In FHIR, a diagnosis is generally modelled as a Condition. OpenMRS distinguishes between a Condition and a Diagnosis and FHIR does to based, essentially on the
Condition.category indicating either that a condition is a
problem-list-item for what OpenMRS calls a “condition” or an
encounter-diagnosis for what OpenMRS calls a diagnosis.
Looking at the FHIR modelling, I’m not sure how one would represent “first time” other than, e.g., giving the diagnosis a
active and making it the first instance of that diagnosis recorded for that patient.
“Repeated” sounds to me like it would be modelled in FHIR as a Condition with a clinicalStatus of
recurrence; however, this valueset isn’t fully available in the equivalent OpenMRS concept.
A note on this: we’re unlikely to ever have a fully adequate solution to mapping between OMRS attributes and FHIR representations. One reason for this is that sometimes data that is represented as attributes in OMRS actually belongs in a standard field in FHIR (e.g., if we implement “repeated” as an attribute, it should affect the
clinicalStatus rather than necessarily adding an extension). But we can certainly provide tooling to aid with those things.
In this case, however, it seems better to extend teh OMRS
ConditionClinicalStatus enum to support
relapse as appropriate.