> ## Documentation Index
> Fetch the complete documentation index at: https://docs.clinikapi.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Assessments

> Record clinical impressions, findings, investigations, and prognosis.

# Assessments

Assessments (FHIR ClinicalImpression) capture a clinician's overall evaluation of a patient — findings, diagnoses, investigations, prognosis, and clinical summary. They're typically created during or after an encounter.

## Create an Assessment

```ts theme={null}
const { data: assessment } = await clinik.assessments.create({
  status: 'completed',
  code: 'initial-assessment',
  patientId: 'pt_abc123',
  encounterId: 'enc_xyz789',
  practitionerId: 'prac_def456',
  description: 'Annual wellness assessment',
  summary: 'Patient presents with well-controlled hypertension and type 2 diabetes. '
    + 'No signs of end-organ damage. Continue current medication regimen. '
    + 'Recommend dietary counseling and increased physical activity.',
  findings: [
    { code: 'I10', text: 'Essential hypertension — well controlled on lisinopril 10mg', basis: 'BP readings over 3 months' },
    { code: 'E11.9', text: 'Type 2 diabetes mellitus — HbA1c 6.8%, at goal', basis: 'Lab panel from today' },
    { text: 'BMI 28.5 — overweight, recommend weight management' },
    { text: 'No peripheral neuropathy on exam' },
  ],
  investigations: [
    { name: 'Lab panel', itemIds: ['obs_cmp_001', 'obs_hba1c_001'] },
    { name: 'Vitals', itemIds: ['obs_bp_001', 'obs_bmi_001'] },
  ],
  problemIds: ['cond_hypertension', 'cond_diabetes'],
  prognosis: [
    { text: 'Good — well controlled with current regimen' },
    { code: 'favorable', text: 'Favorable with continued compliance' },
  ],
  note: 'Follow up in 3 months. Order HbA1c and CMP at next visit.',
  effectiveDateTime: '2025-01-15T10:00:00Z',
});
```

## Assessment Code

Classify the type of assessment:

```ts theme={null}
const { data } = await clinik.assessments.create({
  status: 'completed',
  code: 'discharge',  // initial-assessment, follow-up, discharge, pre-operative
  patientId: 'pt_abc123',
  summary: 'Patient stable for discharge...',
  // ...
});
```

## Status Reason

Explain why an assessment is still in progress:

```ts theme={null}
const { data } = await clinik.assessments.create({
  status: 'in-progress',
  statusReason: 'Awaiting lab results before finalizing',
  patientId: 'pt_abc123',
  summary: 'Preliminary assessment — pending CMP results.',
  // ...
});
```

## Findings with Basis

Document which investigations support each finding:

```ts theme={null}
findings: [
  {
    code: 'I10',
    text: 'Essential hypertension',
    basis: 'Blood pressure 148/92 on three separate readings',
  },
  {
    code: 'E11.9',
    text: 'Type 2 diabetes mellitus',
    basis: 'HbA1c 7.2% (lab panel obs_hba1c_001)',
  },
  {
    text: 'Patient reports improved energy levels',
  },
]
```

## Investigations

Group related clinical investigations:

```ts theme={null}
investigations: [
  {
    name: 'Initial labs',
    itemIds: ['obs_glucose', 'obs_creatinine', 'obs_hba1c'],
  },
  {
    name: 'Imaging',
    itemIds: ['dr_chest_xray_001'],
  },
  {
    name: 'Patient-reported',
    itemIds: ['intake_symptoms_001'],
  },
]
```

## Previous Assessment

Link to a prior assessment for longitudinal tracking:

```ts theme={null}
const { data } = await clinik.assessments.create({
  status: 'completed',
  code: 'follow-up',
  patientId: 'pt_abc123',
  previousAssessmentId: 'assess_initial_001',
  summary: 'Follow-up: Blood pressure improved since last visit.',
  // ...
});
```

## Problem List

Reference the conditions being assessed:

```ts theme={null}
const { data } = await clinik.assessments.create({
  status: 'completed',
  patientId: 'pt_abc123',
  problemIds: ['cond_hypertension', 'cond_diabetes', 'allergy_penicillin'],
  summary: 'Reviewed active problem list...',
  // ...
});
```

## Prognosis

Document the expected outcome:

```ts theme={null}
prognosis: [
  { text: 'Good — well controlled with current regimen' },
  { code: 'guarded', text: 'Guarded if medication compliance declines' },
]
```

## Status Values

| Status        | Description                   |
| ------------- | ----------------------------- |
| `in-progress` | Assessment is being conducted |
| `completed`   | Assessment is finalized       |

## Update an Assessment

```ts theme={null}
await clinik.assessments.update('assess_abc123', {
  status: 'completed',
  statusReason: 'Lab results received',
  summary: 'Updated summary with lab findings...',
  findings: [
    { code: 'I10', text: 'Essential hypertension — well controlled', basis: 'BP 128/82' },
    { code: 'E11.9', text: 'Type 2 diabetes — at goal', basis: 'HbA1c 6.8%' },
    { text: 'New finding: mild vitamin D deficiency', basis: 'Vitamin D level 22 ng/mL' },
  ],
  investigations: [
    { name: 'Updated labs', itemIds: ['obs_cmp_002', 'obs_vitd_001'] },
  ],
  prognosis: [{ text: 'Good with vitamin D supplementation' }],
  note: 'Added vitamin D 2000 IU daily to plan.',
});
```

## Search Assessments

```ts theme={null}
// All assessments for a patient
const { data } = await clinik.assessments.search({
  patientId: 'pt_abc123',
  status: 'completed',
  sort: '-date',
});

// Assessments by a specific practitioner
const { data: byDoc } = await clinik.assessments.search({
  practitionerId: 'prac_def456',
  dateFrom: '2025-01-01',
});
```

## Assessments vs Notes

| Resource                        | Purpose                                                                       |
| ------------------------------- | ----------------------------------------------------------------------------- |
| Assessment (ClinicalImpression) | Structured clinical evaluation with coded findings, investigations, prognosis |
| Note (DocumentReference)        | Narrative documentation (SOAP notes, discharge summaries)                     |

Use assessments for structured clinical reasoning. Use notes for narrative documentation. They often complement each other — an encounter might have both a progress note and a clinical assessment.