Definition

The CareRecord_Problem extract represents clinical problems and long-term conditions recorded on a patient’s problem list in EMIS Web. A problem is a specific subtype of observation that a clinician has elevated to the problem list, indicating it is a significant or ongoing health condition that requires active tracking and management over time.

Information

The CareRecord_Problem extract provides a view of all problem list entries across patients within the agreement scope. Problems are always linked to a parent observation in CareRecord_Observation via observationguid, and may also reference a parent problem to support hierarchical problem structures.

Each problem record is uniquely identified by observationguid within the agreement scope.

Key Identifiers

• observationguid: The EMIS observation identifier for the problem — joins to CareRecord_Observation to retrieve the clinical code, dates, and consultation context.
• patientguid: References the patient in Admin_Patient.
• organisationguid: References the practice in Admin_Organisation.
• parentproblemobservationguid: References a parent problem observation, enabling hierarchical problem relationships (e.g., a complication linked to a primary condition).
• lastreviewuserinroleguid: References the clinician who last reviewed this problem.

Problem Status and Context

• enddate, enddateprecision: The date the problem was resolved or closed, if applicable.
• expectedduration: The anticipated duration of the condition.
• comment: Free-text clinician notes about the problem.

Practical Use

flowchart TB
  subgraph container["Data Collection"]
    n1["Problem Code"]
    n2["Status & Significance"]
    n3["Start & End Dates"]
  end

  n17["Organisation 1"] --> n7
  n17["Organisation 1"] --> n5
  n18["Organisation 2"] --> n6
  n18["Organisation 2"] --> n8

  n7["Patient 123"] --> container
  n5["Patient 98"] --> container
  n6["Patient 456"] --> container
  n8["Patient 47"] --> container

  container --> n16["Gather problem data"]
  n16 --> n14["ETL"]
  n14 --> n15["CareRecord_Problem Model"]

  n7:::rect
  n5:::rect
  n6:::rect
  n8:::rect