QDM currently defines four datatypes in the Condition/Diagnosis/Problem category:

• Diagnosis, Active
• Diagnosis, Inactive
• Diagnosis, Resolved
• Diagnosis, Family History

QDM users have identified several problems related to these datatypes. They can be broadly organized into five categories:

1. Specificity: Should QDM distinguish between diagnoses, conditions, problems, etc.?
2. State: Diagnoses change datatypes as they progress through states (but probably shouldn't). The Inactive state is ambiguous and poorly supported in EHRs.
3. DateTimes: The formal datetime attribute definitions don't align well with actual use in measures (and may not align well with EHR representations).
4. Ordinality: Support for "principal" diagnoses is poorly supported, especially in regards to tying the ordinality to the encounter.
5. Miscellaneous: Other attributes in Diagnosis datatypes should be considered for applicability and potentially removed or modified.

In addition, we should consider if Family History should really be a Diagnosis datatype or if it should have some other representation.