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10.1.10 Resource Observation - Mappings

Maturity Level : N/A
Responsible Owner: Orders and Observations icon Work Group Standards Status : Informative Security Category : Patient Compartments : Device , Encounter , Group , Patient , Practitioner , RelatedPerson

Mappings:

FiveWs Pattern Mapping

Workflow Pattern

HL7 V2 Mapping

SNOMED CT Attribute Binding

SNOMED CT Concept Domain Binding

RIM Mapping

Mappings for the observation Observation resource (see Mappings to Other Standards for further information & status).

10.1.10.1 FiveWs Pattern Mapping ( http://hl7.org/fhir/fivews icon )

Observation clinical.diagnostics
    identifier FiveWs.identifier
    status FiveWs.status
    category FiveWs.class
    code FiveWs.what[x]
    subject FiveWs.subject[x] FiveWs.subject
    focus FiveWs.subject[x] FiveWs.subject
    encounter FiveWs.context
    effective[x] FiveWs.done[x]
    issued FiveWs.recorded
    performer FiveWs.actor
        code FiveWs.what[x]

10.1.10.2 Workflow Pattern ( http://hl7.org/fhir/workflow icon )

Observation Event
    identifier Event.identifier
    instantiates[x]     basedOn Event.instantiatesCanonical Event.basedOn
    basedOn     partOf Event.basedOn Event.partOf
    partOf     status Event.partOf Event.status
    status     category Event.status Event.category
    code Event.code
    subject Event.subject
    encounter Event.encounter
    effective[x] Event.occurrence[x]
    performer Event.performer.actor
    note Event.note

10.1.10.3 HL7 V2 Mapping ( http://hl7.org/v2 icon )

The mappings provided in this tab are indicative of how HL7 v2 fields relate to HL7 FHIR attributes in this resource, but is not complete and without critical HL7 v2 context. The HL7 v2-FHIR Implementation guide, located here icon , provides additional guidance on transforming an HL7 v2 message to FHIR resources for FHIR R4 and FHIR R6.
Observation OBX
    identifier OBX-21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 3) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
    instantiates[x]     basedOn ORC
    triggeredBy ORC
        observation
        type
        reason
    partOf Varies by domain
    status OBX-11 Map FHIR Observation.status to OBX-11. If FHIR carries Observation.dataAbsentReason = ‘not-asked’, set OBX-11 to the v2 as ‘N’. If there is alternate-code extension on Observation.status with code ‘X’, set OBX-11 as ‘X’.
    category OBX-29
    code OBX-3
    subject PID-3
    focus OBX-3
    encounter     organizer
    encounter PV1
    effective[x] OBX-14, and/or OBX-19 after v2.4 (depends on who observation made) OBX-14 (If Observation carries the AnalysisDateTime extension, then map the extension to OBX-19)
    issued OBR-22 (or MSH-7), or perhaps OBX-19 (depends on who observation made)
    performer OBX-15 / (Practitioner) OBX-15, OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO' OBX-24, OBX-25. Person/role → OBX-16 (Responsible Observer). If conveying performing org and medical director: use OBX-25 (XCN) for the director with role code “MDIR” (system v2-0912), and OBX-23/24 for org name/address; if there is no director, OBX-23/24 carry the org. OBX-15 is available for producer id (identifier for the producer).
    value[x] OBX-2, OBX-5, OBX-6
    dataAbsentReason N/A OBX-32, OBX-11. Map Observation.dataAbsentReason to OBX-32 (Observation Value Absent Reason). Additionally, when dataAbsentReason.code = 'not-asked', also set OBX-11 = 'N'.
    interpretation OBX-8
    note     interpretationContext
    note NTE-3 (partner NTE to OBX, or sometimes another (child?) OBX)
    bodySite OBX-20
    bodyStructure
    method OBX-17
    specimen SPM segment (OBX-33 for Specimen.identifier mapping)
    device OBX-17 OBX-18 / PRT -10
    referenceRange OBX-7
        low OBX-7
        high OBX-7
        normalValue OBX-7
        type OBX-10
        appliesTo OBX-10
        age
        text OBX-7
    hasMember Relationships established by OBX-4 usage
    derivedFrom Relationships established by OBX-4 usage
    component containment by OBX-4?
        code OBX-3
        value[x] OBX-2, OBX-5, OBX-6
        dataAbsentReason N/A
        interpretation OBX-8
        referenceRange OBX-7

10.1.10.4 SNOMED CT Attribute Binding ( http://snomed.org/attributebinding icon )

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding corresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
    instantiates[x]
Observation
    identifier
    basedOn
    triggeredBy
        observation
        type
        reason
    partOf
    status
    category
    code 116680003 |Is a|
    subject
    focus
    organizer
    encounter
    effective[x]
    issued
    performer
    value[x] 363714003 |Interprets|
    dataAbsentReason
    interpretation 363713009 |Has interpretation|
    note     interpretationContext
    note
    bodySite 718497002 |Inherent location|
    bodyStructure
    method
    specimen 704319004 |Inherent in|
    device 424226004 |Using device|
    referenceRange
        low
        high
        normalValue
        type
        appliesTo
        age
        text
    hasMember
    derivedFrom
    component
        code
        value[x] 363714003 |Interprets|
        dataAbsentReason
        interpretation 363713009 |Has interpretation|
        referenceRange

10.1.10.5 SNOMED CT Concept Domain Binding ( http://snomed.info/conceptdomain icon )

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
    instantiates[x]
Observation < 363787002 |Observable entity|
    identifier
    basedOn
    triggeredBy
        observation
        type
        reason
    partOf
    status < 445584004 |Report by finality status|
    category
    code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
    subject
    focus
    organizer
    encounter
    effective[x]
    issued
    performer
    value[x] < 441742003 |Evaluation finding|
    dataAbsentReason
    interpretation < 260245000 |Findings values|
    note     interpretationContext
    note
    bodySite < 123037004 |Body structure|
    bodyStructure
    method
    specimen < 123038009 |Specimen|
    device < 49062001 |Device|
    referenceRange
        low
        high
        normalValue
        type < 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
        appliesTo < 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
        age
        text
    hasMember
    derivedFrom
    component
        code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
        value[x] 363714003 |Interprets| < 441742003 |Evaluation finding|
        dataAbsentReason
        interpretation < 260245000 |Findings values|
        referenceRange

10.1.10.6 RIM Mapping ( http://hl7.org/v3 icon )

Observation Observation[classCode=OBS, moodCode=EVN]
    identifier id
    instantiates[x] .outboundRelationship[typeCode=DEFN].target     basedOn .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
    triggeredBy .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
        observation outBoundRelationship
        type code
        reason annotation
    partOf .outboundRelationship[typeCode=FLFS].target
    status status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
    category .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
    code code
    subject participation[typeCode=RTGT]
    focus participation[typeCode=SBJ]
    encounter inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
    effective[x] effectiveTime
    issued participation[typeCode=AUT].time
    performer participation[typeCode=PRF]
    value[x] value
    dataAbsentReason value.nullFlavor
    interpretation interpretationCode
    note     interpretationContext .outboundRelationship[typeCode=PERT].target
    note subjectOf.observationEvent[code="annotation"].value
    bodySite targetSiteCode
    bodyStructure targetSiteCode
    method methodCode
    specimen participation[typeCode=SPC].specimen
    device participation[typeCode=DEV]
    referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
        low value:IVL_PQ.low
        high value:IVL_PQ.high
        normalValue value:IVL_PQ.normal
        type interpretationCode
        appliesTo interpretationCode
        age outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
        text value:ST
    hasMember outBoundRelationship
    derivedFrom .targetObservation
    component outBoundRelationship[typeCode=COMP]
        code code
        value[x] value
        dataAbsentReason value.nullFlavor
        interpretation interpretationCode
        referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]