Measurements
and
simple
assertions
made
about
a
patient,
device
or
other
subject.
4.15.1
Scope
and
Usage
Observations
are
a
central
element
in
healthcare,
used
to
support
diagnosis,
monitor
progress,
determine
baselines
and
patterns
and
even
capture
demographic
characteristics.
Most
observations
are
simple
name/value
pair
assertions
with
some
metadata,
but
some
observations
group
other
observations
together
logically,
or
even
are
multi-component
observations.
Note
that
the
resources
DiagnosticReport
and
DeviceObservationReport
provide
a
clinical
or
workflow
context
for
a
set
of
observations.
Expected
uses
for
the
Observation
resource
include:
Personal
characteristics:
height,
weight,
eye-color
Diagnoses
(Note:
trackable
conditions,
allergies,
adverse
reactions
and
more
complex
structures
are
handled
elsewhere)
Social
history:
tobacco
use,
family
supports,
cognitive
status
Core
characteristics:
pregnancy
status,
death
assertion
4.15.2
Background
and
Context
The
observation
resource
has
the
following
aspects:
status
and
reliability
(mandatory)
-
all
users
of
observations
SHALL
be
sure
of
the
status
of
the
observation
name
(mandatory)
-
describes
what
was
observed.
Sometimes
called
this
is
called
the
observation
"code"
identifier
-
Unique
identifier
for
this
particular
observation
so
it
can
be
recognized
in
all
contexts
where
it
is
represented
value
-
the
actual
value
that
was
observed
related
observations
-
Other
observations
that
are
components
of
this
observation,
or
provide
supporting
information,
context
or
warnings
about
this
observation
subject,
bodysite
-
the
patient,
or
group
of
patients,
location,
or
device,
that
this
observation
was
made
on.
Note
that
group
of
patients
is
most
often
used
in
veterinary
care.
For
individual
patients,
the
location
on
the
body
may
also
be
specified,
though
this
is
often
implicit
in
the
Observation.name
applies[x]
-
the
time
or
period
that
this
observation
was
made
on
the
subject.
Each
observation
has
multiple
times
-
prepared,
made,
reported
etc
-
but
the
important
time
is
when
the
data
relates
to
the
patient
condition
interpretation,
comments,
and
reference
range:
information
to
help
understand
the
observed
value
method,
issued,
performer
-
additional
information
about
how
the
test
was
performed
that
may
help
understand
the
observation.
The
method
is
often
implicit
in
the
Observation.name
Typically,
an
observation
will
have
either
a
value
or
component
observations,
and
not
both.
Inv-2
:
Can
only
have
normal
range
if
value
is
a
quantity
(xpath:
exists(f:valueQuantity)
or
not(exists(f:normalRange))
)
Inv-3
:
On
Observation.referenceRange:
Must
have
at
least
a
low
or
a
high
(and
no
comparators)
(xpath
on
f:Observation/f:referenceRange:
(exists(f:low)
or
exists(f:high))
and
not(exists(f:low/f:comparator))
and
not(exists(f:high/f:comparator))
)
4.15.4
Notes:
The
element,
Observation.value[x],
has
a
variable
name
depending
on
the
type
as
follows:
valueQuantity
valueCodeableConcept
valueAttachment
valueRatio
valuePeriod
valueSampledData
valueString
The
appliesDateTime
or
appliesPeriod
is
the
time
that
the
observation
is
most
relevant
as
an
observation
of
the
subject.
For
a
biological
subject
(e.g.
a
human
patient),
this
is
the
physiologically
relevant
time
of
the
observation.
In
the
case
of
an
observation
using
a
specimen,
this
represents
the
start
and
end
of
the
specimen
collection
(e.g.
24
hour
Urine
Sodium),
but
if
the
collection
time
is
sufficiently
short,
this
is
reported
as
a
point
in
time
value
(e.g.
normal
venepuncture).
In
the
case
of
an
observation
obtained
directly
from
a
subject
(e.g.,
BP,
Chest
X-ray),
this
is
the
start
and
end
time
of
the
observation
process,
which
again,
is
often
reported
as
a
single
point
in
time.
At
its
simplest,
resource
instances
can
consist
of
only
a
type
and
a
value,
with
a
reliability
and
status
flag.
The
relevance
of
other
properties
will
vary
based
on
the
type
of
observation.
Reference
ranges
may
be
useful
for
lab
tests
and
other
measures
like
systolic
blood
pressure,
but
will
have
little
relevance
for
something
like
"pregnancy
status"
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
may
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
Profiles
will
be
created
to
provide
guidance
on
capturing
certain
types
of
simple
observations.
This
resource
focuses
on
the
level
of
detail
captured
by
most
systems.
However,
any
"simple"
observation
can
easily
be
broken
into
numerous
components
and
sub-components
to
provide
additional
information
relevant
in
certain
circumstances.
As
with
other
resources,
extensions
can
be
used
to
introduce
this
additional
complexity.
Because
there
are
multiple
types
allowed
for
the
value
element,
multiple
value
search
parameters
are
defined.
There
is
no
standard
parameter
for
searching
values
of
type
Attachment,
or
Ratio
4.15.5
Search
Parameters
Search
parameters
for
this
resource.
The
standard
parameters
also
apply.
See
Searching
for
more
information
about
searching
in
REST,
messaging,
and
services.
.
Page
versions:
R5
R4B
R4
R3
R2
<!-- from Resource: extension, modifierExtension, language, text, and contained --> <name><!-- 1..1 CodeableConcept Type of observation (code / type) --></name> <value[x]><!-- 0..1 Quantity|CodeableConcept|Attachment|Ratio|Period| SampledData|string Actual result --></value[x]> <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc. --></interpretation> <comments value="[string]"/><!-- 0..1 Comments about result --> <applies[x]><!-- 0..1 dateTime|Period Physiologically Relevant time/time-period for observation --></applies[x]> <issued value="[instant]"/><!-- 0..1 Date/Time this was made available --> <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended + --> <reliability value="[code]"/><!-- 1..1 ok | ongoing | early | questionable | calibrating | error + --> <bodySite><!-- 0..1 CodeableConcept Observed body part --></bodySite> <method><!-- 0..1 CodeableConcept How it was done --></method> <identifier><!-- 0..1 Identifier Unique Id for this particular observation --></identifier> <subject><!-- 0..1 Resource(Patient|Group|Device|Location) Who and/or what this is about --></subject> <specimen><!-- 0..1 Resource(Specimen) Specimen used for this observation --></specimen> <performer><!-- 0..* Resource(Practitioner|Device|Organization) Who did the observation --></performer> <referenceRange> <!-- 0..* Provides guide for interpretation --> <low><!--
0..1 Quantity Low Range, if relevant --></low> <high><!--
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