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10.1.9 10.1.10 Resource Observation - Mappings

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

Mappings:

RIM FiveWs Pattern Mapping

Workflow Pattern

HL7 V2 Mapping

SNOMED CT Attribute Binding

SNOMED CT Concept Domain Binding

HL7 v2 Mapping Workflow RIM Mapping

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

10.1.9.1 10.1.10.1 Mappings for RIM FiveWs Pattern Mapping (http://hl7.org/v3) ( http://hl7.org/fhir/fivews icon )

.outboundRelationship[typeCode=FLFS].target .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Observation Observation[classCode=OBS, moodCode=EVN] clinical.diagnostics
    identifier FiveWs.identifier
id     status FiveWs.status
    basedOn     category FiveWs.class
    code FiveWs.what[x]
    status     subject FiveWs.subject
status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"     focus FiveWs.subject
    category     encounter FiveWs.context
    effective[x] FiveWs.done[x]
    code     issued FiveWs.recorded
code     performer FiveWs.actor
    subject         code FiveWs.what[x]

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

Observation Event
participation[typeCode=SBJ]     identifier Event.identifier
    context     basedOn Event.basedOn
inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]     partOf Event.partOf
    effective[x]     status Event.status
effectiveTime     category Event.category
    issued     code Event.code
participation[typeCode=AUT].time     subject Event.subject
    encounter Event.encounter
    effective[x] Event.occurrence[x]
    performer Event.performer.actor
participation[typeCode=PRF]     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.
.typeCode
    value[x] Observation OBX
value     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.
    dataAbsentReason     basedOn ORC
value.nullFlavor     triggeredBy ORC
    interpretation         observation
interpretationCode         type
    comment         reason
subjectOf.observationEvent[code="annotation"].value     partOf Varies by domain
    bodySite     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’.
targetSiteCode     category OBX-29
    method     code OBX-3
methodCode     subject PID-3
    specimen     focus OBX-3
participation[typeCode=SPC].specimen     organizer
    device     encounter PV1
participation[typeCode=DEV]     effective[x] OBX-14 (If Observation carries the AnalysisDateTime extension, then map the extension to OBX-19)
    referenceRange     issued OBR-22 (or MSH-7), or perhaps OBX-19 (depends on who observation made)
outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]     performer OBX-15, OBX-16, OBX-23, 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).
        low     value[x] OBX-2, OBX-5, OBX-6
value:IVL_PQ.low     dataAbsentReason 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'.
        high     interpretation OBX-8
value:IVL_PQ.high     interpretationContext
        type     note NTE-3 (partner NTE to OBX, or sometimes another (child?) OBX)
interpretationCode     bodySite OBX-20
        appliesTo     bodyStructure
interpretationCode     method OBX-17
        age     specimen SPM segment (OBX-33 for Specimen.identifier mapping)
outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value     device OBX-18 / PRT -10
        text     referenceRange OBX-7
value:ST         low OBX-7
    related         high OBX-7
outBoundRelationship         normalValue OBX-7
        type OBX-10
        appliesTo OBX-10
        target         age .targetObservation
    component         text OBX-7
outBoundRelationship[typeCode=COMP]     hasMember Relationships established by OBX-4 usage
        code     derivedFrom Relationships established by OBX-4 usage
code     component containment by OBX-4?
        value[x]         code OBX-3
value         value[x] OBX-2, OBX-5, OBX-6
        dataAbsentReason value.nullFlavor N/A
        interpretation interpretationCode OBX-8
        referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN] OBX-7

10.1.9.2 10.1.10.4 Mappings for SNOMED CT Attribute Binding (http://snomed.info/sct) ( 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
Observation
    identifier
    basedOn
    triggeredBy
        observation
        type
        reason
    partOf
    status
    category
    code 116680003 |Is a|
    subject
    context     focus
    organizer
    encounter
    effective[x]
    issued
    performer
    value[x] 363714003 |Interprets|
    dataAbsentReason
    interpretation 363713009 |Has interpretation|
    comment     interpretationContext
    bodySite     note
    bodySite 718497002 |Inherent location|
    bodyStructure
    method
    specimen 704319004 |Inherent in|
    device 424226004 |Using device|
    referenceRange
        low
        high
        type         normalValue
        appliesTo         type
        age         appliesTo
        text         age
    related         text
        type     hasMember
        target     derivedFrom
    component
        code
        value[x] 363714003 |Interprets|
        dataAbsentReason
        interpretation 363713009 |Has interpretation|
        referenceRange

10.1.9.3 10.1.10.5 Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain) ( 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
Observation < 363787002 |Observable entity|
    identifier
    basedOn
    status     triggeredBy
        observation
        type
        reason
    partOf
    status < 445584004 |Report by finality status|
    category
    code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
    subject
    context     focus
    organizer
    encounter
    effective[x]
    issued
    performer
    value[x] < 441742003 |Evaluation finding|
    dataAbsentReason
    interpretation < 260245000 |Findings values|
    comment     interpretationContext
    bodySite     note
    bodySite < 123037004 |Body structure|
    bodyStructure
    method
    specimen < 123038009 |Specimen|
    device < 49062001 |Device|
    referenceRange
        low
        high
        type         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     related
        type     hasMember
        target     derivedFrom
    component
        code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
        value[x] 363714003 |Interprets| < 441742003 |Evaluation finding|
        dataAbsentReason
        interpretation < 260245000 |Findings values|
        referenceRange

10.1.9.4 10.1.10.6 Mappings for HL7 v2 RIM Mapping (http://hl7.org/v2) ( http://hl7.org/v3 icon )

ORC     status OBX-11     category     code OBX-3     subject PID-3     context PV1     effective[x] OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)     issued OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)     performer OBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'     value[x] OBX.2, OBX.5, OBX.6     dataAbsentReason N/A     interpretation OBX-8     comment NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX) OBX-20 OBX.7 OBX-7 OBX.7 10.1.9.5 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)         type
Observation OBX Observation[classCode=OBS, moodCode=EVN]
    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 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4. id
    basedOn .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
    bodySite     triggeredBy .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
    method         observation OBX-17 outBoundRelationship
    specimen         type SPM segment code
    device         reason OBX-17 / PRT -10 annotation
    referenceRange     partOf .outboundRelationship[typeCode=FLFS].target
        low     status OBX-7 status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
        high     category .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
        type     code OBX-10 code
        appliesTo OBX-10     subject         age participation[typeCode=RTGT]
        text     focus OBX-7 participation[typeCode=SBJ]
    related     encounter Relationships established by OBX-4 usage inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
        type     effective[x] N/A         target effectiveTime
    component     issued containment by OBX-4? participation[typeCode=AUT].time
        code     performer OBX-3 participation[typeCode=PRF]
        value[x]     value[x] OBX.2, OBX.5, OBX.6 value
        dataAbsentReason     dataAbsentReason N/A value.nullFlavor
        interpretation     interpretation OBX-8 interpretationCode
        referenceRange     interpretationContext .outboundRelationship[typeCode=PERT].target
Observation     note Event subjectOf.observationEvent[code="annotation"].value
    identifier     bodySite Event.identifier targetSiteCode
    basedOn     bodyStructure Event.basedOn targetSiteCode
    status Event.status     method     category methodCode
    code     specimen Event.code participation[typeCode=SPC].specimen
    subject     device Event.subject participation[typeCode=DEV]
    context     referenceRange Event.context outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
    effective[x]         low Event.occurrence[x]     issued value:IVL_PQ.low
    performer         high Event.performer value:IVL_PQ.high
    value[x]         normalValue Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason) value:IVL_PQ.normal
    dataAbsentReason         type Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)     interpretation interpretationCode
    comment         appliesTo Event.note interpretationCode
    bodySite         age     method outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
    specimen         text     device value:ST
    referenceRange     hasMember         low outBoundRelationship
        high     derivedFrom .targetObservation
        appliesTo     component         age outBoundRelationship[typeCode=COMP]
        text         code     related code
        type         value[x]         target value
    component         dataAbsentReason         code value.nullFlavor
        value[x]         interpretation         dataAbsentReason interpretationCode
        interpretation         referenceRange         referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]