DSTU2 FHIR Release 3 (STU)

This page is part of the FHIR Specification (v1.0.2: DSTU (v3.0.2: STU 2). 3). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2 R3 R2

4.20.8 10.1.9 Resource Observation - Mappings

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

Mappings:

RIM Mapping

SNOMED CT Attribute Binding

SNOMED CT Concept Domain Binding

HL7 v2 Mapping

Workflow Mapping

Mappings for the observation resource.

4.20.8.1 10.1.9.1 Mappings for RIM Mapping (http://hl7.org/v3)

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

10.1.9.2 Mappings for SNOMED CT Attribute Binding (http://snomed.info/sct)

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

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

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

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

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

4.20.8.2 10.1.9.4 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

Observation OBX
    identifier     identifier OBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
    status     basedOn ORC
    status OBX-11
    category     category
    code     code OBX-3
    subject     subject PID-3
    encounter     context PV1
    effective[x]     effective[x] OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
    issued     issued OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
    performer     performer OBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
    value[x]     value[x] OBX.2, OBX.5, OBX.6
    dataAbsentReason     dataAbsentReason N/A
    interpretation     interpretation OBX-8
    comments     comment NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
    bodySite     bodySite OBX-20
    method     method OBX-17
    specimen     specimen SPM segment
    device     device OBX-17 / PRT -10
    referenceRange     referenceRange OBX.7
        low         low OBX-7
        high         high OBX-7
        meaning         type OBX-10? OBX-10
        age         appliesTo OBX-10
        age
        text         text OBX-7
    related     related Relationships established by OBX-4 usage
        type         type N/A
        target         target
    component     component containment by OBX-4?
        code         code OBX-3
        value[x]         value[x] OBX.2, OBX.5, OBX.6
        dataAbsentReason         dataAbsentReason N/A
        referenceRange         interpretation OBX-8
        referenceRange OBX.7

10.1.9.5 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)

Observation Event
    identifier Event.identifier
    basedOn Event.basedOn
    status Event.status
    category
    code Event.code
    subject Event.subject
    context Event.context
    effective[x] Event.occurrence[x]
    issued
    performer Event.performer
    value[x] Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
    dataAbsentReason Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
    interpretation
    comment Event.note
    bodySite
    method
    specimen
    device
    referenceRange
        low
        high
        type
        appliesTo
        age
        text
    related
        type
        target
    component
        code
        value[x]
        dataAbsentReason
        interpretation
        referenceRange