This structure is derived from Observationvitalsigns Observationvitalsignsbase .

Summary

10.1.19.72.2 10.1.18.75.2 Complete Summary of the Mandatory Requirements

1. One code in Observation.code Observation.category which must have
   • a fixed Observation.code.coding.system Observation.category.coding.system = 'http ://loinc.org'
   • a fixed Observation.code.coding.code Observation.category.coding.code = '39156-5'
   • Other additional Codings are allowed The code (or codes) for the measurement obtained in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. . All codes SHALL have a system value
2. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
   • Each Observation.valueQuantity must have:
     • One numeric value in Observation.valueQuantity.value
     • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
     • a UCUM unit code in Observation.valueQuantity.code = 'kg/m2'

Mandatory: 8 elements Must-Support: 4 elements Fixed Value: 4 3 elements

This indicates the differences between this profile and the base Observationvitalsigns Observationvitalsignsbase structure.

Name	Flags	Card.	Type	Description & Constraints
Observation	C 0..*	0 .. *	Observationvitalsigns Observationvitalsignsbase	FHIR Body Mass Index (BMI) Profile Constraints: vs-4
code	S	1 .. 1	CodeableConcept	Body Mass Index (BMI) Slices for coding 0 Binding: .. Vital Signs - BMI * ( Coding preferred ) : Code defined by a terminology system This identifies the set of LOINC codes that are appropriate for representing body mass index (BMI) vital sign measurements in Observation.code. Slice: Required Pattern: Unordered, Open by value:code, value:system At least the following
coding:BMICode coding	1..1	1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 39156-5
valueQuantity	1..1 S C Quantity	Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. 0 value S .. 1 1..1	decimal Quantity	Numerical value (with implicit precision) The quantity for the vital sign being observed. unit Binding: BMI Units S ( 1..1 string required ) : Unit representation kg/m2
system dataAbsentReason	S 1..1 C uri	System that defines coded unit form Fixed Value: 0 http://unitsofmeasure.org .. code S 1	1..1 code CodeableConcept	Coded responses from Why the common UCUM units for vital signs result value set. Fixed Value: kg/m2 is missing
Documentation for this format

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observationvitalsigns Observationvitalsignsbase structure.

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observationvitalsigns Observationvitalsignsbase	FHIR Body Mass Index (BMI) Profile Constraints: vs-4
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?! Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: All Languages ( required ): ) : IETF language tag for a human language Additional Bindings Purpose Common Languages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
instantiates[x] Σ TU 0..1 canonical ( ObservationDefinition ), Reference ( ObservationDefinition ) Instantiates FHIR ObservationDefinition basedOn	Σ	0..*	Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest )	Fulfills plan, proposal or order
triggeredBy		0..*	BackboneElement	Triggering observation(s)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
observation	Σ	1..1	Reference ( Observation )	Triggering observation
type	Σ	1..1	code	reflex | repeat | re-run Binding: triggered Bytype ( required ): ) : The type of TriggeredBy Observation.
reason		0..1	string	Reason that the observation was triggered
partOf	Σ	0..*	Reference ( MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy )	Part of referenced event
status	?! S Σ	1..1	code	registered | specimen-in-process | preliminary | final | amended + | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained Binding: Observation Status ( required ) : Codes providing the status of an observation.
Slices for category	S	1 .. *	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system pattern:$this Binding: Observation Category Codes ( preferred ) : : Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: Observation Category Codes ( preferred ): ) : Codes for high level observation categories. Required Pattern: At least the following
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	S Σ C	1..1	CodeableConcept	Body Mass Index (BMI) Binding: Vital Signs - BMI ( extensible preferred ): ) : This identifies the set of LOINC codes that are appropriate for representing body mass index (BMI) vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type. measurements in Observation.code. Required Pattern: At least the following
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system Fixed Value: coding:BMICode Σ (Complex)
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 39156-5
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	S Σ	1..1	Reference ( Patient )	Who and/or what the observation is about
focus	?! Σ TU	0..*	Reference ( Resource )	What the observation is about, when it is not about the subject of record
organizer	Σ C	0..1	boolean	This observation organizes/groups a set of sub-observations
encounter	Σ	0..1	Reference ( Encounter )	Healthcare event during which this observation is made made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension
effective[x]	S Σ C	1..1	dateTime	Vital Signs are point in time measurements and are recorded using the dateTime data type
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService | Group )	Who is responsible for the observation
Slices for value[x]	Σ C	1 0 .. 1	Quantity	Vital Signs value are recorded using The quantity for the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. vital sign being observed. Slice: Unordered, Closed by type:$this value[x]:valueQuantity S Σ Binding: C 1..1 Quantity Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. id 0..1 id Unique id for inter-element referencing extension 0..* Extension Additional content defined by implementations Slice: Unordered, Open by value:url value Units S Σ ( 1..1 decimal Numerical value (with implicit precision) comparator preferred ?! ) Σ : 0..1 code < | <= | >= | > | ad - how to understand the value Binding: Commonly encountered UCUM units for recording Vital Signs. QuantityComparator ( required ): How the Quantity should be understood and represented.
system value[x]:valueQuantity	S Σ C	0..1	uri Quantity	The quantity for the vital sign being observed. System that defines coded unit form Fixed Value: http://unitsofmeasure.org Binding: code BMI Units S Σ ( C 1..1 code required Coded responses from the common UCUM units for vital signs value set. ) Fixed Value: : kg/m2
dataAbsentReason	S C	0..1	CodeableConcept	Why the result value is missing Binding: Data Absent Reason ( extensible ): ) : Codes specifying why the result ( Observation.value[x] ) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes ( extensible ): ) : Codes identifying interpretations of observations.
interpretationContext		0..*	CodeableReference ( Resource )	Context for understanding the observation Binding: Observation Interpretation Context Codes ( example ) : Codes identifying contextual factors that affect interpretation of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	DEPRECATED: Observed body part Binding: SNOMED CT Body Structures ( example ): ) : SNOMED CT Body site concepts
bodyStructure		0..1	Reference CodeableReference ( BodyStructure )	Observed body structure Binding: SNOMED CT Body Structures ( example ) : SNOMED CT Body Structures
method		0..1	CodeableConcept	How it was done Binding: Observation Methods ( example ): ) : Methods for simple observations.
specimen	C	0..1	Reference ( Specimen | Group )	Specimen used for this observation
device		0..1	Reference ( Device | DeviceMetric )	A reference to the device that generates the measurements or the device settings for the device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity Quantity	Low Range, if relevant
high	C	0..1	SimpleQuantity Quantity	High Range, if relevant
normalValue		0..1	CodeableConcept	Normal value, if relevant Binding: Observation Reference Range Normal Value Codes ( extensible example ): ) : Codes identifying the normal value of the observation.
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes ( preferred ): ) : Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes ( example ): ) : Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	C	0..1	markdown	Text based reference range in an observation
hasMember	Σ	0..*	Reference ( QuestionnaireResponse | MolecularSequence | Vital Signs Profile Observation )	Used when reporting observations included in a vital signs panel components
derivedFrom	Σ	0..*	Reference ( DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile Observation )	Related resource from which the observation is made
component	Σ C	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ C	1..1	CodeableConcept	Vital Sign measurement or component observation (code / type) Binding: Vital Signs LOINC codes with Observation or Both ( extensible example ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type. ) : Codes identifying names of simple observations.
Slices for value[x]	Σ C	0 .. 1		Vital Sign Value The value for the vital sign component being observed. Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference ( MolecularSequence MolecularDefinition )
value[x]:valueQuantity	Σ C	0..1	Quantity	Vital Sign Value component value recorded as a component with UCUM (preferred) Binding: UCUM units - for recording Vital Signs Units and components. ( required preferred ): Commonly encountered ) : UCUM units - for recording Vital Signs. Signs and components.
dataAbsentReason	S C	0..1	CodeableConcept	Why the component result value is missing Binding: Data Absent Reason ( extensible ): ) : Codes specifying why the result ( Observation.value[x] ) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes ( extensible ): ) : Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result value
Documentation for this format

<!-- Observationbmi -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- I 0..1 Meta Metadata about the resource --></meta>
 <

 <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created -->

 <language value="[code]"/><!-- I 0..1 Language of the resource content   -->
 <text><!-- I 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <<a href="bmi-definitions.html#Observation.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>

 <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>

 <identifier><!-- I 0..* Identifier 
     Business Identifier for observation --></identifier>
 <
     Instantiates FHIR ObservationDefinition</instantiates[x]>

 <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <
  <<a href="bmi-definitions.html#Observation.triggeredBy.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>

 <triggeredBy> I 0..* BackboneElement  <!-- I 0..* Triggering observation(s) -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>

  <observation><!-- I 1..1 Reference(Observation) 
      Triggering observation --></observation>
  <<a href="bmi-definitions.html#Observation.triggeredBy.type" title="The type of trigger.

  <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run   -->
  <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered -->
 </triggeredBy>
 <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <
 
 <
  <
   <
   <
   <
   <
   <
  </coding>
  <
 </category>
 <
  
  <
   <
   <
   <
   <
   <
  </coding>
  <
 </code>

 <status value="[code]"/><!-- I 1..1 registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained   -->
 <-- category sliced by pattern:$this  in the specified orderOpen-->

 <category><!-- I 1..1 CodeableConcept Classification of  type of observation   --></category>
 <code><!-- I 1..1 CodeableConcept Body Mass Index (BMI)   --></code>

 <subject><!-- I 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <

 <focus><!-- I 0..* Reference(Resource) 

     What the observation is about, when it is not about the subject of record --></focus>
 <organizer value="[boolean]"/><!-- I 0..1 This observation organizes/groups a set of sub-observations -->

 <encounter><!-- I 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made</encounter>
 <
     Often just a dateTime for Vital Signs</effective[x]>

     Healthcare event during which this observation is made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension --></encounter>
 <effectiveDateTime value="[dateTime]"/><!-- I 1..1 
     Vital Signs are point in time measurements and are recorded using the dateTime data type -->

 <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available -->
 <performer><!-- I 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <
  <
  <
  <
  <
  <
 </valueQuantity>
 <</dataAbsentReason>

 <valueQuantity><!-- I 0..1 Quantity The quantity for the vital sign being observed.   --></valueQuantity>
 <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result value is missing   --></dataAbsentReason>

 <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
 <interpretationContext><!-- I 0..* CodeableReference Context for understanding the observation   --></interpretationContext>

 <note><!-- I 0..* Annotation Comments about the observation --></note>
 <</bodySite>
 <</bodyStructure>

 <bodySite><!-- I 0..1 CodeableConcept DEPRECATED: Observed body part   --></bodySite>
 <bodyStructure><!-- I 0..1 CodeableReference Observed body structure   --></bodyStructure>

 <method><!-- I 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- I 0..1 Reference(Device) 
     A reference to the device that generates the measurements or the device settings for the device --></device>
 <
  <<a href="bmi-definitions.html#Observation.referenceRange.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>
  <

 <referenceRange> I 0..* BackboneElement  <!-- I 0..* Provides guide for interpretation -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- I 0..1 Quantity 

      Low Range, if relevant --></low>
  <

  <high><!-- I 0..1 Quantity 

      High Range, if relevant --></high>
  <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant   --></normalValue>
  <type><!-- I 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- I 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- I 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[markdown]"/><!-- I 0..1 Text based reference range in an observation -->
 </referenceRange>
 <
     Used when reporting vital signs panel components</hasMember>

 <hasMember><!-- I 0..* Reference(Observation) 
     Used when reporting observations included in a vital signs panel --></hasMember>

 <derivedFrom><!-- I 0..* Reference(DocumentReference) 
     Related resource from which the observation is made --></derivedFrom>
 <
  <<a href="bmi-definitions.html#Observation.component.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>
  <</code>

 <component> I 0..* BackboneElement  <!-- I 0..* Component results -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- I 1..1 CodeableConcept Vital Sign measurement or component   --></code>

  <-- value[x] sliced by type:$this  in the specified orderOpen-->
  <</valueQuantity>
  <</dataAbsentReason>

  <valueQuantity><!-- I 0..1 Quantity Vital Sign component value recorded as a component with UCUM (preferred)    --></valueQuantity>
  <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result value is missing   --></dataAbsentReason>

  <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
  <</referenceRange>

  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result value --></referenceRange>

 </component>
</Observation>

{ // Observationbmi
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "

    "implicitRules" : "<uri>", // IA set of rules under which this content was created

    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "<a href="bmi-definitions.html#Observation.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict">

    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored

    "identifier" : [{ Identifier }], // IBusiness Identifier for observation

    "
    "

    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "

    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)

    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "
    " 

    "status" : "<code>", // I R! registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
    "category" : [ //  sliced by pattern:$this  in the specified order, Open 

      { // Classification of  type of observation // I R! 
        // from Element: extension
        " ]
        "
        "

      }
    ],
    "

    "code" : { CodeableConcept }, // I R! Body Mass Index (BMI)

    "subject" : { Reference(Patient) }, // I R! Who and/or what the observation is about
    "
    "

    "
    "

    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "organizer" : <boolean>, // IThis observation organizes/groups a set of sub-observations
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension
    "effectiveDateTime" : "<dateTime>", // I R! Vital Signs are point in time measurements and are recorded using the dateTime data type

    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    " 
      { //  

    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // The quantity for the vital sign being observed. // I

        // from Element: extension
        " ]
        "
        "
        "
        " 
        " 

      }
    ],
    "

    "dataAbsentReason" : { CodeableConcept }, // IWhy the result value is missing

    "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc
    "interpretationContext" : [{ CodeableReference(Resource) }], // IContext for understanding the observation

    "note" : [{ Annotation }], // IComments about the observation
    "
    "

    "bodySite" : { CodeableConcept }, // IDEPRECATED: Observed body part
    "bodyStructure" : { CodeableReference(BodyStructure) }, // IObserved body structure

    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // IA reference to the device that generates the measurements or the device settings for the device
    "
    "

    "referenceRange" : [{ BackboneElement }], // IProvides guide for interpretation
    "hasMember" : [{ Reference(Observation) }], // IUsed when reporting observations included in a vital signs panel

    "derivedFrom" : [{ Reference(DocumentReference) }], // IRelated resource from which the observation is made
    "

    "component" : [{ BackboneElement }], // IComponent results

  }

Summary

10.1.19.72.3 10.1.18.75.3 Complete Summary of the Mandatory Requirements

1. One code in Observation.code Observation.category which must have
   • a fixed Observation.code.coding.system Observation.category.coding.system = 'http ://loinc.org'
   • a fixed Observation.code.coding.code Observation.category.coding.code = '39156-5'
   • Other additional Codings are allowed The code (or codes) for the measurement obtained in Observation.code - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. . All codes SHALL have a system value
2. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsentReason
   • Each Observation.valueQuantity must have:
     • One numeric value in Observation.valueQuantity.value
     • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
     • a UCUM unit code in Observation.valueQuantity.code = 'kg/m2'

Mandatory: 8 elements Must-Support: 4 elements Fixed Value: 4 3 elements

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observationvitalsigns Observationvitalsignsbase structure.

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observationvitalsigns Observationvitalsignsbase	FHIR Body Mass Index (BMI) Profile Constraints: vs-4
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?! Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: All Languages ( required ): ) : IETF language tag for a human language Additional Bindings Purpose Common Languages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
instantiates[x] Σ TU 0..1 canonical ( ObservationDefinition ), Reference ( ObservationDefinition ) Instantiates FHIR ObservationDefinition basedOn	Σ	0..*	Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest )	Fulfills plan, proposal or order
triggeredBy		0..*	BackboneElement	Triggering observation(s)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
observation	Σ	1..1	Reference ( Observation )	Triggering observation
type	Σ	1..1	code	reflex | repeat | re-run Binding: triggered Bytype ( required ): ) : The type of TriggeredBy Observation.
reason		0..1	string	Reason that the observation was triggered
partOf	Σ	0..*	Reference ( MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy )	Part of referenced event
status	?! S Σ	1..1	code	registered | specimen-in-process | preliminary | final | amended + | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained Binding: Observation Status ( required ) : Codes providing the status of an observation.
Slices for category	S	1 .. *	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system pattern:$this Binding: Observation Category Codes ( preferred ) : : Codes for high level observation categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: Observation Category Codes ( preferred ): ) : Codes for high level observation categories. Required Pattern: At least the following
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	S Σ C	1..1	CodeableConcept	Body Mass Index (BMI) Binding: Vital Signs - BMI ( extensible preferred ): ) : This identifies the set of LOINC codes that are appropriate for representing body mass index (BMI) vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type. measurements in Observation.code. Required Pattern: At least the following
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code, value:system Fixed Value: coding:BMICode Σ (Complex)
id		0..1	id string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 39156-5
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	S Σ	1..1	Reference ( Patient )	Who and/or what the observation is about
focus	?! Σ TU	0..*	Reference ( Resource )	What the observation is about, when it is not about the subject of record
organizer	Σ C	0..1	boolean	This observation organizes/groups a set of sub-observations
encounter	Σ	0..1	Reference ( Encounter )	Healthcare event during which this observation is made made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension
effective[x]	S Σ C	1..1	dateTime	Vital Signs are point in time measurements and are recorded using the dateTime data type
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService | Group )	Who is responsible for the observation
Slices for value[x]	Σ C	1 0 .. 1	Quantity	Vital Signs value are recorded using The quantity for the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. vital sign being observed. Slice: Unordered, Closed by type:$this value[x]:valueQuantity S Σ Binding: C 1..1 Quantity Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept. id 0..1 id Unique id for inter-element referencing extension 0..* Extension Additional content defined by implementations Slice: Unordered, Open by value:url value S Σ 1..1 decimal Numerical value (with implicit precision) comparator Units ?! Σ ( 0..1 code preferred < | <= | >= | > | ad - how to understand the value Binding: ) QuantityComparator ( required ): How the Quantity should be understood and represented. unit S : Σ Commonly encountered UCUM units for recording Vital Signs.
system value[x]:valueQuantity	S Σ C	0..1	uri Quantity	The quantity for the vital sign being observed. System that defines coded unit form Fixed Value: http://unitsofmeasure.org Binding: code BMI Units S Σ ( C 1..1 code required Coded responses from the common UCUM units for vital signs value set. ) Fixed Value: : kg/m2
dataAbsentReason	S C	0..1	CodeableConcept	Why the result value is missing Binding: Data Absent Reason ( extensible ): ) : Codes specifying why the result ( Observation.value[x] ) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes ( extensible ): ) : Codes identifying interpretations of observations.
interpretationContext		0..*	CodeableReference ( Resource )	Context for understanding the observation Binding: Observation Interpretation Context Codes ( example ) : Codes identifying contextual factors that affect interpretation of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	DEPRECATED: Observed body part Binding: SNOMED CT Body Structures ( example ): ) : SNOMED CT Body site concepts
bodyStructure		0..1	Reference CodeableReference ( BodyStructure )	Observed body structure Binding: SNOMED CT Body Structures ( example ) : SNOMED CT Body Structures
method		0..1	CodeableConcept	How it was done Binding: Observation Methods ( example ): ) : Methods for simple observations.
specimen	C	0..1	Reference ( Specimen | Group )	Specimen used for this observation
device		0..1	Reference ( Device | DeviceMetric )	A reference to the device that generates the measurements or the device settings for the device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity Quantity	Low Range, if relevant
high	C	0..1	SimpleQuantity Quantity	High Range, if relevant
normalValue		0..1	CodeableConcept	Normal value, if relevant Binding: Observation Reference Range Normal Value Codes ( extensible example ): ) : Codes identifying the normal value of the observation.
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes ( preferred ): ) : Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes ( example ): ) : Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	C	0..1	markdown	Text based reference range in an observation
hasMember	Σ	0..*	Reference ( QuestionnaireResponse | MolecularSequence | Vital Signs Profile Observation )	Used when reporting observations included in a vital signs panel components
derivedFrom	Σ	0..*	Reference ( DocumentReference | ImagingStudy | QuestionnaireResponse | MolecularSequence | Vital Signs Profile Observation )	Related resource from which the observation is made
component	Σ C	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?! Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ C	1..1	CodeableConcept	Vital Sign measurement or component observation (code / type) Binding: Vital Signs LOINC codes with Observation or Both ( extensible example ): This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital Sign Result Type. ) : Codes identifying names of simple observations.
Slices for value[x]	Σ C	0 .. 1		Vital Sign Value The value for the vital sign component being observed. Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference ( MolecularSequence MolecularDefinition )
value[x]:valueQuantity	Σ C	0..1	Quantity	Vital Sign Value component value recorded as a component with UCUM (preferred) Binding: UCUM units - for recording Vital Signs Units and components. ( required preferred ): Commonly encountered ) : UCUM units - for recording Vital Signs. Signs and components.
dataAbsentReason	S C	0..1	CodeableConcept	Why the component result value is missing Binding: Data Absent Reason ( extensible ): ) : Codes specifying why the result ( Observation.value[x] ) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes ( extensible ): ) : Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result value
Documentation for this format

<!-- Observationbmi -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- I 0..1 Meta Metadata about the resource --></meta>
 <

 <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created -->

 <language value="[code]"/><!-- I 0..1 Language of the resource content   -->
 <text><!-- I 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <<a href="bmi-definitions.html#Observation.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>

 <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>

 <identifier><!-- I 0..* Identifier 
     Business Identifier for observation --></identifier>
 <
     Instantiates FHIR ObservationDefinition</instantiates[x]>

 <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <
  <<a href="bmi-definitions.html#Observation.triggeredBy.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>

 <triggeredBy> I 0..* BackboneElement  <!-- I 0..* Triggering observation(s) -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>

  <observation><!-- I 1..1 Reference(Observation) 
      Triggering observation --></observation>
  <<a href="bmi-definitions.html#Observation.triggeredBy.type" title="The type of trigger.

  <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run   -->
  <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered -->
 </triggeredBy>
 <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <
 
 <
  <
   <
   <
   <
   <
   <
  </coding>
  <
 </category>
 <
  
  <
   <
   <
   <
   <
   <
  </coding>
  <
 </code>

 <status value="[code]"/><!-- I 1..1 registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained   -->
 <-- category sliced by pattern:$this  in the specified orderOpen-->

 <category><!-- I 1..1 CodeableConcept Classification of  type of observation   --></category>
 <code><!-- I 1..1 CodeableConcept Body Mass Index (BMI)   --></code>

 <subject><!-- I 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <

 <focus><!-- I 0..* Reference(Resource) 

     What the observation is about, when it is not about the subject of record --></focus>
 <organizer value="[boolean]"/><!-- I 0..1 This observation organizes/groups a set of sub-observations -->

 <encounter><!-- I 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made</encounter>
 <
     Often just a dateTime for Vital Signs</effective[x]>

     Healthcare event during which this observation is made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension --></encounter>
 <effectiveDateTime value="[dateTime]"/><!-- I 1..1 
     Vital Signs are point in time measurements and are recorded using the dateTime data type -->

 <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available -->
 <performer><!-- I 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <
  <
  <
  <
  <
  <
 </valueQuantity>
 <</dataAbsentReason>

 <valueQuantity><!-- I 0..1 Quantity The quantity for the vital sign being observed.   --></valueQuantity>
 <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result value is missing   --></dataAbsentReason>

 <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
 <interpretationContext><!-- I 0..* CodeableReference Context for understanding the observation   --></interpretationContext>

 <note><!-- I 0..* Annotation Comments about the observation --></note>
 <</bodySite>
 <</bodyStructure>

 <bodySite><!-- I 0..1 CodeableConcept DEPRECATED: Observed body part   --></bodySite>
 <bodyStructure><!-- I 0..1 CodeableReference Observed body structure   --></bodyStructure>

 <method><!-- I 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- I 0..1 Reference(Device) 
     A reference to the device that generates the measurements or the device settings for the device --></device>
 <
  <<a href="bmi-definitions.html#Observation.referenceRange.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>
  <

 <referenceRange> I 0..* BackboneElement  <!-- I 0..* Provides guide for interpretation -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- I 0..1 Quantity 

      Low Range, if relevant --></low>
  <

  <high><!-- I 0..1 Quantity 

      High Range, if relevant --></high>
  <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant   --></normalValue>
  <type><!-- I 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- I 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- I 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[markdown]"/><!-- I 0..1 Text based reference range in an observation -->
 </referenceRange>
 <
     Used when reporting vital signs panel components</hasMember>

 <hasMember><!-- I 0..* Reference(Observation) 
     Used when reporting observations included in a vital signs panel --></hasMember>

 <derivedFrom><!-- I 0..* Reference(DocumentReference) 
     Related resource from which the observation is made --></derivedFrom>
 <
  <<a href="bmi-definitions.html#Observation.component.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict"></modifierExtension>
  <</code>

 <component> I 0..* BackboneElement  <!-- I 0..* Component results -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- I 1..1 CodeableConcept Vital Sign measurement or component   --></code>

  <-- value[x] sliced by type:$this  in the specified orderOpen-->
  <</valueQuantity>
  <</dataAbsentReason>

  <valueQuantity><!-- I 0..1 Quantity Vital Sign component value recorded as a component with UCUM (preferred)    --></valueQuantity>
  <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result value is missing   --></dataAbsentReason>

  <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
  <</referenceRange>

  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result value --></referenceRange>

 </component>
</Observation>

{ // Observationbmi
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "

    "implicitRules" : "<uri>", // IA set of rules under which this content was created

    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "<a href="bmi-definitions.html#Observation.modifierExtension" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself) (this element modifies the meaning of other elements)" class="dict">

    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored

    "identifier" : [{ Identifier }], // IBusiness Identifier for observation

    "
    "

    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "

    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)

    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "
    " 

    "status" : "<code>", // I R! registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
    "category" : [ //  sliced by pattern:$this  in the specified order, Open 

      { // Classification of  type of observation // I R! 
        // from Element: extension
        " ]
        "
        "

      }
    ],
    "

    "code" : { CodeableConcept }, // I R! Body Mass Index (BMI)

    "subject" : { Reference(Patient) }, // I R! Who and/or what the observation is about
    "
    "

    "
    "

    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "organizer" : <boolean>, // IThis observation organizes/groups a set of sub-observations
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension
    "effectiveDateTime" : "<dateTime>", // I R! Vital Signs are point in time measurements and are recorded using the dateTime data type

    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    " 
      { //  

    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // The quantity for the vital sign being observed. // I

        // from Element: extension
        " ]
        "
        "
        "
        " 
        " 

      }
    ],
    "

    "dataAbsentReason" : { CodeableConcept }, // IWhy the result value is missing

    "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc
    "interpretationContext" : [{ CodeableReference(Resource) }], // IContext for understanding the observation

    "note" : [{ Annotation }], // IComments about the observation
    "
    "

    "bodySite" : { CodeableConcept }, // IDEPRECATED: Observed body part
    "bodyStructure" : { CodeableReference(BodyStructure) }, // IObserved body structure

    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // IA reference to the device that generates the measurements or the device settings for the device
    "
    "

    "referenceRange" : [{ BackboneElement }], // IProvides guide for interpretation
    "hasMember" : [{ Reference(Observation) }], // IUsed when reporting observations included in a vital signs panel

    "derivedFrom" : [{ Reference(DocumentReference) }], // IRelated resource from which the observation is made
    "

    "component" : [{ BackboneElement }], // IComponent results

  }