FHIR Release 3 (STU) R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

10.1.9 Resource Observation - Mappings

Orders and Observations Work Group Maturity Level : N/A Ballot Status : Informative Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Mappings:

RIM FiveWs Pattern

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

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

Observation Observation[classCode=OBS, moodCode=EVN]
    identifier id FiveWs.identifier
    status FiveWs.status
    category FiveWs.class
    code FiveWs.what[x]
    subject FiveWs.subject[x]
    focus FiveWs.subject[x]
    context FiveWs.context
    effective[x] FiveWs.done[x]
    issued FiveWs.recorded
    performer FiveWs.actor
        code FiveWs.what[x]

10.1.9.2 Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

.outboundRelationship[typeCode=FLFS].target
Observation Event
    identifier Event.identifier
    basedOn Event.basedOn
    partOf Event.partOf
    status status Amended & Final are differentiated by whether it is the subject of a ControlAct event with Event.status
    code Event.code
    subject Event.subject
    context Event.context
    effective[x] Event.occurrence[x]
    performer Event.performer.actor

10.1.9.3 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Observation OBX
    identifier OBX.21 For OBX segments from systems without OBX-21 support a type combination of "revise" 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.
    basedOn ORC
    partOf Varies by domain
    status OBX-11
    category
    code code OBX-3
    subject participation[typeCode=SBJ] PID-3
    focus OBX-3
    context inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN] PV1
    effective[x] effectiveTime OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
    issued participation[typeCode=AUT].time OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
    performer participation[typeCode=PRF] 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] value OBX.2, OBX.5, OBX.6
    dataAbsentReason value.nullFlavor N/A
    interpretation interpretationCode OBX-8
    comment subjectOf.observationEvent[code="annotation"].value NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
    bodySite targetSiteCode OBX-20
    method methodCode OBX-17
    specimen participation[typeCode=SPC].specimen SPM segment
    device participation[typeCode=DEV] OBX-17 / PRT -10
    referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN] OBX.7
        low value:IVL_PQ.low OBX-7
        high value:IVL_PQ.high OBX-7
        type interpretationCode OBX-10
        appliesTo interpretationCode OBX-10
        age outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
        text value:ST OBX-7
    related     hasMember outBoundRelationship Relationships established by OBX-4 usage
        type .typeCode     derivedFrom         target .targetObservation Relationships established by OBX-4 usage
    component outBoundRelationship[typeCode=COMP] containment by OBX-4?
        code code OBX-3
        value[x] value 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 10.1.9.4 Mappings for SNOMED CT Attribute Binding (http://snomed.info/sct)

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 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
    partOf
    status
    category
    code 116680003 |Is a|
    subject
    focus
    context
    effective[x]
    issued
    performer
    value[x] 363714003 |Interprets|
    dataAbsentReason
    interpretation 363713009 |Has interpretation|
    comment
    bodySite 718497002 |Inherent location|
    method
    specimen 704319004 |Inherent in|
    device 424226004 |Using device|
    referenceRange
        low
        high
        type
        appliesTo
        age
        text     related
        type     hasMember
        target     derivedFrom
    component
        code
        value[x] 363714003 |Interprets|
        dataAbsentReason
        interpretation 363713009 |Has interpretation|
        referenceRange

10.1.9.3 10.1.9.5 Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

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
    partOf
    status < 445584004 |Report by finality status|
    category
    code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
    subject
    focus
    context
    effective[x]
    issued
    performer
    value[x] < 441742003 |Evaluation finding|
    dataAbsentReason
    interpretation < 260245000 |Findings values|
    comment
    bodySite < 123037004 |Body structure|
    method
    specimen < 123038009 |Specimen|
    device < 49062001 |Device|
    referenceRange
        low
        high
        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 10.1.9.6 Mappings for HL7 v2 RIM Mapping (http://hl7.org/v2) (http://hl7.org/v3)

        text         referenceRange
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]
ORC     partOf .outboundRelationship[typeCode=FLFS].target
    status OBX-11 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 OBX-3 code
    subject PID-3 participation[typeCode=RTGT] 
    focus participation[typeCode=SBJ]
    context PV1 inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
    effective[x] OBX-14, and/or OBX-19 after v2.4 (depends on who observation made) effectiveTime
    issued OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made) participation[typeCode=AUT].time
    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' participation[typeCode=PRF]
    value[x] OBX.2, OBX.5, OBX.6 value
    dataAbsentReason N/A value.nullFlavor
    interpretation OBX-8 interpretationCode
    comment NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX) subjectOf.observationEvent[code="annotation"].value
    bodySite OBX-20 targetSiteCode
    method OBX-17 methodCode
    specimen SPM segment participation[typeCode=SPC].specimen
    device OBX-17 / PRT -10 participation[typeCode=DEV]
    referenceRange OBX.7 outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
        low OBX-7 value:IVL_PQ.low
        high OBX-7 value:IVL_PQ.high
        type OBX-10 interpretationCode
        appliesTo OBX-10 interpretationCode
        age OBX-7 outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
    related         text Relationships established by OBX-4 usage value:ST
        type     hasMember N/A outBoundRelationship
        target     derivedFrom .targetObservation
    component containment by OBX-4? outBoundRelationship[typeCode=COMP]
        code OBX-3 code
        value[x] OBX.2, OBX.5, OBX.6 value
        dataAbsentReason N/A value.nullFlavor
        interpretation OBX-8 interpretationCode
        referenceRange OBX.7 10.1.9.5 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow) Observation Event     identifier Event.identifier     basedOn Event.basedOn     status Event.status     category     code Event.code     subject Event.subject     context Event.context     effective[x] Event.occurrence[x]     issued     performer Event.performer     value[x] Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)     dataAbsentReason Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)     interpretation     comment Event.note     bodySite     method     specimen     device     referenceRange         low         high         type         appliesTo         age         text     related         type         target     component         code         value[x]         dataAbsentReason         interpretation outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]