v2.6.

Refer to HL7 Table 0725 - Mood Codes in Chapter 2C, Code Tables, for allowed values.