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The
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Content
Examples
Formal
Definitions
Mappings
Profiles
4.15
Resource
Observation
-
Content
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:
Vital
signs:
temperature,
blood
pressure,
respiration
rate
Laboratory
Data
and
other
Diagnostic
Measures
Measurements
emitted
by
Devices
Clinical
assessments
such
as
APGAR
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
&quot;code&quot;
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.
4.15.3
Resource
Content
Observation
(
Resource
)
Describes
what
was
observed.
Sometimes
this
is
called
the
observation
&quot;code&quot;
name
:
CodeableConcept
1..1
&lt;&lt;
Codes
identifying
types
of
simple
observations
ObservationType
&gt;&gt;
The
information
determined
as
a
result
of
making
the
observation,
if
the
information
has
a
simple
value
value[x]
:
Quantity
|
CodeableConcept
|
Attachment
|
Ratio
|
Period
|
SampledData
|
string
0..1
The
assessment
made
based
on
the
result
of
the
observation
interpretation
:
CodeableConcept
0..1
&lt;&lt;
Codes
identifying
interpretations
of
observations
ObservationInterpretation
&gt;&gt;
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
comments
:
string
0..1
The
time
or
time-period
the
observed
value
is
asserted
as
being
true.
For
biological
subjects
-
e.g.
human
patients
-
this
is
usually
called
the
&quot;physiologically
relevant
time&quot;.
This
is
usually
either
the
time
of
the
procedure
or
of
specimen
collection,
but
very
often
the
source
of
the
date/time
is
not
known,
only
the
date/time
itself
applies[x]
:
dateTime
|
Period
0..1
Date/Time
this
was
made
available
issued
:
instant
0..1
The
status
of
the
result
value
(this
element
modifies
the
meaning
of
other
elements)
status
:
code
1..1
&lt;&lt;
Codes
providing
the
status
of
an
observation
ObservationStatus
&gt;&gt;
An
estimate
of
the
degree
to
which
quality
issues
have
impacted
on
the
value
reported
(this
element
modifies
the
meaning
of
other
elements)
reliability
:
code
1..1
&lt;&lt;
Codes
that
provide
an
estimate
of
the
degree
to
which
quality
issues
have
impacted
on
the
value
of
an
observation
ObservationReliability
&gt;&gt;
Indicates
where
on
the
subject's
body
the
observation
was
made
bodySite
:
CodeableConcept
0..1
&lt;&lt;
Codes
describing
anatomical
locations.
May
include
laterality
BodySite
&gt;&gt;
Indicates
the
mechanism
used
to
perform
the
observation
method
:
CodeableConcept
0..1
&lt;&lt;
Methods
for
simple
observations
ObservationMethod
&gt;&gt;
A
unique
identifier
for
the
simple
observation
identifier
:
Identifier
0..1
The
thing
the
observation
is
being
made
about
subject
:
Resource
(
Patient
|
Group
|
Device
|
Location
)
0..1
The
specimen
that
was
used
when
this
observation
was
made
specimen
:
Resource
(
Specimen
)
0..1
Who
was
responsible
for
asserting
the
observed
value
as
&quot;true&quot;
performer
:
Resource
(
Practitioner
|
Device
|
Organization
)
0..*
ReferenceRange
The
value
of
the
low
bound
of
the
reference
range.
If
this
is
omitted,
the
low
bound
of
the
reference
range
is
assumed
to
be
meaningless.
E.g.
&lt;2.3
low
:
Quantity
0..1
The
value
of
the
high
bound
of
the
reference
range.
If
this
is
omitted,
the
high
bound
of
the
reference
range
is
assumed
to
be
meaningless.
E.g.
&gt;5
high
:
Quantity
0..1
Code
for
the
meaning
of
the
reference
range
meaning
:
CodeableConcept
0..1
&lt;&lt;
Code
for
the
meaning
of
a
reference
range
ObservationRangeMeaning
&gt;&gt;
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
age
:
Range
0..1
Related
A
code
specifying
the
kind
of
relationship
that
exists
with
the
target
observation
type
:
code
0..1
&lt;&lt;
Codes
specifying
how
two
observations
are
related
ObservationRelationshipType
&gt;&gt;
A
reference
to
the
observation
that
is
related
to
this
observation
target
:
Resource
(
Observation
)
1..1
Guidance
on
how
to
interpret
the
value
by
comparison
to
a
normal
or
recommended
range
referenceRange
0..*
Related
observations
-
either
components,
or
previous
observations,
or
statements
of
derivation
related
0..*
This
resource
is
referenced
by
AllergyIntolerance
,
DeviceObservationReport
,
DiagnosticReport
,
Immunization
,
ImmunizationRecommendation
and
Procedure

&lt;
 &lt;!-- from  --&gt;
 &lt;&lt;/name&gt;
 &lt;|
   &lt;/value[x]&gt;
 &lt;&lt;/interpretation&gt;
 &lt;
 &lt;
     Physiologically Relevant time/time-period for observation&lt;/applies[x]&gt;
 &lt;
 &lt;
 &lt;
 &lt;&lt;/bodySite&gt;
 &lt;&lt;/method&gt;
 &lt;&lt;/identifier&gt;
 &lt;&lt;/subject&gt;
 &lt;&lt;/specimen&gt;
 &lt;&lt;/performer&gt;
 &lt;
  &lt;&lt;/low&gt;
  &lt;&lt;/high&gt;
  &lt;&lt;/meaning&gt;
  &lt;&lt;/age&gt;
 &lt;/referenceRange&gt;
 &lt;
  &lt;
  &lt;&lt;/target&gt;
 &lt;/related&gt;
&lt;/Observation&gt;
Alternate
definitions:
Schema
/
Schematron
,
Resource
Profile
4.15.3.1
Terminology
Bindings
Path
Definition
Type
Reference
Observation.name
Codes
identifying
types
of
simple
observations
Example
http://hl7.org/fhir/vs/observation-codes
Observation.interpretation
Codes
identifying
interpretations
of
observations
Incomplete
http://hl7.org/fhir/vs/observation-interpretation
Observation.status
Codes
providing
the
status
of
an
observation
Fixed
http://hl7.org/fhir/observation-status
Observation.reliability
Codes
that
provide
an
estimate
of
the
degree
to
which
quality
issues
have
impacted
on
the
value
of
an
observation
Fixed
http://hl7.org/fhir/observation-reliability
Observation.bodySite
Codes
describing
anatomical
locations.
May
include
laterality
Example
http://hl7.org/fhir/vs/body-site
Observation.method
Methods
for
simple
observations
Example
http://hl7.org/fhir/vs/observation-methods
Observation.referenceRange.meaning
Code
for
the
meaning
of
a
reference
range
Example
http://hl7.org/fhir/vs/referencerange-meaning
Observation.related.type
Codes
specifying
how
two
observations
are
related
Fixed
http://hl7.org/fhir/observation-relationshiptypes
4.15.3.2
Constraints
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
&quot;pregnancy
status&quot;
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
&quot;simple&quot;
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.
Name
Type
Description
Paths
_id
token
The
logical
resource
id
associated
with
the
resource
(must
be
supported
by
all
servers)
_language
token
The
language
of
the
resource
date
date
Obtained
date/time.
If
the
obtained
element
is
a
period,
a
date
that
falls
in
the
period
Observation.applies[x]
name
token
The
name
of
the
observation
type
Observation.name
name-value-[x]
composite
Both
name
and
one
of
the
value
parameters
performer
reference
Who
and/or
what
performed
the
observation
Observation.performer
(
Device
,
Organization
,
Practitioner
)
related
composite
Related
Observations
-
search
on
related-type
and
related-target
together
related-target
reference
Observation
that
is
related
to
this
one
Observation.related.target
(
Observation
)
related-type
token
has-component
|
has-member
|
derived-from
|
sequel-to
|
replaces
|
qualified-by
|
interfered-by
Observation.related.type
reliability
token
The
reliability
of
the
observation
Observation.reliability
specimen
reference
Specimen
used
for
this
observation
Observation.specimen
(
Specimen
)
status
token
The
status
of
the
observation
Observation.status
subject
reference
The
subject
that
the
observation
is
about
Observation.subject
(
Device
,
Location
,
Patient
,
Group
)
value-concept
token
The
value
of
the
observation,
if
the
value
is
a
CodeableConcept
Observation.value[x]
value-date
date
The
value
of
the
observation,
if
the
value
is
a
Period
Observation.value[x]
value-quantity
quantity
The
value
of
the
observation,
if
the
value
is
a
Quantity,
or
a
SampledData
(just
search
on
the
bounds
of
the
values
in
sampled
data)
Observation.value[x]
value-string
string
The
value
of
the
observation,
if
the
value
is
a
string,
and
also
searches
in
CodeableConcept.text
Observation.value[x]
&copy;
HL7.org
2011+.
FHIR
DSTU
(v0.0.82.2943)
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30,
2014
18:10+1000.
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