observation-bodyheight
Observationbodyheight
<?xml version="1.0" encoding="UTF-8"?>
#### Complete Summary of the Mandatory Requirements
1. One code in `Observation.code` which must have
- a fixed `Observation.code.coding.system`=**'http ://loinc.org'**
- a fixed `Observation.code.coding.code`= **'8302-2'**
- 8306-3 -Body height - lying (i.e., body length - typically used for infants) MAY
be included as an additional observation code - Other additional Codings are allowed
in `Observation.code`- e.g. more specific LOINC
Codes, SNOMED CT concepts, system specific codes. All codes
SHALL have an system value
1. Either one Observation.valueQuantity or, if there is no value, one code in Observation.DataAbsent
Reason
- 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 = **'cm', or '[in_i]'**
This profile defines how to represent Body Height observations in FHIR using a standard
LOINC code and UCUM units of measure.
Used for simple observations such as device measurements, laboratory atomic results, vital
signs, height, weight, smoking status, comments, etc. Other resources are used to provide
context for observations such as laboratory reports, etc.
If the resource is contained in another resource, it SHALL be referred to from elsewhere
in the resource or SHALL refer to the containing resource
contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
nts().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))))
or descendants().where(reference = '#').exists() or descendants().where(as(canonical)
= '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched',
id).empty()
not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere
nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
a meta.lastUpdated
When a resource has no narrative, only systems that fully understand the data can display
the resource to a human safely. Including a human readable representation in the resource
makes for a much more robust eco-system and cheaper handling of resources by intermediary
systems. Some ecosystems restrict distribution of resources to only those systems that
do fully understand the resources, and as a consequence implementers may believe that
the narrative is superfluous. However experience shows that such eco-systems often open
up to new participants over time.
If Observation.code is the same as an Observation.component.code then the value element
associated with the code SHALL NOT be present
not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return
f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@
value]))
If there is no component or hasMember element then either a value[x] or a data absent
reason must be present.
The logical id of the resource, as used in the URL for the resource. Once assigned, this
value never changes.
The only time that a resource does not have an id is when it is being submitted to the
server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the resource.
A reference to a set of rules that were followed when the resource was constructed, and
which must be understood when processing the content. Often, this is a reference to an
implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of
trading partners. This inherently limits the usefulness of the data in the long term.
However, the existing health eco-system is highly fractured, and not yet ready to define,
collect, and exchange data in a generally computable sense. Wherever possible, implementers
and/or specification writers should avoid using this element. Often, when used, the URL
is a reference to an implementation guide that defines these special rules as part of
it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional
knowledge about the resource that modifies it's meaning or interpretation
Language is provided to support indexing and accessibility (typically, services such as
text to speech use the language tag). The html language tag in the narrative applies
to the narrative. The language tag on the resource may be used to specify the language
of other presentations generated from the data in the resource. Not all the content has
to be in the base language. The Resource.language should not be assumed to apply to the
narrative automatically. If a language is specified, it should it also be specified on
the div element in the html (see rules in HTML5 for information about the relationship
between xml:lang and the html lang attribute).
A human-readable narrative that contains a summary of the resource and can be used to
represent the content of the resource to a human. The narrative need not encode all the
structured data, but is required to contain sufficient detail to make it "clinically
safe" for a human to just read the narrative. Resource definitions may define what
content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have
a narrative. In some cases, a resource may only have text with little or no additional
discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary
for data from legacy systems where information is captured as a "text blob"
or where text is additionally entered raw or narrated and encoded information is added
later.
These resources do not have an independent existence apart from the resource that contains
them - they cannot be identified independently, and nor can they have their own independent
transaction scope.
This should never be done when the content can be identified properly, as once identification
is lost, it is extremely difficult (and context dependent) to restore it again. Contained
resources may have profiles and tags In their meta elements, but SHALL NOT have security
labels.
Containing new R4B resources within R4 resources may cause interoperability issues if
instances are shared with R4 systems
($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable
or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this
is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition
or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus
or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence
or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefi
nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition
or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat
ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource
is SubscriptionTopic)
not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package
dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA
uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio
n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe
finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre
dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|
f:SubscriptionStatus|f:SubscriptionTopic)
May be used to represent additional information that is not part of the basic definition
of the resource. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
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 manageable, 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).
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
distinguished from the vast majority of extensions which can be safely ignored. This
promotes interoperability by eliminating the need for implementers to prohibit the presence
of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
ml#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource
that contains them
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.
A plan, proposal or order that is fulfilled in whole or in part by this event. For example,
a MedicationRequest may require a patient to have laboratory test performed before it
is dispensed.
Allows tracing of authorization for the event and tracking whether proposals/recommendations
were acted upon.
A larger event of which this particular Observation is a component or step. For example,
an observation as part of a procedure.
To link an Observation to an Encounter use `encounter`. See the [Notes](observation.html#obsgroupi
ng) below for guidance on referencing another Observation.
This element is labeled as a modifier because the status contains codes that mark the
resource as not currently valid.
Need to track the status of individual results. Some results are finalized before the
whole report is finalized.
This element is labeled as a modifier because it is a status element that contains status
entered-in-error which means that the resource should not be treated as valid
status Amended & Final are differentiated by whether it is the subject of a ControlAct
event with a type of "revise"
In addition to the required category valueset, this element allows various categorization
schemes based on the owner’s definition of the category and effectively multiple categories
can be used at once. The level of granularity is defined by the category concepts in
the value set.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN&quo
t;].code
In addition to the required category valueset, this element allows various categorization
schemes based on the owner’s definition of the category and effectively multiple categories
can be used at once. The level of granularity is defined by the category concepts in
the value set.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN&quo
t;].code
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions
such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of
codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one
of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code
systems.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be
references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of
FHIR defined special URIs or it should reference to some definition that establishes the
system clearly and unambiguously.
The version of the code system which was used when choosing this code. Note that a well-maintained
code system does not need the version reported, because the meaning of codes is consistent
across versions. However this cannot consistently be assured, and when the meaning is
not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code
system versions, the recommendation is to use the date (expressed in FHIR date format)
on which that version was officially published as the version date.
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression
in a syntax defined by the coding system (e.g. post-coordination).
A representation of the meaning of the code in the system, following the rules of the
system.
Need to be able to carry a human-readable meaning of the code for readers that do not
know the system.
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available
items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting
point for new translations. There is some ambiguity about what exactly 'directly chosen'
implies, and trading partner agreement may be needed to clarify the use of this element
and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code
pair was chosen explicitly, rather than inferred by the system based on some rules or
language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected
fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target
dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true";
fhir:target dt:CDCoding.codingRationale\#O ]
A human language representation of the concept as seen/selected/uttered by the user who
entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the
nuances of the human using them, or sometimes there is no appropriate code at all. In
these cases, the text is used to capture the full meaning of the source.
additional codes that translate or map to this code are allowed. For example a more granular
LOINC code or code that is used locally in a system.
5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet
HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).
This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital
Sign Result Type.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions
such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of
codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one
of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code
systems.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions
such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of
codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one
of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code
systems.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be
references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of
FHIR defined special URIs or it should reference to some definition that establishes the
system clearly and unambiguously.
The version of the code system which was used when choosing this code. Note that a well-maintained
code system does not need the version reported, because the meaning of codes is consistent
across versions. However this cannot consistently be assured, and when the meaning is
not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code
system versions, the recommendation is to use the date (expressed in FHIR date format)
on which that version was officially published as the version date.
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression
in a syntax defined by the coding system (e.g. post-coordination).
A representation of the meaning of the code in the system, following the rules of the
system.
Need to be able to carry a human-readable meaning of the code for readers that do not
know the system.
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available
items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting
point for new translations. There is some ambiguity about what exactly 'directly chosen'
implies, and trading partner agreement may be needed to clarify the use of this element
and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code
pair was chosen explicitly, rather than inferred by the system based on some rules or
language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected
fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target
dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true";
fhir:target dt:CDCoding.codingRationale\#O ]
A human language representation of the concept as seen/selected/uttered by the user who
entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the
nuances of the human using them, or sometimes there is no appropriate code at all. In
these cases, the text is used to capture the full meaning of the source.
The patient, or group of patients, location, or device this observation is about and into
whose record the observation is placed. If the actual focus of the observation is different
from the subject (or a sample of, part, or region of the subject), the `focus` element
or the `code` itself specifies the actual focus of the observation.
One would expect this element to be a cardinality of 1..1. The only circumstance in which
the subject can be missing is when the observation is made by a device that does not know
the patient. In this case, the observation SHALL be matched to a patient through some
context/channel matching technique, and at this point, the observation should be updated.
The actual focus of an observation when it is not the patient of record representing something
or someone associated with the patient such as a spouse, parent, fetus, or donor. For
example, fetus observations in a mother's record. The focus of an observation could also
be an existing condition, an intervention, the subject's diet, another observation of
the subject, or a body structure such as tumor or implanted device. An example use
case would be using the Observation resource to capture whether the mother is trained
to change her child's tracheostomy tube. In this example, the child is the patient of
record and the mother is the focus.
Typically, an observation is made about the subject - a patient, or group of patients,
location, or device - and the distinction between the subject and what is directly measured
for an observation is specified in the observation code itself ( e.g., "Blood Glucose")
and does not need to be represented separately using this element. Use `specimen` if
a reference to a specimen is required. If a code is required instead of a resource use
either `bodysite` for bodysites or the standard extension [focusCode](extension-observation-focusco
de.html).
The healthcare event (e.g. a patient and healthcare provider interaction) during which
this observation is made.
This will typically be the encounter the event occurred within, but some events may be
initiated prior to or after the official completion of an encounter but still be tied
to the context of the encounter (e.g. pre-admission laboratory tests).
For some observations it may be important to know the link between an observation and
a particular encounter.
At least a date should be present unless this observation is a historical report. For
recording imprecise or "fuzzy" times (For example, a blood glucose measurement
taken "after breakfast") use the [Timing](datatypes.html#timing) datatype which
allow the measurement to be tied to regular life events.
Knowing when an observation was deemed true is important to its relevance as well as determining
trends.
if Observation.effective[x] is dateTime and has a value then that value shall be precise
to the day
The date and time this version of the observation was made available to providers, typically
after the results have been reviewed and verified.
For Observations that don’t require review and verification, it may be the same as the
[`lastUpdated` ](resource-definitions.html#Meta.lastUpdated) time of the resource itself.
For Observations that do require review and verification for certain updates, it might
not be the same as the `lastUpdated` time of the resource itself due to a non-clinically
significant update that doesn’t require the new version to be reviewed and verified again.
May give a degree of confidence in the observation and also indicates where follow-up
questions should be directed.
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'
Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept.
Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept.
An observation may have; 1) a single value here, 2) both a value and a set of related
or component values, or 3) only a set of related or component values. If a value is
present, the datatype for this element should be determined by Observation.code. A CodeableConcept
with just a text would be used instead of a string if the field was usually coded, or
if the type associated with the Observation.code defines a coded value. For additional
guidance, see the [Notes section](observation.html#notes) below.
Commonly encountered UCUM units for recording Vital Signs quantity units as codes. If
extending this valueset the codes SHOULD come from UCUM.
Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept.
Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept.
An observation may have; 1) a single value here, 2) both a value and a set of related
or component values, or 3) only a set of related or component values. If a value is
present, the datatype for this element should be determined by Observation.code. A CodeableConcept
with just a text would be used instead of a string if the field was usually coded, or
if the type associated with the Observation.code defines a coded value. For additional
guidance, see the [Notes section](observation.html#notes) below.
Commonly encountered UCUM units for recording Vital Signs quantity units as codes. If
extending this valueset the codes SHOULD come from UCUM.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
The value of the measured amount. The value includes an implicit precision in the presentation
of the value.
The implicit precision in the value should always be honored. Monetary values have their
own rules for handling precision (refer to standard accounting text books).
How the value should be understood and represented - whether the actual value is greater
or less than the stated value due to measurement issues; e.g. if the comparator is "<"
, then the real value is < stated value.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due
to the limitations of measuring methodology.
This is labeled as "Is Modifier" because the comparator modifies the interpretation
of the value significantly. If there is no comparator, then there is no modification of
the value
There are many representations for units of measure and in many contexts, particular representations
are fixed and required. I.e. mcg for micrograms.
The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or
ISO 4217 for currency. The context of use may additionally require a code from a particular
system.
Need a computable form of the unit that is fixed across all forms. UCUM provides this
for quantities, but SNOMED CT provides many units of interest.
Null or exceptional values can be represented two ways in FHIR Observations. One way
is to simply include them in the value set and represent the exceptions in the value.
For example, measurement values for a serology test could be "detected", "not
detected", "inconclusive", or "specimen unsatisfactory".
The alternate way is to use the value element for actual observations and use the explicit
dataAbsentReason element to record exceptional values. For example, the dataAbsentReason
code "error" could be used when the measurement was not completed. Note that
an observation may only be reported if there are values to report. For example differential
cell counts values may be reported only when > 0. Because of these options, use-case
agreements are required to interpret general observations for null or exceptional values.
Historically used for laboratory results (known as 'abnormal flag' ), its use extends
to other use cases where coded interpretations are relevant. Often reported as one or
more simple compact codes this element is often placed adjacent to the result value in
reports and flow sheets to signal the meaning/normalcy status of the result.
For some results, particularly numeric results, an interpretation is necessary to fully
understand the significance of a result.
May include general statements about the observation, or statements about significant,
unexpected or unreliable results values, or information about its source when relevant
to its interpretation.
Indicates the site on the subject's body where the observation was made (i.e. the target
site).
Only used if not implicit in code found in Observation.code. In many systems, this may
be represented as a related observation instead of an inline component.
If the use case requires BodySite to be handled as a separate resource (e.g. to identify
and track separately) then use the standard extension[ bodySite](extension-bodysite.html).
In some cases, method can impact results and is thus used for determining whether results
can be compared or determining significance of results.
Should only be used if not implicit in code found in `Observation.code`. Observations
are not made on specimens themselves; they are made on a subject, but in many cases by
the means of a specimen. Note that although specimens are often involved, they are not
always tracked and reported explicitly. Also note that observation resources may be used
in contexts that track the specimen explicitly (e.g. Diagnostic Report).
Note that this is not meant to represent a device involved in the transmission of the
result, e.g., a gateway. Such devices may be documented using the Provenance resource
where relevant.
Guidance on how to interpret the value by comparison to a normal or recommended range.
Multiple reference ranges are interpreted as an "OR". In other words, to
represent two distinct target populations, two `referenceRange` elements would be used.
Most observations only have one generic reference range. Systems MAY choose to restrict
to only supplying the relevant reference range based on knowledge about the patient (e.g.,
specific to the patient's age, gender, weight and other factors), but this might not be
possible or appropriate. Whenever more than one reference range is supplied, the differences
between them SHOULD be provided in the reference range and/or age properties.
Knowing what values are considered "normal" can help evaluate the significance
of a particular result. Need to be able to provide multiple reference ranges for different
contexts.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
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 manageable,
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).
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
distinguished from the vast majority of extensions which can be safely ignored. This
promotes interoperability by eliminating the need for implementers to prohibit the presence
of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
ml#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the element
that contains them
The value of the low bound of the reference range. The low bound of the reference range
endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the
low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).
The value of the high bound of the reference range. The high bound of the reference range
endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the
high bound is omitted, it is assumed to be meaningless (e.g. reference range is >=
2.3).
Codes to indicate the what part of the targeted reference population it applies to. For
example, the normal or therapeutic range.
This SHOULD be populated if there is more than one range. If this element is not present
then the normal range is assumed.
Need to be able to say what kind of reference range this is - normal, recommended, therapeutic,
etc., - for proper interpretation.
< 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|
Codes to indicate the target population this reference range applies to. For example,
a reference range may be based on the normal population or a particular sex or race.
Multiple `appliesTo` are interpreted as an "AND" of the target populations.
For example, to represent a target population of African American females, both a code
of female and a code for African American would be used.
This SHOULD be populated if there is more than one range. If this element is not present
then the normal population is assumed.
< 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|
The age at which this reference range is applicable. This is a neonatal age (e.g. number
of weeks at term) if the meaning says so.
Text based reference range in an observation which may be used when a quantitative range
is not appropriate for an observation. An example would be a reference value of "Negative"
; or a list or table of "normals".
When using this element, an observation will typically have either a value or a set of
related resources, although both may be present in some cases. For a discussion on the
ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping)
below. Note that a system may calculate results from [QuestionnaireResponse](questionnaireresponse.
html) into a final score and represent the score as an Observation.
The target resource that represents a measurement from which this observation value is
derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound
image.
All the reference choices that are listed in this element can represent clinical observations
and other measurements that may be the source for a derived value. The most common reference
will be another Observation. For a discussion on the ways Observations can assembled
in groups together, see [Notes](observation.html#obsgrouping) below.
For a discussion on the ways Observations can be assembled in groups together see [Notes](observatio
n.html#notes) below.
Component observations share the same attributes in the Observation resource as the primary
observation and are always treated a part of a single observation (they are not separable).
However, the reference range for the primary observation value is not inherited by the
component values and is required when appropriate for each component observation.
Unique id for the element within a resource (for internal references). This may be any
string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition
of the element. To make the use of extensions safe and manageable, 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.
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
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 manageable,
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).
There can be no stigma associated with the use of extensions by any application, project,
or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
The use of extensions is what allows the FHIR specification to retain a core level of
simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
distinguished from the vast majority of extensions which can be safely ignored. This
promotes interoperability by eliminating the need for implementers to prohibit the presence
of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
ml#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the element
that contains them
*All* code-value and component.code-component.value pairs need to be taken into account
to correctly understand the meaning of the observation.
This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP Vital
Sign Result Type.
< 363787002 |Observable entity| OR
< 386053000 |Evaluation procedure|
Used when observation has a set of component observations. An observation may have both
a value (e.g. an Apgar score) and component observations (the observations from which
the Apgar score was derived). If a value is present, the datatype for this element should
be determined by Observation.code. A CodeableConcept with just a text would be used instead
of a string if the field was usually coded, or if the type associated with the Observation.code
defines a coded value. For additional guidance, see the [Notes section](observation.html#notes)
below.
Commonly encountered UCUM units for recording Vital Signs quantity units as codes. If
extending this valueset the codes SHOULD come from UCUM.
Provides a reason why the expected value in the element Observation.component.value[x]
is missing.
"Null" or exceptional values can be represented two ways in FHIR Observations.
One way is to simply include them in the value set and represent the exceptions in the
value. For example, measurement values for a serology test could be "detected",
"not detected", "inconclusive", or "test not done".
The alternate way is to use the value element for actual observations and use the explicit
dataAbsentReason element to record exceptional values. For example, the dataAbsentReason
code "error" could be used when the measurement was not completed. Because
of these options, use-case agreements are required to interpret general observations for
exceptional values.
Historically used for laboratory results (known as 'abnormal flag' ), its use extends
to other use cases where coded interpretations are relevant. Often reported as one or
more simple compact codes this element is often placed adjacent to the result value in
reports and flow sheets to signal the meaning/normalcy status of the result.
For some results, particularly numeric results, an interpretation is necessary to fully
understand the significance of a result.
Most observations only have one generic reference range. Systems MAY choose to restrict
to only supplying the relevant reference range based on knowledge about the patient (e.g.,
specific to the patient's age, gender, weight and other factors), but this might not be
possible or appropriate. Whenever more than one reference range is supplied, the differences
between them SHOULD be provided in the reference range and/or age properties.
Knowing what values are considered "normal" can help evaluate the significance
of a particular result. Need to be able to provide multiple reference ranges for different
contexts.
This profile defines how to represent Body Height observations in FHIR using a standard
LOINC code and UCUM units of measure.
additional codes that translate or map to this code are allowed. For example a more granular
LOINC code or code that is used locally in a system.
<?xml version="1.0" encoding="UTF-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="bodyheight"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="#### Complete Summary of the Mandatory Requirements
1. One code in `Observation.code` which must have
- a fixed `Observation.code.coding.system`=**'http ://loinc.org'**
- a fixed `Observation.code.coding.code`= **'8302-2'**
- 8306-3 -Body height - lying (i.e., body length - typically used for infants)
MAY be included as an additional observation code - Other additional Codings are
allowed in `Observation.code`- e.g. more specific LOINC
Codes, SNOMED CT concepts, system specific codes. All codes
SHALL have a system value
1. Either one Observation.valueQuantity or, if there is no value, one code in Observation.Dat
aAbsentReason
- 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 = **'cm', or '[in_i]'**"/>
</extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="5"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <extension url="http://hl7.org/fhir/build/StructureDefinition/summary"> <valueString value="#### Complete Summary of the Mandatory Requirements
1. One code in `Observation.code` which must have
- a fixed `Observation.code.coding.system`=**'http ://loinc.org'**
- a fixed `Observation.code.coding.code`= **'8302-2'**
- 8306-3 -Body height - lying (i.e., body length - typically used for infants)
MAY be included as an additional observation code - Other additional Codings are
allowed in `Observation.code`- e.g. more specific LOINC
Codes, SNOMED CT concepts, system specific codes. All codes
SHALL have a system value
1. Either one Observation.valueQuantity or, if there is no value, one code in Observation.Dat
aAbsentReason
- 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 = **'cm', or '[in_i]'**"/>
</extension> <url value="http://hl7.org/fhir/StructureDefinition/bodyheight"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.5.1463"/> </identifier> <version value="5.0.0-draft-final"/> <name value="Observationbodyheight"/> <title value="Observation Body Height Profile"/> <status value="draft"/> <experimental value="false"/> <date value="2018-08-11"/> <publisher value="Health Level Seven International (Orders and Observations Workgroup)"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations"/> </telecom> </contact> <description value="FHIR Body Height Profile"/> <fhirVersion value="5.0.0-draft-final"/> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="sct-concept"/> <uri value="http://snomed.info/conceptdomain"/> <name value="SNOMED CT Concept Domain Binding"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 V2 Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="sct-attr"/> <uri value="http://snomed.org/attributebinding"/> <name value="SNOMED CT Attribute Binding"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="Observation"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> <derivation value="constraint"/> <snapshot> <element id="Observation"> <path value="Observation"/> <short value="FHIR Body Height Profile"/> <definition value="This profile defines how to represent Body Height observations in FHIR using a
standard LOINC code and UCUM units of measure."/>
<comment value="Used for simple observations such as device measurements, laboratory atomic results,
vital signs, height, weight, smoking status, comments, etc. Other resources are
used to provide context for observations such as laboratory reports, etc."/>
<alias value="Vital Signs"/> <alias value="Measurement"/> <alias value="Results"/> <alias value="Tests"/> <min value="0"/> <max value="*"/> <base> <path value="Observation"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL be referred to from
elsewhere in the resource or SHALL refer to the containing resource"/>
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy
pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))
or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical)
= '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmat
ched', id).empty()"/>
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
or a meta.lastUpdated"/>
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
display the resource to a human safely. Including a human readable representation
in the resource makes for a much more robust eco-system and cheaper handling of
resources by intermediary systems. Some ecosystems restrict distribution of resources
to only those systems that do fully understand the resources, and as a consequence
implementers may believe that the narrative is superfluous. However experience
shows that such eco-systems often open up to new participants over time."/>
</extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="obs-6"/> <severity value="error"/> <human value="dataAbsentReason SHALL only be present if Observation.value[x] is not present"/> <expression value="dataAbsentReason.empty() or value.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> </constraint> <constraint> <key value="obs-7"/> <severity value="error"/> <human value="If Observation.component.code is the same as Observation.code, then Observation.value
SHALL NOT be present (the Observation.component.value[x] holds the value)."/>
<expression value="value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty
()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/> </constraint> <constraint> <key value="obs-8"/> <severity value="error"/> <human value="bodyStructure SHALL only be present if Observation.bodySite is not present"/> <expression value="bodySite.exists() implies bodyStructure.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> </constraint> <constraint> <key value="vs-2"/> <severity value="error"/> <human value="If there is no component or hasMember element then either a value[x] or a data
absent reason must be present."/>
<expression value="(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or
value.exists())"/>
<source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity. Role, or Act"/> </mapping> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 363787002 |Observable entity|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=OBS, moodCode=EVN]"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.diagnostics"/> </mapping> </element> <element id="Observation.id"> <path value="Observation.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
this value never changes."/>
<comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
for cases like the create and conditional update. Otherwise, the use of the resouce
id depends on the given use case."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Observation.meta"> <path value="Observation.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
Changes to the content might not always be associated with version changes to the
resource."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Observation.implicitRules"> <path value="Observation.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed,
and which must be understood when processing the content. Often, this is a reference
to an implementation guide that defines the special rules along with other profiles
etc."/>
<comment value="Asserting this rule set restricts the content to be only understood by a limited
set of trading partners. This inherently limits the usefulness of the data in the
long term. However, the existing health eco-system is highly fractured, and not
yet ready to define, collect, and exchange data in a generally computable sense.
Wherever possible, implementers and/or specification writers should avoid using
this element. Often, when used, the URL is a reference to an implementation guide
that defines these special rules as part of its narrative along with other profiles,
value sets, etc."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
knowledge about the resource that modifies its meaning or interpretation"/>
<isSummary value="true"/> </element> <element id="Observation.language"> <path value="Observation.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="Language is provided to support indexing and accessibility (typically, services
such as text to speech use the language tag). The html language tag in the narrative
applies to the narrative. The language tag on the resource may be used to specify
the language of other presentations generated from the data in the resource. Not
all the content has to be in the base language. The Resource.language should not
be assumed to apply to the narrative automatically. If a language is specified,
it should it also be specified on the div element in the html (see rules in HTML5
for information about the relationship between xml:lang and the html lang attribute)."/>
<min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0-draft-final"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </additional> </binding> </element> <element id="Observation.text"> <path value="Observation.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource and can be used
to represent the content of the resource to a human. The narrative need not encode
all the structured data, but is required to contain sufficient detail to make it
"clinically safe" for a human to just read the narrative. Resource definitions
may define what content should be represented in the narrative to ensure clinical
safety."/>
<comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
have a narrative. In some cases, a resource may only have text with little or no
additional discrete data (as long as all minOccurs=1 elements are satisfied).
This may be necessary for data from legacy systems where information is captured
as a "text blob" or where text is additionally entered raw or narrated
and encoded information is added later."/>
<alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="Observation.contained"> <path value="Observation.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that
contains them - they cannot be identified independently, nor can they have their
own independent transaction scope. This is allowed to be a Parameters resource
if and only if it is referenced by a resource that provides context/meaning."/>
<comment value="This should never be done when the content can be identified properly, as once
identification is lost, it is extremely difficult (and context dependent) to restore
it again. Contained resources may have profiles and tags in their meta elements,
but SHALL NOT have security labels."/>
<alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the resource. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
resource that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Observation.identifier"> <path value="Observation.identifier"/> <short value="Business Identifier for observation"/> <definition value="A unique identifier assigned to this observation."/> <requirements value="Allows observations to be distinguished and referenced."/> <min value="0"/> <max value="*"/> <base> <path value="Observation.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="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."/>
</mapping> <mapping> <identity value="rim"/> <map value="id"/> </mapping> </element> <element id="Observation.instantiates[x]"> <path value="Observation.instantiates[x]"/> <short value="Instantiates FHIR ObservationDefinition"/> <definition value="The reference to a FHIR ObservationDefinition resource that provides the definition
that is adhered to in whole or in part by this Observation instance."/>
<comment value="ObservationDefinition can be referenced by its canonical url using instantiatesCanonical,
or by a name or an identifier using the appropriate sub-elements of instantiatesReference."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.instantiates[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="canonical"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ObservationDefinition"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ObservationDefinition"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.instantiatesCanonical"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=DEFN].target"/> </mapping> </element> <element id="Observation.basedOn"> <path value="Observation.basedOn"/> <short value="Fulfills plan, proposal or order"/> <definition value="A plan, proposal or order that is fulfilled in whole or in part by this event.
For example, a MedicationRequest may require a patient to have laboratory test
performed before it is dispensed."/>
<requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations
were acted upon."/>
<alias value="Fulfills"/> <min value="0"/> <max value="*"/> <base> <path value="Observation.basedOn"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.basedOn"/> </mapping> <mapping> <identity value="v2"/> <map value="ORC"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/> </mapping> </element> <element id="Observation.triggeredBy"> <path value="Observation.triggeredBy"/> <short value="Triggering observation(s)"/> <definition value="Identifies the observation(s) that triggered the performance of this observation."/> <min value="0"/> <max value="*"/> <base> <path value="Observation.triggeredBy"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="ORC"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/> </mapping> </element> <element id="Observation.triggeredBy.id"> <path value="Observation.triggeredBy.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.triggeredBy.extension"> <path value="Observation.triggeredBy.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.triggeredBy.modifierExtension"> <path value="Observation.triggeredBy.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Observation.triggeredBy.observation"> <path value="Observation.triggeredBy.observation"/> <short value="Triggering observation"/> <definition value="Reference to the triggering observation."/> <min value="1"/> <max value="1"/> <base> <path value="Observation.triggeredBy.observation"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="outBoundRelationship"/> </mapping> </element> <element id="Observation.triggeredBy.type"> <path value="Observation.triggeredBy.type"/> <short value="reflex | repeat | re-run"/> <definition value="The type of trigger.
Reflex | Repeat | Re-run."/>
<min value="1"/> <max value="1"/> <base> <path value="Observation.triggeredBy.type"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="TriggeredByType"/> </extension> <strength value="required"/> <description value="The type of TriggeredBy Observation."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-triggeredbytype|5.0.0-draft-final"/> </binding> <mapping> <identity value="rim"/> <map value="code"/> </mapping> </element> <element id="Observation.triggeredBy.reason"> <path value="Observation.triggeredBy.reason"/> <short value="Reason that the observation was triggered"/> <definition value="Provides the reason why this observation was performed as a result of the observation(s)
referenced."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.triggeredBy.reason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="annotation"/> </mapping> </element> <element id="Observation.partOf"> <path value="Observation.partOf"/> <short value="Part of referenced event"/> <definition value="A larger event of which this particular Observation is a component or step. For
example, an observation as part of a procedure."/>
<comment value="To link an Observation to an Encounter use `encounter`. See the [Notes](observation.html#ob
sgrouping) below for guidance on referencing another Observation."/>
<alias value="Container"/> <min value="0"/> <max value="*"/> <base> <path value="Observation.partOf"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/GenomicStudy"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.partOf"/> </mapping> <mapping> <identity value="v2"/> <map value="Varies by domain"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=FLFS].target"/> </mapping> </element> <element id="Observation.status"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint"> <valueString value="default: final"/> </extension> <path value="Observation.status"/> <short value="registered | preliminary | final | amended +"/> <definition value="The status of the result value."/> <comment value="This element is labeled as a modifier because the status contains codes that mark
the resource as not currently valid."/>
<requirements value="Need to track the status of individual results. Some results are finalized before
the whole report is finalized."/>
<min value="1"/> <max value="1"/> <base> <path value="Observation.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because it is a status element that contains
status entered-in-error which means that the resource should not be treated as
valid"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status"/> </extension> <strength value="required"/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-status"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 445584004 |Report by finality status|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-11"/> </mapping> <mapping> <identity value="rim"/> <map value="status Amended & Final are differentiated by whether it is the subject of
a ControlAct event with a type of "revise""/>
</mapping> </element> <element id="Observation.category"> <path value="Observation.category"/> <slicing> <discriminator> <type value="value"/> <path value="coding.code"/> </discriminator> <discriminator> <type value="value"/> <path value="coding.system"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Classification of type of observation"/> <definition value="A code that classifies the general type of observation being made."/> <comment value="In addition to the required category valueset, this element allows various categorization
schemes based on the owner’s definition of the category and effectively multiple
categories can be used at once. The level of granularity is defined by the category
concepts in the value set."/>
<requirements value="Used for filtering what observations are retrieved and displayed."/> <min value="1"/> <max value="*"/> <base> <path value="Observation.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCategory"/> </extension> <strength value="preferred"/> <description value="Codes for high level observation categories."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="
EVN"].code"/>
</mapping> </element> <element id="Observation.category:VSCat"> <path value="Observation.category"/> <sliceName value="VSCat"/> <short value="Classification of type of observation"/> <definition value="A code that classifies the general type of observation being made."/> <comment value="In addition to the required category valueset, this element allows various categorization
schemes based on the owner’s definition of the category and effectively multiple
categories can be used at once. The level of granularity is defined by the category
concepts in the value set."/>
<requirements value="Used for filtering what observations are retrieved and displayed."/> <min value="1"/> <max value="1"/> <base> <path value="Observation.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCategory"/> </extension> <strength value="preferred"/> <description value="Codes for high level observation categories."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="
EVN"].code"/>
</mapping> </element> <element id="Observation.category:VSCat.id"> <path value="Observation.category.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.category:VSCat.extension"> <path value="Observation.category.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.category:VSCat.coding"> <path value="Observation.category.coding"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal
definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.
Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally,
at most only one of the coding values will be labeled as UserSelected = true."/>
<requirements value="Allows for alternative encodings within a code system, and translations to other
code systems."/>
<min value="1"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Observation.category:VSCat.coding.id"> <path value="Observation.category.coding.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.category:VSCat.coding.extension"> <path value="Observation.category.coding.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.category:VSCat.coding.system"> <path value="Observation.category.coding.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in
the code."/>
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL
be references to the HL7 OID registry. Otherwise, the URI should come from HL7's
list of FHIR defined special URIs or it should be an absolute reference to some
definition that establishes the system clearly and unambiguously."/>
<requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://terminology.hl7.org/CodeSystem/observation-category"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="Observation.category:VSCat.coding.version"> <path value="Observation.category.coding.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that
a well-maintained code system does not need the version reported, because the meaning
of codes is consistent across versions. However this cannot consistently be assured,
and when the meaning is not guaranteed to be consistent, the version SHOULD be
exchanged."/>
<comment value="Where the terminology does not clearly define what string should be used to identify
code system versions, the recommendation is to use the date (expressed in FHIR
date format) on which that version was officially published as the version date."/>
<min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="Observation.category:VSCat.coding.code"> <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding"> <valueBoolean value="true"/> </extension> <path value="Observation.category.coding.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or
an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
<requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="vital-signs"/> <condition value="cod-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="Observation.category:VSCat.coding.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Observation.category.coding.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules
of the system."/>
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that
do not know the system."/>
<min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <condition value="cod-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="Observation.category:VSCat.coding.userSelected"> <path value="Observation.category.coding.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list
of available items (codes or displays)."/>
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting
point for new translations. There is some ambiguity about what exactly 'directly
chosen' implies, and trading partner agreement may be needed to clarify the use
of this element and its consequences more completely."/>
<requirements value="This has been identified as a clinical safety criterium - that this exact system/code
pair was chosen explicitly, rather than inferred by the system based on some rules
or language processing."/>
<min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected
fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;
fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [
fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O
]"/>
</mapping> </element> <element id="Observation.category:VSCat.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Observation.category.text"/> <short value="Plain text representation of the concept"/> <definition value="A human language representation of the concept as seen/selected/uttered by the
user who entered the data and/or which represents the intended meaning of the user."/>
<comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="The codes from the terminologies do not always capture the correct meaning with
all the nuances of the human using them, or sometimes there is no appropriate code
at all. In these cases, the text is used to capture the full meaning of the source."/>
<min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Observation.code"> <path value="Observation.code"/> <short value="Body Height"/> <definition value="Body Height."/> <comment value="additional codes that translate or map to this code are allowed. For example a
more granular LOINC code or code that is used locally in a system."/>
<requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from
ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)."/>
<alias value="Name"/> <alias value="Test"/> <min value="1"/> <max value="1"/> <base> <path value="Observation.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="obs-7"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/definition"> <valueString value="This identifies the vital sign result type."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns"/> </extension> <strength value="extensible"/> <description value="This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP
Vital Sign Result Type."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-3"/> </mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="116680003 |Is a|"/> </mapping> </element> <element id="Observation.code.id"> <path value="Observation.code.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding"/> <slicing> <discriminator> <type value="value"/> <path value="code"/> </discriminator> <discriminator> <type value="value"/> <path value="system"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal
definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.
Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally,
at most only one of the coding values will be labeled as UserSelected = true."/>
<requirements value="Allows for alternative encodings within a code system, and translations to other
code systems."/>
<min value="0"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode"> <path value="Observation.code.coding"/> <sliceName value="BodyHeightCode"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal
definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.
Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally,
at most only one of the coding values will be labeled as UserSelected = true."/>
<requirements value="Allows for alternative encodings within a code system, and translations to other
code systems."/>
<min value="1"/> <max value="1"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.id"> <path value="Observation.code.coding.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.extension"> <path value="Observation.code.coding.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.system"> <path value="Observation.code.coding.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in
the code."/>
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL
be references to the HL7 OID registry. Otherwise, the URI should come from HL7's
list of FHIR defined special URIs or it should be an absolute reference to some
definition that establishes the system clearly and unambiguously."/>
<requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://loinc.org"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.version"> <path value="Observation.code.coding.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that
a well-maintained code system does not need the version reported, because the meaning
of codes is consistent across versions. However this cannot consistently be assured,
and when the meaning is not guaranteed to be consistent, the version SHOULD be
exchanged."/>
<comment value="Where the terminology does not clearly define what string should be used to identify
code system versions, the recommendation is to use the date (expressed in FHIR
date format) on which that version was officially published as the version date."/>
<min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.code"> <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding"> <valueBoolean value="true"/> </extension> <path value="Observation.code.coding.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or
an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
<requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="8302-2"/> <condition value="cod-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Observation.code.coding.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules
of the system."/>
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that
do not know the system."/>
<min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <condition value="cod-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="Observation.code.coding:BodyHeightCode.userSelected"> <path value="Observation.code.coding.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list
of available items (codes or displays)."/>
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting
point for new translations. There is some ambiguity about what exactly 'directly
chosen' implies, and trading partner agreement may be needed to clarify the use
of this element and its consequences more completely."/>
<requirements value="This has been identified as a clinical safety criterium - that this exact system/code
pair was chosen explicitly, rather than inferred by the system based on some rules
or language processing."/>
<min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected
fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;
fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [
fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O
]"/>
</mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Observation.code.text"/> <short value="Plain text representation of the concept"/> <definition value="A human language representation of the concept as seen/selected/uttered by the
user who entered the data and/or which represents the intended meaning of the user."/>
<comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="The codes from the terminologies do not always capture the correct meaning with
all the nuances of the human using them, or sometimes there is no appropriate code
at all. In these cases, the text is used to capture the full meaning of the source."/>
<min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject"/> <short value="Who and/or what the observation is about"/> <definition value="The patient, or group of patients, location, device, organization, procedure or
practitioner this observation is about and into whose or what record the observation
is placed. If the actual focus of the observation is different from the subject
(or a sample of, part, or region of the subject), the `focus` element or the `code`
itself specifies the actual focus of the observation."/>
<comment value="One would expect this element to be a cardinality of 1..1. The only circumstance
in which the subject can be missing is when the observation is made by a device
that does not know the patient. In this case, the observation SHALL be matched
to a patient through some context/channel matching technique, and at this point,
the observation should be updated. The subject of an Observation may in some cases
be a procedure. This supports the regulatory inspection use case where observations
are captured during inspections of a procedure that is being performed (independent
of any particular patient or whether patient related at all)."/>
<requirements value="Observations have no value if you don't know who or what they're about."/> <min value="1"/> <max value="1"/> <base> <path value="Observation.subject"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=RTGT]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> </element> <element id="Observation.focus"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <path value="Observation.focus"/> <short value="What the observation is about, when it is not about the subject of record"/> <definition value="The actual focus of an observation when it is not the patient of record representing
something or someone associated with the patient such as a spouse, parent, fetus,
or donor. For example, fetus observations in a mother's record. The focus of an
observation could also be an existing condition, an intervention, the subject's
diet, another observation of the subject, or a body structure such as tumor or
implanted device. An example use case would be using the Observation resource
to capture whether the mother is trained to change her child's tracheostomy tube.
In this example, the child is the patient of record and the mother is the focus."/>
<comment value="Typically, an observation is made about the subject - a patient, or group of patients,
location, or device - and the distinction between the subject and what is directly
measured for an observation is specified in the observation code itself ( e.g.,
"Blood Glucose") and does not need to be represented separately using
this element. Use `specimen` if a reference to a specimen is required. If a code
is required instead of a resource use either `bodysite` for bodysites or the standard
extension [http://hl7.org/fhir/StructureDefinition/observation-focusCode](http://hl7.org/fhir
/extensions/StructureDefinition-observation-focusCode.html)."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.focus"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-3"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SBJ]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> </element> <element id="Observation.encounter"> <path value="Observation.encounter"/> <short value="Healthcare event during which this observation is made"/> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) during
which this observation is made."/>
<comment value="This will typically be the encounter the event occurred within, but some events
may be initiated prior to or after the official completion of an encounter but
still be tied to the context of the encounter (e.g. pre-admission laboratory tests)."/>
<requirements value="For some observations it may be important to know the link between an observation
and a particular encounter."/>
<alias value="Context"/> <min value="0"/> <max value="1"/> <base> <path value="Observation.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.encounter"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="v2"/> <map value="PV1"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/> </mapping> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]"/> <short value="Often just a dateTime for Vital Signs"/> <definition value="Often just a dateTime for Vital Signs."/> <comment value="At least a date should be present unless this observation is a historical report.
For recording imprecise or "fuzzy" times (For example, a blood glucose
measurement taken "after breakfast") use the [Timing](datatypes.html#timing)
datatype which allow the measurement to be tied to regular life events."/>
<requirements value="Knowing when an observation was deemed true is important to its relevance as well
as determining trends."/>
<alias value="Occurrence"/> <min value="1"/> <max value="1"/> <base> <path value="Observation.effective[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="Period"/> </type> <condition value="vs-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="vs-1"/> <severity value="error"/> <human value="if Observation.effective[x] is dateTime and has a value then that value shall be
precise to the day"/>
<expression value="($this as dateTime).toString().length() >= 8"/> <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.occurrence[x]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.done[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)"/> </mapping> <mapping> <identity value="rim"/> <map value="effectiveTime"/> </mapping> </element> <element id="Observation.issued"> <path value="Observation.issued"/> <short value="Date/Time this version was made available"/> <definition value="The date and time this version of the observation was made available to providers,
typically after the results have been reviewed and verified."/>
<comment value="For Observations that don't require review and verification, it may be the same
as the [`lastUpdated` ](resource-definitions.html#Meta.lastUpdated) time of the
resource itself. For Observations that do require review and verification for
certain updates, it might not be the same as the `lastUpdated` time of the resource
itself due to a non-clinically significant update that doesn't require the new
version to be reviewed and verified again."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.issued"/> <min value="0"/> <max value="1"/> </base> <type> <code value="instant"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="v2"/> <map value="OBR-22 (or MSH-7), or perhaps OBX-19 (depends on who observation made)"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=AUT].time"/> </mapping> </element> <element id="Observation.performer"> <path value="Observation.performer"/> <short value="Who is responsible for the observation"/> <definition value="Who was responsible for asserting the observed value as "true"."/> <requirements value="May give a degree of confidence in the observation and also indicates where follow-up
questions should be directed."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.performer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> <mapping> <identity value="v2"/> <map value="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'"/>
</mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=PRF]"/> </mapping> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept."/>
<definition value="Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept."/>
<comment value="- An observation may have:
1. a single value here
1. both a value and a set of related or component values
1. only a set of related or component values.
- If a value is present, the datatype for this element should be determined by
the `code`.
- *CodeableConcept* with just a text would be used instead of a string if the
field was usually coded, or if the type associated with the `code` defines a coded
value.
- *Attachment* is used if the observation result value is a binary file such as
an image. If the observation result value is derived from the binary file (for
example 'X' detected and here is the the proof in this image), the binary file
may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
used as a definitional resource, not as a paitent-specific finding. Similarly,
the use of valueCanonical should only be used to refer definitional URIs. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/>
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> </type> <type> <code value="CodeableConcept"/> </type> <type> <code value="markdown"/> </type> <type> <code value="boolean"/> </type> <type> <code value="integer"/> </type> <type> <code value="Range"/> </type> <type> <code value="Ratio"/> </type> <type> <code value="SampledData"/> </type> <type> <code value="time"/> </type> <type> <code value="dateTime"/> </type> <type> <code value="Period"/> </type> <type> <code value="Attachment"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> </type> <type> <code value="canonical"/> </type> <condition value="obs-7"/> <condition value="obs-6"/> <condition value="vs-2"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="sct-concept"/> <map value="< 441742003 |Evaluation finding|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-2, OBX-5, OBX-6"/> </mapping> <mapping> <identity value="rim"/> <map value="value"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="363714003 |Interprets|"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity"> <path value="Observation.value[x]"/> <sliceName value="valueQuantity"/> <short value="Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept."/>
<definition value="Vital Signs value are recorded using the Quantity data type. For supporting observations
such as Cuff size could use other datatypes such as CodeableConcept."/>
<comment value="- An observation may have:
1. a single value here
1. both a value and a set of related or component values
1. only a set of related or component values.
- If a value is present, the datatype for this element should be determined by
the `code`.
- *CodeableConcept* with just a text would be used instead of a string if the
field was usually coded, or if the type associated with the `code` defines a coded
value.
- *Attachment* is used if the observation result value is a binary file such as
an image. If the observation result value is derived from the binary file (for
example 'X' detected and here is the the proof in this image), the binary file
may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
used as a definitional resource, not as a paitent-specific finding. Similarly,
the use of valueCanonical should only be used to refer definitional URIs. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/>
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> </type> <condition value="obs-7"/> <condition value="obs-6"/> <condition value="vs-2"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="sct-concept"/> <map value="< 441742003 |Evaluation finding|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-2, OBX-5, OBX-6"/> </mapping> <mapping> <identity value="rim"/> <map value="value"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="363714003 |Interprets|"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.id"> <path value="Observation.value[x].id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.extension"> <path value="Observation.value[x].extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.value"> <path value="Observation.value[x].value"/> <short value="Numerical value (with implicit precision)"/> <definition value="The value of the measured amount. The value includes an implicit precision in the
presentation of the value."/>
<comment value="The implicit precision in the value should always be honored. Monetary values have
their own rules for handling precision (refer to standard accounting text books)."/>
<requirements value="Precision is handled implicitly in almost all cases of measurement."/> <min value="1"/> <max value="1"/> <base> <path value="Quantity.value"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="SN.2 / CQ - N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.comparator"> <path value="Observation.value[x].comparator"/> <short value="< | <= | >= | > | ad - how to understand the value"/> <definition value="How the value should be understood and represented - whether the actual value is
greater or less than the stated value due to measurement issues; e.g. if the comparator
is "<" , then the real value is < stated value."/>
<requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L
due to the limitations of measuring methodology."/>
<min value="0"/> <max value="1"/> <base> <path value="Quantity.comparator"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the
interpretation of the value significantly. If there is no comparator, then there
is no modification of the value"/>
<isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/binding-definition"> <valueString value="How the Quantity should be understood and represented."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator"/> </extension> <strength value="required"/> <description value="How the Quantity should be understood and represented."/> <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0-draft-final"/> </binding> <mapping> <identity value="v2"/> <map value="SN.1 / CQ.1"/> </mapping> <mapping> <identity value="rim"/> <map value="IVL properties"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Observation.value[x].unit"/> <short value="Unit representation"/> <definition value="A human-readable form of the unit."/> <requirements value="There are many representations for units of measure and in many contexts, particular
representations are fixed and required. I.e. mcg for micrograms."/>
<min value="1"/> <max value="1"/> <base> <path value="Quantity.unit"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.unit"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.system"> <path value="Observation.value[x].system"/> <short value="System that defines coded unit form"/> <definition value="The identification of the system that provides the coded form of the unit."/> <requirements value="Need to know the system that defines the coded form of the unit."/> <min value="1"/> <max value="1"/> <base> <path value="Quantity.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://unitsofmeasure.org"/> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="CO.codeSystem, PQ.translation.codeSystem"/> </mapping> </element> <element id="Observation.value[x]:valueQuantity.code"> <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding"> <valueBoolean value="true"/> </extension> <path value="Observation.value[x].code"/> <short value="Coded responses from the common UCUM units for vital signs value set."/> <definition value="Coded responses from the common UCUM units for vital signs value set."/> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units)
or ISO 4217 for currency. The context of use may additionally require a code from
a particular system."/>
<requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides
this for quantities, but SNOMED CT provides many units of interest."/>
<min value="1"/> <max value="1"/> <base> <path value="Quantity.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/definition"> <valueString value="Common UCUM units for body length measures such as Body Height and Head Circumference."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits"/> </extension> <strength value="required"/> <description value="cm | [in_i]"/> <valueSet value="http://hl7.org/fhir/ValueSet/ucum-bodylength"/> </binding> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.code, MO.currency, PQ.translation.code"/> </mapping> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason"/> <short value="Why the result is missing"/> <definition value="Provides a reason why the expected value in the element Observation.value[x] is
missing."/>
<comment value="Null or exceptional values can be represented two ways in FHIR Observations. One
way is to simply include them in the value set and represent the exceptions in
the value. For example, measurement values for a serology test could be "detected"
;, "not detected", "inconclusive", or "specimen unsatisfactory"
.
The alternate way is to use the value element for actual observations and use the
explicit dataAbsentReason element to record exceptional values. For example, the
dataAbsentReason code "error" could be used when the measurement was
not completed. Note that an observation may only be reported if there are values
to report. For example differential cell counts values may be reported only when
> 0. Because of these options, use-case agreements are required to interpret
general observations for null or exceptional values."/>
<requirements value="For many results it is necessary to handle exceptional values in measurements."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.dataAbsentReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="obs-6"/> <condition value="vs-2"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="extensible"/> <description value="Codes specifying why the result (`Observation.value[x]`) is missing."/> <valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> </binding> <mapping> <identity value="v2"/> <map value="N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="value.nullFlavor"/> </mapping> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation"/> <short value="High, low, normal, etc"/> <definition value="A categorical assessment of an observation value. For example, high, low, normal."/> <comment value="Historically used for laboratory results (known as 'abnormal flag' ), its use
extends to other use cases where coded interpretations are relevant. Often reported
as one or more simple compact codes this element is often placed adjacent to the
result value in reports and flow sheets to signal the meaning/normalcy status of
the result."/>
<requirements value="For some results, particularly numeric results, an interpretation is necessary
to fully understand the significance of a result."/>
<alias value="Abnormal Flag"/> <min value="0"/> <max value="*"/> <base> <path value="Observation.interpretation"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation"/> </extension> <strength value="extensible"/> <description value="Codes identifying interpretations of observations."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 260245000 |Findings values|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-8"/> </mapping> <mapping> <identity value="rim"/> <map value="interpretationCode"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="363713009 |Has interpretation|"/> </mapping> </element> <element id="Observation.note"> <path value="Observation.note"/> <short value="Comments about the observation"/> <definition value="Comments about the observation or the results."/> <comment value="May include general statements about the observation, or statements about significant,
unexpected or unreliable results values, or information about its source when relevant
to its interpretation."/>
<requirements value="Need to be able to provide free text additional information."/> <min value="0"/> <max value="*"/> <base> <path value="Observation.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="NTE-3 (partner NTE to OBX, or sometimes another (child?) OBX)"/> </mapping> <mapping> <identity value="rim"/> <map value="subjectOf.observationEvent[code="annotation"].value"/> </mapping> </element> <element id="Observation.bodySite"> <path value="Observation.bodySite"/> <short value="Observed body part"/> <definition value="Indicates the site on the subject's body where the observation was made (i.e. the
target site)."/>
<comment value="Only used if not implicit in code found in Observation.code. In many systems,
this may be represented as a related observation instead of an inline component."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.bodySite"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="obs-8"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/binding-definition"> <valueString value="Codes describing anatomical locations. May include laterality."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodySite"/> </extension> <strength value="example"/> <description value="SNOMED CT Body site concepts"/> <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 123037004 |Body structure|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-20"/> </mapping> <mapping> <identity value="rim"/> <map value="targetSiteCode"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="718497002 |Inherent location|"/> </mapping> </element> <element id="Observation.bodyStructure"> <path value="Observation.bodyStructure"/> <short value="Observed body structure"/> <definition value="Indicates the body structure on the subject's body where the observation was made
(i.e. the target site)."/>
<comment value="Only used if not implicit in code found in Observation.code or bodySite is used.
In many systems, this may be represented as a related observation instead of an
inline component."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.bodyStructure"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure"/> </type> <condition value="obs-8"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="targetSiteCode"/> </mapping> </element> <element id="Observation.method"> <path value="Observation.method"/> <short value="How it was done"/> <definition value="Indicates the mechanism used to perform the observation."/> <comment value="Only used if not implicit in code for Observation.code."/> <requirements value="In some cases, method can impact results and is thus used for determining whether
results can be compared or determining significance of results."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.method"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationMethod"/> </extension> <strength value="example"/> <description value="Methods for simple observations."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-methods"/> </binding> <mapping> <identity value="v2"/> <map value="OBX-17"/> </mapping> <mapping> <identity value="rim"/> <map value="methodCode"/> </mapping> </element> <element id="Observation.specimen"> <path value="Observation.specimen"/> <short value="Specimen used for this observation"/> <definition value="The specimen that was used when this observation was made."/> <comment value="Should only be used if not implicit in code found in `Observation.code`. Observations
are not made on specimens themselves; they are made on a subject, but in many cases
by the means of a specimen. Note that although specimens are often involved, they
are not always tracked and reported explicitly. Also note that observation resources
may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report)."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.specimen"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="obs-9"/> <severity value="error"/> <human value="If Observation.specimen is a reference to Group, the group can only have specimens"/> <expression value="(reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().m
ember.entity.resolve().all($this is Specimen)"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="sct-concept"/> <map value="< 123038009 |Specimen|"/> </mapping> <mapping> <identity value="v2"/> <map value="SPM segment"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=SPC].specimen"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="704319004 |Inherent in|"/> </mapping> </element> <element id="Observation.device"> <path value="Observation.device"/> <short value="(Measurement) Device"/> <definition value="The device used to generate the observation data."/> <comment value="Note that this is not meant to represent a device involved in the transmission
of the result, e.g., a gateway. Such devices may be documented using the Provenance
resource where relevant."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.device"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="sct-concept"/> <map value="< 49062001 |Device|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-17 / PRT -10"/> </mapping> <mapping> <identity value="rim"/> <map value="participation[typeCode=DEV]"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="424226004 |Using device|"/> </mapping> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange"/> <short value="Provides guide for interpretation"/> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended
range. Multiple reference ranges are interpreted as an "OR". In other
words, to represent two distinct target populations, two `referenceRange` elements
would be used."/>
<comment value="Most observations only have one generic reference range. Systems MAY choose to
restrict to only supplying the relevant reference range based on knowledge about
the patient (e.g., specific to the patient's age, gender, weight and other factors),
but this might not be possible or appropriate. Whenever more than one reference
range is supplied, the differences between them SHOULD be provided in the reference
range and/or age properties."/>
<requirements value="Knowing what values are considered "normal" can help evaluate the significance
of a particular result. Need to be able to provide multiple reference ranges for
different contexts."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.referenceRange"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="obs-3"/> <severity value="error"/> <human value="Must have at least a low or a high or text"/> <expression value="low.exists() or high.exists() or text.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX-7"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/> </mapping> </element> <element id="Observation.referenceRange.id"> <path value="Observation.referenceRange.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.referenceRange.modifierExtension"> <path value="Observation.referenceRange.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low"/> <short value="Low Range, if relevant"/> <definition value="The value of the low bound of the reference range. The low bound of the reference
range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9).
If the low bound is omitted, it is assumed to be meaningless (e.g. reference range
is <=2.3)."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.referenceRange.low"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <condition value="obs-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX-7"/> </mapping> <mapping> <identity value="rim"/> <map value="value:IVL_PQ.low"/> </mapping> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high"/> <short value="High Range, if relevant"/> <definition value="The value of the high bound of the reference range. The high bound of the reference
range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9).
If the high bound is omitted, it is assumed to be meaningless (e.g. reference
range is >= 2.3)."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.referenceRange.high"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <condition value="obs-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX-7"/> </mapping> <mapping> <identity value="rim"/> <map value="value:IVL_PQ.high"/> </mapping> </element> <element id="Observation.referenceRange.normalValue"> <path value="Observation.referenceRange.normalValue"/> <short value="Normal value, if relevant"/> <definition value="The value of the normal value of the reference range."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.referenceRange.normalValue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationReferenceRangeNormalValue"/> </extension> <strength value="extensible"/> <description value="Codes identifying the normal value of the observation."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-referencerange-normalvalue"/> </binding> <mapping> <identity value="v2"/> <map value="OBX-7"/> </mapping> <mapping> <identity value="rim"/> <map value="value:IVL_PQ.normal"/> </mapping> </element> <element id="Observation.referenceRange.type"> <path value="Observation.referenceRange.type"/> <short value="Reference range qualifier"/> <definition value="Codes to indicate the what part of the targeted reference population it applies
to. For example, the normal or therapeutic range."/>
<comment value="This SHOULD be populated if there is more than one range. If this element is not
present then the normal range is assumed."/>
<requirements value="Need to be able to say what kind of reference range this is - normal, recommended,
therapeutic, etc., - for proper interpretation."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.referenceRange.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationRangeMeaning"/> </extension> <strength value="preferred"/> <description value="Code for the meaning of a reference range."/> <valueSet value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 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|"/>
</mapping> <mapping> <identity value="v2"/> <map value="OBX-10"/> </mapping> <mapping> <identity value="rim"/> <map value="interpretationCode"/> </mapping> </element> <element id="Observation.referenceRange.appliesTo"> <path value="Observation.referenceRange.appliesTo"/> <short value="Reference range population"/> <definition value="Codes to indicate the target population this reference range applies to. For example,
a reference range may be based on the normal population or a particular sex or
race. Multiple `appliesTo` are interpreted as an "AND" of the target
populations. For example, to represent a target population of African American
females, both a code of female and a code for African American would be used."/>
<comment value="This SHOULD be populated if there is more than one range. If this element is not
present then the normal population is assumed."/>
<requirements value="Need to be able to identify the target population for proper interpretation."/> <min value="0"/> <max value="*"/> <base> <path value="Observation.referenceRange.appliesTo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationRangeType"/> </extension> <strength value="example"/> <description value="Codes identifying the population the reference range applies to."/> <valueSet value="http://hl7.org/fhir/ValueSet/referencerange-appliesto"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 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|"/>
</mapping> <mapping> <identity value="v2"/> <map value="OBX-10"/> </mapping> <mapping> <identity value="rim"/> <map value="interpretationCode"/> </mapping> </element> <element id="Observation.referenceRange.age"> <path value="Observation.referenceRange.age"/> <short value="Applicable age range, if relevant"/> <definition value="The age at which this reference range is applicable. This is a neonatal age (e.g.
number of weeks at term) if the meaning says so."/>
<requirements value="Some analytes vary greatly over age."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.referenceRange.age"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Range"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value"/> </mapping> </element> <element id="Observation.referenceRange.text"> <path value="Observation.referenceRange.text"/> <short value="Text based reference range in an observation"/> <definition value="Text based reference range in an observation which may be used when a quantitative
range is not appropriate for an observation. An example would be a reference value
of "Negative" or a list or table of "normals"."/>
<min value="0"/> <max value="1"/> <base> <path value="Observation.referenceRange.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <condition value="obs-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX-7"/> </mapping> <mapping> <identity value="rim"/> <map value="value:ST"/> </mapping> </element> <element id="Observation.hasMember"> <path value="Observation.hasMember"/> <short value="Used when reporting vital signs panel components"/> <definition value="Used when reporting vital signs panel components."/> <comment value="When using this element, an observation will typically have either a value or a
set of related resources, although both may be present in some cases. For a discussion
on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgr
ouping) below. Note that a system may calculate results from [QuestionnaireResponse](question
naireresponse.html) into a final score and represent the score as an Observation."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.hasMember"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Relationships established by OBX-4 usage"/> </mapping> <mapping> <identity value="rim"/> <map value="outBoundRelationship"/> </mapping> </element> <element id="Observation.derivedFrom"> <path value="Observation.derivedFrom"/> <short value="Related resource from which the observation is made"/> <definition value="The target resource that represents a measurement from which this observation value
is derived. For example, a calculated anion gap or a fetal measurement based on
an ultrasound image."/>
<comment value="All the reference choices that are listed in this element can represent clinical
observations and other measurements that may be the source for a derived value.
The most common reference will be another Observation. For a discussion on the
ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping)
below."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.derivedFrom"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Relationships established by OBX-4 usage"/> </mapping> <mapping> <identity value="rim"/> <map value=".targetObservation"/> </mapping> </element> <element id="Observation.component"> <path value="Observation.component"/> <short value="Used when reporting systolic and diastolic blood pressure."/> <definition value="Used when reporting systolic and diastolic blood pressure."/> <comment value="For a discussion on the ways Observations can be assembled in groups together see
[Notes](observation.html#notes) below."/>
<requirements value="Component observations share the same attributes in the Observation resource as
the primary observation and are always treated a part of a single observation (they
are not separable). However, the reference range for the primary observation
value is not inherited by the component values and is required when appropriate
for each component observation."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.component"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <condition value="obs-7"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="vs-3"/> <severity value="error"/> <human value="If there is no a value a data absent reason must be present"/> <expression value="value.exists() or dataAbsentReason.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="containment by OBX-4?"/> </mapping> <mapping> <identity value="rim"/> <map value="outBoundRelationship[typeCode=COMP]"/> </mapping> </element> <element id="Observation.component.id"> <path value="Observation.component.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may
be any string value that does not contain spaces."/>
<min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition
of the element. 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."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Observation.component.modifierExtension"> <path value="Observation.component.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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)."/>
<comment value="There can be no stigma associated with the use of extensions by any application,
project, or standard - regardless of the institution or jurisdiction that uses
or defines the extensions. The use of extensions is what allows the FHIR specification
to retain a core level of simplicity for everyone."/>
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
clearly distinguished from the vast majority of extensions which can be safely
ignored. This promotes interoperability by eliminating the need for implementers
to prohibit the presence of extensions. For further information, see the [definition
of modifier extensions](extensibility.html#modifierExtension)."/>
<alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
element that contains them"/>
<isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Observation.component.code"> <path value="Observation.component.code"/> <short value="Type of component observation (code / type)"/> <definition value="Describes what was observed. Sometimes this is called the observation "code"."/> <comment value="*All* code-value and component.code-component.value pairs need to be taken into
account to correctly understand the meaning of the observation."/>
<requirements value="Knowing what kind of observation is being made is essential to understanding the
observation."/>
<min value="1"/> <max value="1"/> <base> <path value="Observation.component.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="obs-7"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/definition"> <valueString value="This identifies the vital sign result type."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns"/> </extension> <strength value="extensible"/> <description value="This identifies the vital sign result type. Original source C-CDA R1.1 , HITSP
Vital Sign Result Type."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 363787002 |Observable entity| OR
< 386053000 |Evaluation procedure|"/>
</mapping> <mapping> <identity value="v2"/> <map value="OBX-3"/> </mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> </element> <element id="Observation.component.value[x]"> <path value="Observation.component.value[x]"/> <short value="Vital Sign Value recorded with UCUM"/> <definition value="Vital Sign Value recorded with UCUM."/> <comment value="Used when observation has a set of component observations:
- An observation may have both a value (e.g. an Apgar score) and component observations
(the observations from which the Apgar score was derived).
- If a value is present, the datatype for this element should be determined by
the `code`.
- *CodeableConcept* with just a text would be used instead of a string if the
field was usually coded, or if the type associated with the `code` defines a coded
value.
- *Attachment* is used if the observation result value is a binary file such as
an image. If the observation result value is derived from the binary file (for
example 'X' detected and here is the the proof in this image), the binary file
may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
the `code`.
- *CodeableConcept* with just a text would be used instead of a string if the
field was usually coded, or if the type associated with the `code` defines a coded
value.
- *Attachment* is used if the observation result value is a binary file such as
an image. If the observation result value is derived from the binary file (for
example 'X' detected and here is the the proof in this image), the binary file
may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
used as a definitional resource, not as a paitent-specific finding. Similarly,
the use of valueCanonical should only be used to refer definitional URIs. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/>
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.component.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> </type> <type> <code value="CodeableConcept"/> </type> <type> <code value="markdown"/> </type> <type> <code value="boolean"/> </type> <type> <code value="integer"/> </type> <type> <code value="Range"/> </type> <type> <code value="Ratio"/> </type> <type> <code value="SampledData"/> </type> <type> <code value="time"/> </type> <type> <code value="dateTime"/> </type> <type> <code value="Period"/> </type> <type> <code value="Attachment"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> </type> <type> <code value="canonical"/> </type> <condition value="vs-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/definition"> <valueString value="Common UCUM units for recording Vital Signs."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits"/> </extension> <strength value="required"/> <description value="Commonly encountered UCUM units for recording Vital Signs."/> <valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common"/> </binding> <mapping> <identity value="sct-concept"/> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-2, OBX-5, OBX-6"/> </mapping> <mapping> <identity value="rim"/> <map value="value"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="363714003 |Interprets|"/> </mapping> </element> <element id="Observation.component.dataAbsentReason"> <path value="Observation.component.dataAbsentReason"/> <short value="Why the component result is missing"/> <definition value="Provides a reason why the expected value in the element Observation.component.value[x]
is missing."/>
<comment value=""Null" or exceptional values can be represented two ways in FHIR Observations.
One way is to simply include them in the value set and represent the exceptions
in the value. For example, measurement values for a serology test could be "detected&q
uot;, "not detected", "inconclusive", or "test not done".
The alternate way is to use the value element for actual observations and use the
explicit dataAbsentReason element to record exceptional values. For example, the
dataAbsentReason code "error" could be used when the measurement was
not completed. Because of these options, use-case agreements are required to interpret
general observations for exceptional values."/>
<requirements value="For many results it is necessary to handle exceptional values in measurements."/> <min value="0"/> <max value="1"/> <base> <path value="Observation.component.dataAbsentReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="vs-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="extensible"/> <description value="Codes specifying why the result (`Observation.value[x]`) is missing."/> <valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> </binding> <mapping> <identity value="v2"/> <map value="N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="value.nullFlavor"/> </mapping> </element> <element id="Observation.component.interpretation"> <path value="Observation.component.interpretation"/> <short value="High, low, normal, etc"/> <definition value="A categorical assessment of an observation value. For example, high, low, normal."/> <comment value="Historically used for laboratory results (known as 'abnormal flag' ), its use
extends to other use cases where coded interpretations are relevant. Often reported
as one or more simple compact codes this element is often placed adjacent to the
result value in reports and flow sheets to signal the meaning/normalcy status of
the result."/>
<requirements value="For some results, particularly numeric results, an interpretation is necessary
to fully understand the significance of a result."/>
<alias value="Abnormal Flag"/> <min value="0"/> <max value="*"/> <base> <path value="Observation.component.interpretation"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation"/> </extension> <strength value="extensible"/> <description value="Codes identifying interpretations of observations."/> <valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 260245000 |Findings values|"/> </mapping> <mapping> <identity value="v2"/> <map value="OBX-8"/> </mapping> <mapping> <identity value="rim"/> <map value="interpretationCode"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="363713009 |Has interpretation|"/> </mapping> </element> <element id="Observation.component.referenceRange"> <path value="Observation.component.referenceRange"/> <short value="Provides guide for interpretation of component result"/> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended
range."/>
<comment value="Most observations only have one generic reference range. Systems MAY choose to
restrict to only supplying the relevant reference range based on knowledge about
the patient (e.g., specific to the patient's age, gender, weight and other factors),
but this might not be possible or appropriate. Whenever more than one reference
range is supplied, the differences between them SHOULD be provided in the reference
range and/or age properties."/>
<requirements value="Knowing what values are considered "normal" can help evaluate the significance
of a particular result. Need to be able to provide multiple reference ranges for
different contexts."/>
<min value="0"/> <max value="*"/> <base> <path value="Observation.component.referenceRange"/> <min value="0"/> <max value="*"/> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="OBX-7"/> </mapping> <mapping> <identity value="rim"/> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/> </mapping> </element> </snapshot> <differential> <element id="Observation"> <path value="Observation"/> <short value="FHIR Body Height Profile"/> <definition value="This profile defines how to represent Body Height observations in FHIR using a
standard LOINC code and UCUM units of measure."/>
<min value="0"/> <max value="*"/> </element> <element id="Observation.code"> <path value="Observation.code"/> <short value="Body Height"/> <definition value="Body Height."/> <comment value="additional codes that translate or map to this code are allowed. For example a
more granular LOINC code or code that is used locally in a system."/>
<alias value="Test"/> <alias value="Name"/> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding"/> <slicing> <discriminator> <type value="value"/> <path value="code"/> </discriminator> <discriminator> <type value="value"/> <path value="system"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> </element> <element id="Observation.code.coding:BodyHeightCode"> <path value="Observation.code.coding"/> <sliceName value="BodyHeightCode"/> <min value="1"/> <max value="1"/> </element> <element id="Observation.code.coding:BodyHeightCode.system"> <path value="Observation.code.coding.system"/> <min value="1"/> <max value="1"/> <type> <code value="uri"/> </type> <fixedUri value="http://loinc.org"/> </element> <element id="Observation.code.coding:BodyHeightCode.code"> <path value="Observation.code.coding.code"/> <min value="1"/> <max value="1"/> <type> <code value="code"/> </type> <fixedCode value="8302-2"/> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity"/> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value"/> <min value="1"/> <max value="1"/> <type> <code value="decimal"/> </type> <mustSupport value="true"/> </element> <element id="Observation.valueQuantity.unit"> <path value="Observation.valueQuantity.unit"/> <min value="1"/> <max value="1"/> <type> <code value="string"/> </type> <mustSupport value="true"/> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system"/> <min value="1"/> <max value="1"/> <type> <code value="uri"/> </type> <fixedUri value="http://unitsofmeasure.org"/> <mustSupport value="true"/> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code"/> <short value="Coded responses from the common UCUM units for vital signs value set."/> <definition value="Coded responses from the common UCUM units for vital signs value set."/> <min value="1"/> <max value="1"/> <type> <code value="code"/> </type> <mustSupport value="true"/> <binding> <extension url="http://hl7.org/fhir/build/StructureDefinition/definition"> <valueString value="Common UCUM units for body length measures such as Body Height and Head Circumference."/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits"/> </extension> <strength value="required"/> <description value="cm | [in_i]"/> <valueSet value="http://hl7.org/fhir/ValueSet/ucum-bodylength"/> </binding> </element> </differential>
</
StructureDefinition
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