{
  "types": [
    "Observation"
  ],
  "Observation": {
    "elements": {
      "Observation.basedOn": {
        "removed-types": [
          "Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)"
        ],
        "added-types": [
          "Reference(CarePlan | DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest)"
        ]
      },
      "Observation.triggeredBy": {
        "status": "new"
      },
      "Observation.triggeredBy.observation": {
        "status": "new"
      },
      "Observation.triggeredBy.type": {
        "status": "new"
      },
      "Observation.triggeredBy.reason": {
        "status": "new"
      },
      "Observation.status": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "corrected"
        ],
        "added-codes": [
          "specimen-in-process",
          "cannot-be-obtained"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-status|4.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Observation.subject": {
        "removed-types": [
          "Reference(Patient | Group | Device | Location)"
        ],
        "added-types": [
          "Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct)"
        ]
      },
      "Observation.focus": {
        "modifier": "added"
      },
      "Observation.organizer": {
        "status": "new"
      },
      "Observation.performer": {
        "removed-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)"
        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService | Group)"
        ]
      },
      "Observation.value[x]": {
        "added-types": [
          "Attachment"
        ]
      },
      "Observation.interpretationContext": {
        "status": "new"
      },
      "Observation.bodyStructure": {
        "status": "new"
      },
      "Observation.specimen": {
        "removed-types": [
          "Reference(Specimen)"
        ],
        "added-types": [
          "Reference(Specimen | Group)"
        ]
      },
      "Observation.referenceRange.low": {
        "removed-types": [
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"
        ],
        "added-types": [
          "Quantity"
        ]
      },
      "Observation.referenceRange.high": {
        "removed-types": [
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"
        ],
        "added-types": [
          "Quantity"
        ]
      },
      "Observation.referenceRange.normalValue": {
        "status": "new"
      },
      "Observation.referenceRange.text": {
        "removed-types": [
          "string"
        ],
        "added-types": [
          "markdown"
        ]
      },
      "Observation.hasMember": {
        "removed-types": [
          "Reference(Observation | QuestionnaireResponse | MolecularSequence)"
        ],
        "added-types": [
          "Reference(Observation | QuestionnaireResponse)"
        ]
      },
      "Observation.derivedFrom": {
        "removed-types": [
          "Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)"
        ],
        "added-types": [
          "Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation)"
        ]
      },
      "Observation.component.value[x]": {
        "added-types": [
          "Attachment"
        ]
      }
    },
    "status": "changed"
  }
}