The PRB segment carries one problem-list entry: the problem code, when it was established and resolved, its life-cycle status, onset, and ranking. It is the core of the PPR (patient problem) message and underpins problem-oriented records.
Purpose
PRB conveys a single clinical problem and its management metadata - identity (PRB-3), instance and episode links, established/resolution dates, life-cycle status, onset, and certainty/ranking - using an action code (PRB-1) to add, update, or delete the entry.
Used in
PRB appears in problem-oriented messages: PPR (patient problem) and related care-record messages. See PPR.
Field-by-field reference
Source: HAPI HL7v2 v2.5.1 javadocs (PRB) for sequence, name, and data type. Length is not published in the javadocs (-); Required and Table # are filled from the HL7 v2.5.1 standard where well-established.
| Seq | Name | Data Type | Length | Req | Repeat | Table # | Description |
|---|---|---|---|---|---|---|---|
| PRB-1 | Action Code | ID | - | R | - | HL70287 | Add/update/delete the problem. |
| PRB-2 | Action Date/Time | TS | - | R | - | - | When the action occurred. |
| PRB-3 | Problem ID | CE | - | R | - | - | The coded problem (e.g. ICD-10/SNOMED). |
| PRB-4 | Problem Instance ID | EI | - | O | - | - | Unique problem instance. |
| PRB-5 | Episode of Care ID | EI | - | O | - | - | Episode of care link. |
| PRB-6 | Problem List Priority | NM | - | O | - | - | Priority on the list. |
| PRB-7 | Problem Established Date/Time | TS | - | O | - | - | When established. |
| PRB-8 | Anticipated Problem Resolution Date/Time | TS | - | O | - | - | Expected resolution. |
| PRB-9 | Actual Problem Resolution Date/Time | TS | - | O | - | - | Actual resolution. |
| PRB-10 | Problem Classification | CE | - | O | - | - | Classification. |
| PRB-11 | Problem Management Discipline | CE | - | O | Y | - | Managing discipline. |
| PRB-12 | Problem Persistence | CE | - | O | - | - | Persistence (chronic, acute). |
| PRB-13 | Problem Confirmation Status | CE | - | O | - | - | Confirmation status. |
| PRB-14 | Problem Life Cycle Status | CE | - | O | - | - | Life-cycle status (active, resolved). |
| PRB-15 | Problem Life Cycle Status Date/Time | TS | - | O | - | - | Status date. |
| PRB-16 | Problem Date of Onset | TS | - | O | - | - | Onset date. |
| PRB-17 | Problem Onset Text | ST | - | O | - | - | Onset description. |
| PRB-18 | Problem Ranking | CE | - | O | - | - | Ranking. |
| PRB-19 | Certainty of Problem | CE | - | O | - | - | Certainty. |
| PRB-20 | Probability of Problem (0-1) | NM | - | O | - | - | Probability. |
| PRB-21 | Individual Awareness of Problem | CE | - | O | - | - | Patient awareness. |
| PRB-22 | Problem Prognosis | CE | - | O | - | - | Prognosis. |
| PRB-23 | Individual Awareness of Prognosis | CE | - | O | - | - | Awareness of prognosis. |
| PRB-24 | Family/Significant Other Awareness of Problem/Prognosis | ST | - | O | - | - | Family awareness. |
| PRB-25 | Security/Sensitivity | CE | - | O | - | - | Security/sensitivity. |
Most-used fields
- PRB-1 Action Code and PRB-2 Action Date/Time drive add/update/delete of the problem entry.
- PRB-3 Problem ID is the coded problem; PRB-14 Life Cycle Status and PRB-16 Onset track its clinical course.
Version differences (2.3 to 2.8.2)
- PRB was introduced with problem/goal messaging in v2.3 and is stable through later versions.
- Coded fields use
CE; later versions addCWE-style coding in some implementations.
Common mistakes
- Ignoring PRB-1 and treating every PRB as an add, duplicating problems.
- Confusing PRB-14 life-cycle status with PRB-13 confirmation status.
Examples
Minimal valid PRB:
PRB|AD|20260610100000|E11.9^Type 2 diabetes^I10
Fully-populated PRB:
PRB|AD|20260610100000|E11.9^Type 2 diabetes^I10|PRB55^MERCYGEN||1|20240101000000|||C^Chronic^L||CH^Chronic^L|CONF^Confirmed^L|A^Active^L|20240101000000|20231215000000
Annotated breakdown of the fully-populated example (selected fields):
PRB ← segment ID
AD ← PRB-1 Action Code (Add)
20260610100000 ← PRB-2 Action Date/Time
E11.9^Type 2 diabetes^I10 ← PRB-3 Problem ID
PRB55^MERCYGEN ← PRB-4 Problem Instance ID
1 ← PRB-6 Problem List Priority
A^Active^L ← PRB-14 Problem Life Cycle Status
20231215000000 ← PRB-16 Problem Date of Onset
In-context inside a PPR^PC1 (problem add):
MSH|^~&|EHR|MERCYGEN|REG|MERCYGEN|20260610100000||PPR^PC1^PPR_PC1|MSG910|P|2.5.1
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
PRB|AD|20260610100000|E11.9^Type 2 diabetes^I10|PRB55^MERCYGEN||1
In-context inside a PPR^PC2 (problem update):
MSH|^~&|EHR|MERCYGEN|REG|MERCYGEN|20260701100000||PPR^PC2^PPR_PC2|MSG911|P|2.5.1
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
PRB|UP|20260701100000|E11.9^Type 2 diabetes^I10|PRB55^MERCYGEN|||||| |||RES^Resolved^L
FHIR mapping
No segment-level ConceptMap is published in the v2-to-FHIR IG for PRB. A problem-list entry maps conceptually to Condition (with clinicalStatus/verificationStatus from the life-cycle and confirmation fields); implementations define this locally.
Engine considerations
- Branch on PRB-1 - update/delete must act on the existing problem (matched by PRB-4), not create duplicates.
- Map PRB-14 life-cycle status to the target system's active/resolved states.
How Vorro parses and produces PRB
Vorro keys problems by PRB-4 instance id, applies PRB-1 add/update/delete semantics idempotently, and maps life-cycle and confirmation status to FHIR Condition status elements on output.
Related pages
- GOL - goals associated with the problem.
- PTH - pathways linking problems and goals.
- PPR messages - the problem message PRB heads.
