This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions Content Detailed Descriptions Mappings XML JSON StructureDefinition: USLabObsOther USLabObsOther Raw XML US Realm laboratory result using one of Attachment|dateTime|Period|SampledData|string|timeData Type for results. US Realm laboratory result using one of Attachment|dateTime|Period|SampledData|string|timeData Type for results. US Realm laboratory result using one of Attachment|dateTime|Period|SampledData|string|timeData Type for results. Laboratory results to ordering providers in the ambulatory care setting and &quot;reportable&quot; laboratory test results to local public health agencies. 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 Lab reports, etc. Observations are a key aspect of healthcare. This resource is used to capture those that do not require more sophisticated mechanisms. The logical id of the resource, as used in the url for the resoure. 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. Bundles always have an id, though it is usually a generated UUID. The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may 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. 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 as much as possible. 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 may 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 &quot;clinically safe&quot; 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. 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. May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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 definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #. Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). 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. Usually modifier elements provide negation or qualification. In order 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. 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. In order 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. 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 V3 Core Principles for more information. Ordering of codings is undefined and SHALL not be used to infer meaning. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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 de-reference to some definition that establish 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 code was chosen by a user directly - i.e. 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. This has been identified as a clinical safety criterium - that this exact code was chosen explicitly, rather than inferred by the system based on some rules or language processing. This is the laboratory defined display text for the lab test if different from the code display text(s). 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. This is the actiual result with a variable datatype. Coded results and quantitative results are addressed in other profiles. Normally, an observation will have either a value or a set of related observations. A few observations (e.g. apgar store) may have both a value and related observations (for apgar, the observations from which the measure is 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 boolean values use valueCodeableConcept and select codes from &lt;http://hl7.org/fhir/v2/vs/0136&gt; (These &quot;yes/no&quot; concepts can be mapped to the display name &quot;true/false&quot; or other mutually exclusive terms that may be needed&quot;). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is &quot;'value' + the type name&quot; with a capital on the first letter of the type). An observation exists to have a value, though it may not if it is in error, or it represents a group of observations. &quot;Null&quot; 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 &quot;detected&quot;, &quot;not detected&quot;, &quot;inconclusive&quot;, or &quot;test not done&quot;. 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 &quot;error&quot; 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. For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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 V3 Core Principles for more information. Ordering of codings is undefined and SHALL not be used to infer meaning. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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 de-reference to some definition that establish 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 code was chosen by a user directly - i.e. 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. This has been identified as a clinical safety criterium - that this exact code was chosen explicitly, rather than inferred by the system based on some rules or language processing. 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. May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result. For lab tests this is the specimen collection date. For Ask at Order Entry Questions (AOE)'s this is the date the question was asked. For lab tests this is the specimen collection date. For Ask at Order Entry Questions (AOE)'s this is the date the question was asked. Knowing when an observation was deemed true is important to its relevance as well as determining trends. OBX-14-date/time of the observation, and/or OBX-19 after v2.4 (depends on who observation made) Need to track the status of individual results - some results are finalised before the whole report is finalised. status Amended &amp; Final are differentiated by whether it is the subject of a ControlAct event with a type of &quot;revise&quot; Note that in most contexts, unreliable results are not recorded, deleted, or otherwise excluded, but it's not always possible to exclude them from the record. If the reliability indicator is present, interpreters of a result, whether human or machine, should always either be aware of the status or prevented from using the observation without being unaware that the reliability is not &quot;ok&quot;. Codes that provide an estimate of the degree to which quality issues have impacted on the value of an observation Indicates the site on the subject's body where the observation was made ( i.e. the target site). Knowing where the observation is made is important for tracking if multiple sites are possible. In some cases, method can impact results and is thus for determining whether results can be compared or determining significance of results. May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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. This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. A text string for the identifier that can be displayed to a human so they can recognize the identifier. There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers. http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the id itself is a full uri The portion of the identifier typically displayed to the user and which is unique within the context of the system. II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, other observer (for example a relative or EMT), or any observation made about the subject. 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. If the target of the observation is different than the subject, the general extension (http://hl7.org/fhir/StructureDefinition/indirectTarget) can be used. Observations are not made on specimens themselves; they are made on a subject, but usually 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 are often used in contexts that track the specimen explicitly (e.g. Diagnostic Report). May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. OBX.15 / (Practitioner) OBX-16-responsible observer, PRT-5-participation person:PRT-4-participatio n='RO' / (Device) OBX-18-equipment instance identifier , PRT-10-participation device:PRT-4-particip ation='EQUIP' / (Organization) OBX-23-performing organization name, PRT-8-participation organization:PRT-4-participation='PO' May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. OBX.15 / (Practitioner) OBX-16-responsible observer, PRT-5-participation person:PRT-4-participatio n='RO' / (Device) OBX-18-equipment instance identifier , PRT-10-participation device:PRT-4-particip ation='EQUIP' / (Organization) OBX-23-performing organization name, PRT-8-participation organization:PRT-4-participation='PO' An extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element. The healthcare event ( e.g. a patient and healthcare provider interaction ) during which this observation is made. For some observations it may be important to know the link between an observation and a particular encounter. 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. Knowing what values are considered &quot;normal&quot; can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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 low bound of the reference range. If this element is omitted, the low bound of the reference range is assumed to be meaningless. (e.g. reference range is &lt;2.3) If the low.comparator element is missing, it is assumed to be '&gt;'. not(exists(f:comparator)) or boolean(f:comparator/@value = '&lt;') or boolean(f:comparator/@value = '&lt;=') The value of the high bound of the reference range. If this element is omitted, the high bound of the reference range is assumed to be meaningless. (e.g. reference range is &gt; 5) If the low.comparator element is missing , it is assumed to be '&lt;'. not(exists(f:comparator)) or boolean(f:comparator/@value = '&gt;') or boolean(f:comparator/@value = '&gt;=') Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.). 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 &quot;Negative&quot ; or a list or table of 'normals'. Normally, an observation will have either a value or a set of related observations. A few observations (e.g. apgar store) may have both a value and related observations (for apgar, the observations from which the measure is derived). Some observations have important relationships to other observations (e.g Blood Pressure = systolic + diastolic), or are derived from other observations (e.g. calculated apgar score). May be used to represent additional information that is not part of the basic definition of the element. In order 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. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. A relationship type SHOULD be provided. If the relationship type is &quot;COMP&quot; (composed), then the observation should not be displayed/interpreted in the absence of the related observations. May need to indicate whether this observation is composed of others, or merely derived from them. US Realm laboratory result using one of Attachment|dateTime|Period|SampledData|string|timeData Type for results. US Realm laboratory result using one of Attachment|dateTime|Period|SampledData|string|timeData Type for results. Laboratory results to ordering providers in the ambulatory care setting and &quot;reportable&quot; laboratory test results to local public health agencies. This is the laboratory defined display text for the lab test if different from the code display text(s). This is the actiual result with a variable datatype. Coded results and quantitative results are addressed in other profiles. For lab tests this is the specimen collection date. For Ask at Order Entry Questions (AOE)'s this is the date the question was asked. For lab tests this is the specimen collection date. For Ask at Order Entry Questions (AOE)'s this is the date the question was asked. </StructureDefinition> © HL7.org 2011+. FHIR DSTU (v0.4.0-4902) generated on Fri, Mar 27, 2015 00:21+1100. Links: What's a DSTU? | Version History | Specification Map | Compare to DSTU1 | | Propose a change