Australian Digital Health Agency FHIR Implementation Guide
1.2.0-ci-build - draft Australia flag

Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

Resource Profile: ADHA Visual Acuity Observation ( Experimental )

Official URL: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-visualacuity-1 Version: 0.1.1
Draft as of 2024-09-12 Computable Name: ADHAObservationVisualAcuity

Copyright/Legal: Copyright © 2023 Australian Digital Health Agency - All rights reserved. Except for the material identified below, this content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/.

This resource includes SNOMED Clinical Terms™ (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO). All rights reserved. SNOMED CT®, was originally created by The College of American Pathologists. “SNOMED” and “SNOMED CT” are registered trademarks of the IHTSDO.

The rights to use and implement or implementation of SNOMED CT content are limited to the extent it is necessary to allow for the end use of this material. No further rights are granted in respect of the International Release and no further use of any SNOMED CT content by any other party is permitted.

All copies of this resource must include this copyright statement and all information contained in this statement.

The purpose of this profile is to represent an observation of patient’s visual acuity, for the electronic exchange of health information between individuals, healthcare providers, and the My Health Record system infrastructure in Australia.

This profile identifies the additional constraints, extensions, and value sets that build on and extend Observation that are supported.

This profile is designed to set an Observation standard for:

  • TBD

This profile may be referred to by APIs, which will be listed here when available.

This content will be taken for discussion with HL7 Australia and may be removed or changed.

Profile specific guidance

Whether the measured vision is corrected or uncorrected should be recorded in the observation code.

The use of a pinhole occluder should be recorded as an additional coding in observation code.

The eye or eyes whose vision is measured should be recorded as a body site.

The type of chart used should be recorded as a device type.

Results in Snellen notation should be recorded as ratios, see example Distance visual acuity, both eyes, as a ratio.

Results in N-point notation should be recorded as quantities, see example Near visual acuity, right eye, in N-point notation.

Results of low vision should be recorded as coded terms, see example Distance visual acuity, left eye, as a code.

Undefined terminology resources include:

  • for category, a code for a category of "Vision"
  • for code, a value set containing the SNOMED CT codes for types of visual acuity test
  • for code, SNOMED CT codes for distance visual acuity, corrected; distance visual acuity, uncorrected; near visual acuity, corrected; near visual acuity, uncorrected
  • for valueCodeableConcept, a value set containing the SNOMED CT codes for low vision results
  • for valueQuantity, a code for unit of measurement for LogMAR notation
  • for valueQuantity, a code for unit of measurement for N-point notation
  • for valueQuantity, a code for unit of measurement for M-size notation
  • for bodySite, a value set containing the SNOMED CT codes for left, right and both eyes.
  • for method, a value set containing the SNOMED CT codes for the types of chart commonly used in Australia.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* Observation Sharpness or acuteness of vision
... status 1..1 code registered | preliminary | final | amended +
Fixed Value: final
... Slices for category 2..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
.... category:exam 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
... code 1..1 CodeableConcept Type of observation (code / type)
Binding: http://snomed.info/sct?fhir_vs (preferred): Visual Acuity Test

... effective[x] 1..1 dateTime Clinically relevant time/time-period for observation
... value[x] 0..1 Actual result
.... valueRatio Ratio
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
... Slices for value[x] Content/Rules for all slices
.... value[x]:valueRatio C 0..1 Ratio Visual acuity expressed as a Snellen fraction
inv-dh-va-01: Value shall include numerator value and denominator value
.... value[x]:valueQuantity C 0..1 Quantity Visual acuity expressed as a simple quantity
inv-dh-va-02: Value shall include value and unit
.... value[x]:valueCodeableConcept 0..1 CodeableConcept Visual acuity expressed as a code
... method 0..1 CodeableConcept Method used to measure visual acuity
... device 0..1 Reference(Device | DeviceMetric) Type of chart used to measure visual acuity

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.codepreferredhttp://snomed.info/sct?fhir_vs
http://snomed.info/sct?fhir_vs

Constraints

IdGradePath(s)DetailsRequirements
inv-dh-va-01errorObservation.value[x]:valueRatioValue shall include numerator value and denominator value
: numerator.value.exists() and denominator.value.exists()
inv-dh-va-02errorObservation.value[x]:valueQuantityValue shall include value and unit
: value.exists() and unit.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Sharpness or acuteness of vision
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
.... category:exam 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: http://snomed.info/sct?fhir_vs (preferred): Visual Acuity Test

... subject Σ 1..1 Reference(Patient) Who and/or what the observation is about
... effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
... Slices for value[x] ΣC 0..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueRatio Ratio
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueRatio ΣC 0..1 Ratio Visual acuity expressed as a Snellen fraction
inv-dh-va-01: Value shall include numerator value and denominator value
.... value[x]:valueQuantity ΣC 0..1 Quantity Visual acuity expressed as a simple quantity
inv-dh-va-02: Value shall include value and unit
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Visual acuity expressed as a code
... method 0..1 CodeableConcept Method used to measure visual acuity
Binding: ObservationMethods (example): Methods for simple observations.

... device 0..1 Reference(Device | DeviceMetric) Type of chart used to measure visual acuity

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:exampreferredPattern: exam
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredhttp://snomed.info/sct?fhir_vs
http://snomed.info/sct?fhir_vs
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
inv-dh-va-01errorObservation.value[x]:valueRatioValue shall include numerator value and denominator value
: numerator.value.exists() and denominator.value.exists()
inv-dh-va-02errorObservation.value[x]:valueQuantityValue shall include value and unit
: value.exists() and unit.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Sharpness or acuteness of vision
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... Slices for category 2..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:exam 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: http://snomed.info/sct?fhir_vs (preferred): Visual Acuity Test

... subject Σ 1..1 Reference(Patient) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 0..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueRatio Ratio
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueRatio ΣC 0..1 Ratio Visual acuity expressed as a Snellen fraction
inv-dh-va-01: Value shall include numerator value and denominator value
.... value[x]:valueQuantity ΣC 0..1 Quantity Visual acuity expressed as a simple quantity
inv-dh-va-02: Value shall include value and unit
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Visual acuity expressed as a code
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1 CodeableConcept Method used to measure visual acuity
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) Type of chart used to measure visual acuity
... referenceRange C 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:exampreferredPattern: exam
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredhttp://snomed.info/sct?fhir_vs
http://snomed.info/sct?fhir_vs
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
inv-dh-va-01errorObservation.value[x]:valueRatioValue shall include numerator value and denominator value
: numerator.value.exists() and denominator.value.exists()
inv-dh-va-02errorObservation.value[x]:valueQuantityValue shall include value and unit
: value.exists() and unit.exists()

This structure is derived from Observation

Summary

Mandatory: 3 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.category

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* Observation Sharpness or acuteness of vision
... status 1..1 code registered | preliminary | final | amended +
Fixed Value: final
... Slices for category 2..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
.... category:exam 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
... code 1..1 CodeableConcept Type of observation (code / type)
Binding: http://snomed.info/sct?fhir_vs (preferred): Visual Acuity Test

... effective[x] 1..1 dateTime Clinically relevant time/time-period for observation
... value[x] 0..1 Actual result
.... valueRatio Ratio
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
... Slices for value[x] Content/Rules for all slices
.... value[x]:valueRatio C 0..1 Ratio Visual acuity expressed as a Snellen fraction
inv-dh-va-01: Value shall include numerator value and denominator value
.... value[x]:valueQuantity C 0..1 Quantity Visual acuity expressed as a simple quantity
inv-dh-va-02: Value shall include value and unit
.... value[x]:valueCodeableConcept 0..1 CodeableConcept Visual acuity expressed as a code
... method 0..1 CodeableConcept Method used to measure visual acuity
... device 0..1 Reference(Device | DeviceMetric) Type of chart used to measure visual acuity

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.codepreferredhttp://snomed.info/sct?fhir_vs
http://snomed.info/sct?fhir_vs

Constraints

IdGradePath(s)DetailsRequirements
inv-dh-va-01errorObservation.value[x]:valueRatioValue shall include numerator value and denominator value
: numerator.value.exists() and denominator.value.exists()
inv-dh-va-02errorObservation.value[x]:valueQuantityValue shall include value and unit
: value.exists() and unit.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Sharpness or acuteness of vision
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
.... category:exam 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: http://snomed.info/sct?fhir_vs (preferred): Visual Acuity Test

... subject Σ 1..1 Reference(Patient) Who and/or what the observation is about
... effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
... Slices for value[x] ΣC 0..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueRatio Ratio
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueRatio ΣC 0..1 Ratio Visual acuity expressed as a Snellen fraction
inv-dh-va-01: Value shall include numerator value and denominator value
.... value[x]:valueQuantity ΣC 0..1 Quantity Visual acuity expressed as a simple quantity
inv-dh-va-02: Value shall include value and unit
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Visual acuity expressed as a code
... method 0..1 CodeableConcept Method used to measure visual acuity
Binding: ObservationMethods (example): Methods for simple observations.

... device 0..1 Reference(Device | DeviceMetric) Type of chart used to measure visual acuity

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:exampreferredPattern: exam
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredhttp://snomed.info/sct?fhir_vs
http://snomed.info/sct?fhir_vs
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
inv-dh-va-01errorObservation.value[x]:valueRatioValue shall include numerator value and denominator value
: numerator.value.exists() and denominator.value.exists()
inv-dh-va-02errorObservation.value[x]:valueQuantityValue shall include value and unit
: value.exists() and unit.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Sharpness or acuteness of vision
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... Slices for category 2..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:exam 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: http://snomed.info/sct?fhir_vs (preferred): Visual Acuity Test

... subject Σ 1..1 Reference(Patient) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 0..1 Actual result
Slice: Unordered, Closed by type:$this
.... valueRatio Ratio
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... value[x]:valueRatio ΣC 0..1 Ratio Visual acuity expressed as a Snellen fraction
inv-dh-va-01: Value shall include numerator value and denominator value
.... value[x]:valueQuantity ΣC 0..1 Quantity Visual acuity expressed as a simple quantity
inv-dh-va-02: Value shall include value and unit
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Visual acuity expressed as a code
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1 CodeableConcept Method used to measure visual acuity
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) Type of chart used to measure visual acuity
... referenceRange C 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:exampreferredPattern: exam
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredhttp://snomed.info/sct?fhir_vs
http://snomed.info/sct?fhir_vs
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
inv-dh-va-01errorObservation.value[x]:valueRatioValue shall include numerator value and denominator value
: numerator.value.exists() and denominator.value.exists()
inv-dh-va-02errorObservation.value[x]:valueQuantityValue shall include value and unit
: value.exists() and unit.exists()

This structure is derived from Observation

Summary

Mandatory: 3 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.category

 

Other representations of profile: CSV, Excel, Schematron

Notes:

No mandatory or optional search parameters for ADHA Visual Acuityprofile.