International Patient Summary Implementation Guide
2.0.0 - STU 2 International flag

International Patient Summary Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ips/ and changes regularly. See the Directory of published versions

Resource Profile: ObservationResultsRadiologyUvIps - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the Observation-results-radiology-uv-ips resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition

Measurements and simple assertions made about a patient, device or other subject.

ShortMeasurements and simple assertions
Comments

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 laboratory reports, etc.

Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesVital Signs, Measurement, Results, Tests
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
hasMemberOrComponent: component and hasMember are mutually exclusive (hasMember.empty() or component.empty())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
2. Observation.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Observation.modifierExtension
Definition

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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Observation.partOf
Definition

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

ShortPart of referenced event
Comments

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

Control0..*
TypeReference(ImagingStudy (IPS), MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)
Is Modifierfalse
Summarytrue
Alternate NamesContainer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Observation.status
Definition

The status of the result value.

Shortregistered | preliminary | final | amended +
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from Results Status Codes - IPShttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
(required to http://hl7.org/fhir/uv/ips/ValueSet/results-status-uv-ips)
Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

LabelObservation 'complete' status codes
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Observation.category
Definition

A code that classifies the general type of observation being made. In this profile, fixed to "imaging".


A code that classifies the general type of observation being made.

ShortClassification of type of observation
Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Control10..*
BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category
(preferred to http://hl7.org/fhir/ValueSet/observation-category)

Codes for high level observation categories.

TypeCodeableConcept(Codeable Concept (IPS))
Is Modifierfalse
Summaryfalse
Requirements

Used for filtering what observations are retrieved and displayed.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 12. Observation.category:radiology
    Slice Nameradiology
    Definition

    A code that classifies the general type of observation being made.

    ShortClassification of type of observation
    Comments

    In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

    Control10..1*
    BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category
    (preferred to http://hl7.org/fhir/ValueSet/observation-category)

    Codes for high level observation categories.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:populate-if-knownProducer (IPS)
      SHALL:handleConsumer (IPS)
      SHOULD:displayConsumer (IPS)
      Summaryfalse
      Requirements

      Used for filtering what observations are retrieved and displayed.

      Pattern Value{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "imaging"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Observation.code
      Definition

      Describes what was observed. Sometimes this is called the observation "name". In this profile the code of the containing observation (the organizer result in the CDA implementation) may correspond to the procedure code (e.g. Chest X-Ray).


      Describes what was observed. Sometimes this is called the observation "name".

      ShortType of observation (code / type)
      Comments

      All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

      Control1..1
      BindingThe codes SHOULD be taken from For example codes, see Results Radiology Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
      (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips)
      TypeCodeableConcept(Codeable Concept (IPS))
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:populate-if-knownProducer (IPS)
        SHALL:handleConsumer (IPS)
        SHOULD:displayConsumer (IPS)
        Summarytrue
        Requirements

        Knowing what kind of observation is being made is essential to understanding the observation.

        LabelDiagnostic Procedure Code
        Alternate NamesName
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Observation.subject
        Definition

        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, donor, other observer (for example a relative or EMT), or any observation made about the subject.

        In this profile is constrained to the patient


        The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

        ShortWho and/or what the observation is about
        Comments

        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.

        Control10..1
        TypeReference(Patient (IPS), Patient, Group, Device, Location)
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:populate-if-knownProducer (IPS)
          SHALL:handleConsumer (IPS)
          SHOULD:displayConsumer (IPS)
          Summarytrue
          Requirements

          Observations have no value if you don't know who or what they're about.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. Observation.subject.reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortLiteral reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control10..1
          This element is affected by the following invariants: ref-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:populate-if-knownProducer (IPS)
            SHALL:handleConsumer (IPS)
            SHOULD:displayConsumer (IPS)
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. Observation.effective[x]
            Definition

            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 "physiologically relevant time". 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.

            ShortClinically relevant time/time-period for observation
            Comments

            At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

            Control10..1
            TypeChoice of: dateTime, Period, Timing, instant
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Obligations
              ObligationsActor
              SHALL:populate-if-knownProducer (IPS)
              SHALL:handleConsumer (IPS)
              SHOULD:displayConsumer (IPS)
              Summarytrue
              Requirements

              Knowing when an observation was deemed true is important to its relevance as well as determining trends.

              Alternate NamesOccurrence
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ips-1: Datetime must be at least to day. ($this.ofType(dateTime).empty() or ($this as dateTime).toString().length() >= 8)
              SlicingThis element introduces a set of slices on Observation.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 22. Observation.effective[x]:effectiveDateTime
                Slice NameeffectiveDateTime
                Definition

                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 "physiologically relevant time". 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.

                ShortClinically relevant time/time-period for observation
                Comments

                At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                Control0..1
                TypedateTime, Period, Timing, instant
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHOULD:able-to-populateProducer (IPS)
                  SHALL:handleConsumer (IPS)
                  SHOULD:displayConsumer (IPS)
                  Summarytrue
                  Requirements

                  Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                  Alternate NamesOccurrence
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  24. Observation.performer
                  Definition

                  Who was responsible for asserting the observed value as "true".

                  ShortWho is responsible for the observation
                  Control10..*
                  TypeReference(Practitioner (IPS), PractitionerRole (IPS), Organization (IPS), CareTeam, Patient (IPS), RelatedPerson, Practitioner, PractitionerRole, Organization, Patient)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownProducer (IPS)
                    SHALL:handleConsumer (IPS)
                    SHOULD:displayConsumer (IPS)
                    Summarytrue
                    Requirements

                    May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    26. Observation.value[x]
                    Definition

                    The information determined as a result of making the observation, if the information has a simple value.

                    ShortActual result
                    Comments

                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. 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 additional guidance, see the Notes section below.

                    Control0..1
                    This element is affected by the following invariants: obs-7
                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 28. Observation.value[x]:valueString
                      Slice NamevalueString
                      Definition

                      The information determined as a result of making the observation, if the information has a simple value.

                      ShortActual result
                      Comments

                      An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. 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 additional guidance, see the Notes section below.

                      Control0..1
                      This element is affected by the following invariants: obs-7
                      Typestring, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHALL:populate-if-knownProducer (IPS)
                        SHALL:handleConsumer (IPS)
                        SHOULD:displayConsumer (IPS)
                        Summarytrue
                        Requirements

                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                        LabelOverall Conclusion
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        30. Observation.bodySite
                        Definition

                        Indicates the site on the subject's body where the observation was made (i.e. the target site).

                        ShortObserved body part
                        Comments

                        Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

                        If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

                        Control0..1
                        BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site
                        (example to http://hl7.org/fhir/ValueSet/body-site)

                        Codes describing anatomical locations. May include laterality.

                        TypeCodeableConcept(Codeable Concept (IPS))
                        Is Modifierfalse
                        Summaryfalse
                        Labelbody site
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        32. Observation.device
                        Definition

                        The device used to generate the observation data.

                        Short(Measurement) Device
                        Comments

                        Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

                        Control0..1
                        TypeReference(Device - Performer or Observer (IPS), Device, DeviceMetric)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        34. Observation.hasMember
                        Definition

                        This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

                        ShortRelated resource that belongs to the Observation group
                        Comments

                        When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.


                        When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

                        Control0..*
                        TypeReference(Observation Results - Radiology (IPS), Observation, QuestionnaireResponse, MolecularSequence)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        36. Observation.component
                        Definition

                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                        ShortComponent results
                        Comments

                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownProducer (IPS)
                          SHALL:handleConsumer (IPS)
                          SHOULD:displayConsumer (IPS)
                          Summarytrue
                          Requirements

                          Required if not(exists(Observation.valueString))


                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                          • type @ value
                          • 38. Observation.component.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            40. Observation.component.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes
                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                            Codes identifying names of simple observations.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            42. Observation.component:observationText
                            Slice NameobservationText
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortObservation TextComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            44. Observation.component:observationText.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            46. Observation.component:observationText.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Results Radiology Textual Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                            (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-txtobs-uv-ips)
                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            48. Observation.component:observationText.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                            Control10..1
                            Typestring, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            50. Observation.component:observationCode
                            Slice NameobservationCode
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortObservation CodeComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            52. Observation.component:observationCode.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            54. Observation.component:observationCode.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Results Radiology Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                            (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips)
                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            56. Observation.component:observationCode.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                            Control10..1
                            TypeCodeableConcept(Codeable Concept (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            58. Observation.component:numericQuantityMeasurement
                            Slice NamenumericQuantityMeasurement
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortObservation Measurement, including linear, area and volume quantity measurementsComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            60. Observation.component:numericQuantityMeasurement.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            62. Observation.component:numericQuantityMeasurement.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Results Radiology Measurement Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                            (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                            Codes identifying numeric measurements


                            Codes identifying names of simple observations.

                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            64. Observation.component:numericQuantityMeasurement.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                            Control10..1
                            TypeQuantity(Quantity (IPS)), dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            66. Observation.component:numericRangeMeasurement
                            Slice NamenumericRangeMeasurement
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortObservation Measurement, including linear, area and volume range measurementsComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            68. Observation.component:numericRangeMeasurement.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            70. Observation.component:numericRangeMeasurement.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Results Radiology Measurement Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                            (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                            Codes identifying numeric measurements


                            Codes identifying names of simple observations.

                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            72. Observation.component:numericRangeMeasurement.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                            Control10..1
                            TypeRange(Range (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            74. Observation.component:numericRatioMeasurement
                            Slice NamenumericRatioMeasurement
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortObservation Measurement, including linear, area and volume ratio measurementsComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            76. Observation.component:numericRatioMeasurement.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            78. Observation.component:numericRatioMeasurement.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Results Radiology Measurement Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                            (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                            Codes identifying numeric measurements


                            Codes identifying names of simple observations.

                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            80. Observation.component:numericRatioMeasurement.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                            Control10..1
                            TypeRatio(Ratio (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, integer, time, Range, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            82. Observation.component:numericSampledDataMeasurement
                            Slice NamenumericSampledDataMeasurement
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            ShortObservation Measurement, including linear, area and volume sampled data measurementsComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            84. Observation.component:numericSampledDataMeasurement.modifierExtension
                            Definition

                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            86. Observation.component:numericSampledDataMeasurement.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Results Radiology Measurement Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                            (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                            Codes identifying numeric measurements


                            Codes identifying names of simple observations.

                            TypeCodeableConcept(Codeable Concept (IPS))
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            88. Observation.component:numericSampledDataMeasurement.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                            Control10..1
                            TypeSampledData, dateTime, boolean, string, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                            Guidance on how to interpret the contents of this table can be foundhere

                            0. Observation
                            InvariantshasMemberOrComponent: component and hasMember are mutually exclusive (hasMember.empty() or component.empty())
                            2. Observation.partOf
                            TypeReference(ImagingStudy (IPS))
                            4. Observation.status
                            BindingThe codes SHALL be taken from Results Status Codes - IPS
                            (required to http://hl7.org/fhir/uv/ips/ValueSet/results-status-uv-ips)
                            LabelObservation 'complete' status codes
                            6. Observation.category
                            Definition

                            A code that classifies the general type of observation being made. In this profile, fixed to "imaging".

                            Control1..?
                            TypeCodeableConcept(Codeable Concept (IPS))
                            SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • pattern @ $this
                            • 8. Observation.category:radiology
                              Slice Nameradiology
                              Control1..1
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownProducer (IPS)
                                SHALL:handleConsumer (IPS)
                                SHOULD:displayConsumer (IPS)
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                    "code" : "imaging"
                                  }]
                                }
                                10. Observation.code
                                Definition

                                Describes what was observed. Sometimes this is called the observation "name". In this profile the code of the containing observation (the organizer result in the CDA implementation) may correspond to the procedure code (e.g. Chest X-Ray).

                                BindingThe codes SHOULD be taken from Results Radiology Observation - IPS
                                (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips)
                                TypeCodeableConcept(Codeable Concept (IPS))
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownProducer (IPS)
                                  SHALL:handleConsumer (IPS)
                                  SHOULD:displayConsumer (IPS)
                                  LabelDiagnostic Procedure Code
                                  12. Observation.subject
                                  Definition

                                  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, donor, other observer (for example a relative or EMT), or any observation made about the subject.

                                  In this profile is constrained to the patient

                                  Control1..?
                                  TypeReference(Patient (IPS))
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownProducer (IPS)
                                    SHALL:handleConsumer (IPS)
                                    SHOULD:displayConsumer (IPS)
                                    14. Observation.subject.reference
                                    Control1..?
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownProducer (IPS)
                                      SHALL:handleConsumer (IPS)
                                      SHOULD:displayConsumer (IPS)
                                      16. Observation.effective[x]
                                      Control1..?
                                      TypeChoice of: dateTime, Period, Timing, instant
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownProducer (IPS)
                                        SHALL:handleConsumer (IPS)
                                        SHOULD:displayConsumer (IPS)
                                        Invariantsips-1: Datetime must be at least to day. ($this.ofType(dateTime).empty() or ($this as dateTime).toString().length() >= 8)
                                        SlicingThis element introduces a set of slices on Observation.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 18. Observation.effective[x]:effectiveDateTime
                                          Slice NameeffectiveDateTime
                                          Control0..1
                                          TypedateTime
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHOULD:able-to-populateProducer (IPS)
                                            SHALL:handleConsumer (IPS)
                                            SHOULD:displayConsumer (IPS)
                                            20. Observation.performer
                                            Control1..?
                                            TypeReference(Practitioner (IPS), PractitionerRole (IPS), Organization (IPS), CareTeam, Patient (IPS), RelatedPerson)
                                            Must Supporttrue
                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownProducer (IPS)
                                              SHALL:handleConsumer (IPS)
                                              SHOULD:displayConsumer (IPS)
                                              22. Observation.value[x]
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • type @ $this
                                              • 24. Observation.value[x]:valueString
                                                Slice NamevalueString
                                                Control0..1
                                                Typestring
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate-if-knownProducer (IPS)
                                                  SHALL:handleConsumer (IPS)
                                                  SHOULD:displayConsumer (IPS)
                                                  LabelOverall Conclusion
                                                  26. Observation.bodySite
                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                  Labelbody site
                                                  28. Observation.device
                                                  TypeReference(Device - Performer or Observer (IPS))
                                                  30. Observation.hasMember
                                                  TypeReference(Observation Results - Radiology (IPS))
                                                  32. Observation.component
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-knownProducer (IPS)
                                                    SHALL:handleConsumer (IPS)
                                                    SHOULD:displayConsumer (IPS)
                                                    Requirements

                                                    Required if not(exists(Observation.valueString))

                                                    SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                    • type @ value
                                                    • 34. Observation.component:observationText
                                                      Slice NameobservationText
                                                      ShortObservation Text
                                                      Control0..*
                                                      36. Observation.component:observationText.code
                                                      BindingUnless not suitable, these codes SHALL be taken from Results Radiology Textual Observation - IPS
                                                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-txtobs-uv-ips)
                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      38. Observation.component:observationText.value[x]
                                                      Control1..?
                                                      Typestring
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      40. Observation.component:observationCode
                                                      Slice NameobservationCode
                                                      ShortObservation Code
                                                      Control0..*
                                                      42. Observation.component:observationCode.code
                                                      BindingUnless not suitable, these codes SHALL be taken from Results Radiology Observation - IPS
                                                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips)
                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      44. Observation.component:observationCode.value[x]
                                                      Control1..?
                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      46. Observation.component:numericQuantityMeasurement
                                                      Slice NamenumericQuantityMeasurement
                                                      ShortObservation Measurement, including linear, area and volume quantity measurements
                                                      Control0..*
                                                      48. Observation.component:numericQuantityMeasurement.code
                                                      BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                      Codes identifying numeric measurements

                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      50. Observation.component:numericQuantityMeasurement.value[x]
                                                      Control1..?
                                                      TypeQuantity(Quantity (IPS))
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      52. Observation.component:numericRangeMeasurement
                                                      Slice NamenumericRangeMeasurement
                                                      ShortObservation Measurement, including linear, area and volume range measurements
                                                      Control0..*
                                                      54. Observation.component:numericRangeMeasurement.code
                                                      BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                      Codes identifying numeric measurements

                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      56. Observation.component:numericRangeMeasurement.value[x]
                                                      Control1..?
                                                      TypeRange(Range (IPS))
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      58. Observation.component:numericRatioMeasurement
                                                      Slice NamenumericRatioMeasurement
                                                      ShortObservation Measurement, including linear, area and volume ratio measurements
                                                      Control0..*
                                                      60. Observation.component:numericRatioMeasurement.code
                                                      BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                      Codes identifying numeric measurements

                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      62. Observation.component:numericRatioMeasurement.value[x]
                                                      Control1..?
                                                      TypeRatio(Ratio (IPS))
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      64. Observation.component:numericSampledDataMeasurement
                                                      Slice NamenumericSampledDataMeasurement
                                                      ShortObservation Measurement, including linear, area and volume sampled data measurements
                                                      Control0..*
                                                      66. Observation.component:numericSampledDataMeasurement.code
                                                      BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                      (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                      Codes identifying numeric measurements

                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      68. Observation.component:numericSampledDataMeasurement.value[x]
                                                      Control1..?
                                                      TypeSampledData
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]

                                                      Guidance on how to interpret the contents of this table can be foundhere

                                                      0. Observation
                                                      Definition

                                                      Measurements and simple assertions made about a patient, device or other subject.

                                                      ShortMeasurements and simple assertions
                                                      Comments

                                                      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 laboratory reports, etc.

                                                      Control0..*
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate NamesVital Signs, Measurement, Results, Tests
                                                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                      obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                                      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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                                      hasMemberOrComponent: component and hasMember are mutually exclusive (hasMember.empty() or component.empty())
                                                      2. Observation.id
                                                      Definition

                                                      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                      ShortLogical id of this artifact
                                                      Comments

                                                      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                      Control0..1
                                                      Typeid
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      4. Observation.meta
                                                      Definition

                                                      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                      ShortMetadata about the resource
                                                      Control0..1
                                                      TypeMeta
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      6. Observation.implicitRules
                                                      Definition

                                                      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                      ShortA set of rules under which this content was created
                                                      Comments

                                                      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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                      Control0..1
                                                      Typeuri
                                                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      8. Observation.language
                                                      Definition

                                                      The base language in which the resource is written.

                                                      ShortLanguage of the resource content
                                                      Comments

                                                      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).

                                                      Control0..1
                                                      BindingThe codes SHOULD be taken from CommonLanguages
                                                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                      A human language.

                                                      Additional BindingsPurpose
                                                      AllLanguagesMax Binding
                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      10. Observation.text
                                                      Definition

                                                      A human-readable narrative that contains a summary of the resource and can 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                      ShortText summary of the resource, for human interpretation
                                                      Comments

                                                      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                      Control0..1
                                                      TypeNarrative
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesnarrative, html, xhtml, display
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      12. Observation.contained
                                                      Definition

                                                      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.

                                                      ShortContained, inline Resources
                                                      Comments

                                                      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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                      Control0..*
                                                      TypeResource
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesinline resources, anonymous resources, contained resources
                                                      14. Observation.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      16. Observation.modifierExtension
                                                      Definition

                                                      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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                      Summaryfalse
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      18. Observation.identifier
                                                      Definition

                                                      A unique identifier assigned to this observation.

                                                      ShortBusiness Identifier for observation
                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Allows observations to be distinguished and referenced.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      20. Observation.basedOn
                                                      Definition

                                                      A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

                                                      ShortFulfills plan, proposal or order
                                                      Control0..*
                                                      TypeReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                                                      Alternate NamesFulfills
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      22. Observation.partOf
                                                      Definition

                                                      A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

                                                      ShortPart of referenced event
                                                      Comments

                                                      To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

                                                      Control0..*
                                                      TypeReference(ImagingStudy (IPS))
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Alternate NamesContainer
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      24. Observation.status
                                                      Definition

                                                      The status of the result value.

                                                      Shortregistered | preliminary | final | amended +
                                                      Comments

                                                      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                      Control1..1
                                                      BindingThe codes SHALL be taken from Results Status Codes - IPS
                                                      (required to http://hl7.org/fhir/uv/ips/ValueSet/results-status-uv-ips)
                                                      Typecode
                                                      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need to track the status of individual results. Some results are finalized before the whole report is finalized.

                                                      LabelObservation 'complete' status codes
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      26. Observation.category
                                                      Definition

                                                      A code that classifies the general type of observation being made. In this profile, fixed to "imaging".

                                                      ShortClassification of type of observation
                                                      Comments

                                                      In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                      Control1..*
                                                      BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                      (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                      Codes for high level observation categories.

                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Used for filtering what observations are retrieved and displayed.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • pattern @ $this
                                                      • 28. Observation.category:radiology
                                                        Slice Nameradiology
                                                        Definition

                                                        A code that classifies the general type of observation being made.

                                                        ShortClassification of type of observation
                                                        Comments

                                                        In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                        Control1..1
                                                        BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                        (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                        Codes for high level observation categories.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:populate-if-knownProducer (IPS)
                                                          SHALL:handleConsumer (IPS)
                                                          SHOULD:displayConsumer (IPS)
                                                          Summaryfalse
                                                          Requirements

                                                          Used for filtering what observations are retrieved and displayed.

                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                                              "code" : "imaging"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          30. Observation.code
                                                          Definition

                                                          Describes what was observed. Sometimes this is called the observation "name". In this profile the code of the containing observation (the organizer result in the CDA implementation) may correspond to the procedure code (e.g. Chest X-Ray).

                                                          ShortType of observation (code / type)
                                                          Comments

                                                          All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                          Control1..1
                                                          BindingThe codes SHOULD be taken from Results Radiology Observation - IPS
                                                          (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips)
                                                          TypeCodeableConcept(Codeable Concept (IPS))
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:populate-if-knownProducer (IPS)
                                                            SHALL:handleConsumer (IPS)
                                                            SHOULD:displayConsumer (IPS)
                                                            Summarytrue
                                                            Requirements

                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                            LabelDiagnostic Procedure Code
                                                            Alternate NamesName
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            32. Observation.subject
                                                            Definition

                                                            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, donor, other observer (for example a relative or EMT), or any observation made about the subject.

                                                            In this profile is constrained to the patient

                                                            ShortWho and/or what the observation is about
                                                            Comments

                                                            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.

                                                            Control1..1
                                                            TypeReference(Patient (IPS))
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:populate-if-knownProducer (IPS)
                                                              SHALL:handleConsumer (IPS)
                                                              SHOULD:displayConsumer (IPS)
                                                              Summarytrue
                                                              Requirements

                                                              Observations have no value if you don't know who or what they're about.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              34. Observation.subject.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              36. Observation.subject.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              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.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Observation.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 38. Observation.subject.reference
                                                                Definition

                                                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                ShortLiteral reference, Relative, internal or absolute URL
                                                                Comments

                                                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                Control1..1
                                                                This element is affected by the following invariants: ref-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:populate-if-knownProducer (IPS)
                                                                  SHALL:handleConsumer (IPS)
                                                                  SHOULD:displayConsumer (IPS)
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  40. Observation.subject.type
                                                                  Definition

                                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                  ShortType the reference refers to (e.g. "Patient")
                                                                  Comments

                                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                  Control0..1
                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                  Aa resource (or, for logical models, the URI of the logical model).

                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  42. Observation.subject.identifier
                                                                  Definition

                                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                  ShortLogical reference, when literal reference is not known
                                                                  Comments

                                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                  Control0..1
                                                                  TypeIdentifier
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  44. Observation.subject.display
                                                                  Definition

                                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                                  ShortText alternative for the resource
                                                                  Comments

                                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  46. Observation.focus
                                                                  Definition

                                                                  The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

                                                                  ShortWhat the observation is about, when it is not about the subject of record
                                                                  Comments

                                                                  Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

                                                                  Control0..*
                                                                  TypeReference(Resource)
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  48. Observation.encounter
                                                                  Definition

                                                                  The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

                                                                  ShortHealthcare event during which this observation is made
                                                                  Comments

                                                                  This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

                                                                  Control0..1
                                                                  TypeReference(Encounter)
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Requirements

                                                                  For some observations it may be important to know the link between an observation and a particular encounter.

                                                                  Alternate NamesContext
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  50. Observation.effective[x]
                                                                  Definition

                                                                  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 "physiologically relevant time". 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.

                                                                  ShortClinically relevant time/time-period for observation
                                                                  Comments

                                                                  At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                  Control1..1
                                                                  TypeChoice of: dateTime, Period
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populate-if-knownProducer (IPS)
                                                                    SHALL:handleConsumer (IPS)
                                                                    SHOULD:displayConsumer (IPS)
                                                                    Summarytrue
                                                                    Requirements

                                                                    Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                    Alternate NamesOccurrence
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ips-1: Datetime must be at least to day. ($this.ofType(dateTime).empty() or ($this as dateTime).toString().length() >= 8)
                                                                    SlicingThis element introduces a set of slices on Observation.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • type @ $this
                                                                    • 52. Observation.effective[x]:effectiveDateTime
                                                                      Slice NameeffectiveDateTime
                                                                      Definition

                                                                      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 "physiologically relevant time". 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.

                                                                      ShortClinically relevant time/time-period for observation
                                                                      Comments

                                                                      At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                      Control0..1
                                                                      TypedateTime
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHOULD:able-to-populateProducer (IPS)
                                                                        SHALL:handleConsumer (IPS)
                                                                        SHOULD:displayConsumer (IPS)
                                                                        Summarytrue
                                                                        Requirements

                                                                        Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                        Alternate NamesOccurrence
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        54. Observation.issued
                                                                        Definition

                                                                        The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

                                                                        ShortDate/Time this version was made available
                                                                        Comments

                                                                        For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

                                                                        Control0..1
                                                                        Typeinstant
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        56. Observation.performer
                                                                        Definition

                                                                        Who was responsible for asserting the observed value as "true".

                                                                        ShortWho is responsible for the observation
                                                                        Control1..*
                                                                        TypeReference(Practitioner (IPS), PractitionerRole (IPS), Organization (IPS), CareTeam, Patient (IPS), RelatedPerson)
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:populate-if-knownProducer (IPS)
                                                                          SHALL:handleConsumer (IPS)
                                                                          SHOULD:displayConsumer (IPS)
                                                                          Summarytrue
                                                                          Requirements

                                                                          May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          58. Observation.value[x]
                                                                          Definition

                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                          ShortActual result
                                                                          Comments

                                                                          An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. 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 additional guidance, see the Notes section below.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: obs-7
                                                                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • type @ $this
                                                                          • 60. Observation.value[x]:valueString
                                                                            Slice NamevalueString
                                                                            Definition

                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                            ShortActual result
                                                                            Comments

                                                                            An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. 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 additional guidance, see the Notes section below.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: obs-7
                                                                            Typestring
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:populate-if-knownProducer (IPS)
                                                                              SHALL:handleConsumer (IPS)
                                                                              SHOULD:displayConsumer (IPS)
                                                                              Summarytrue
                                                                              Requirements

                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                              LabelOverall Conclusion
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              62. Observation.dataAbsentReason
                                                                              Definition

                                                                              Provides a reason why the expected value in the element Observation.value[x] is missing.

                                                                              ShortWhy the result is missing
                                                                              Comments

                                                                              Null 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 "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

                                                                              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 "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: obs-6
                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              64. Observation.interpretation
                                                                              Definition

                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                              ShortHigh, low, normal, etc.
                                                                              Comments

                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                              Control0..*
                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                              Codes identifying interpretations of observations.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                              Alternate NamesAbnormal Flag
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              66. Observation.note
                                                                              Definition

                                                                              Comments about the observation or the results.

                                                                              ShortComments about the observation
                                                                              Comments

                                                                              May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

                                                                              Control0..*
                                                                              TypeAnnotation
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Need to be able to provide free text additional information.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              68. Observation.bodySite
                                                                              Definition

                                                                              Indicates the site on the subject's body where the observation was made (i.e. the target site).

                                                                              ShortObserved body part
                                                                              Comments

                                                                              Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

                                                                              If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

                                                                              Control0..1
                                                                              BindingFor example codes, see SNOMEDCTBodyStructures
                                                                              (example to http://hl7.org/fhir/ValueSet/body-site)

                                                                              Codes describing anatomical locations. May include laterality.

                                                                              TypeCodeableConcept(Codeable Concept (IPS))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Labelbody site
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              70. Observation.method
                                                                              Definition

                                                                              Indicates the mechanism used to perform the observation.

                                                                              ShortHow it was done
                                                                              Comments

                                                                              Only used if not implicit in code for Observation.code.

                                                                              Control0..1
                                                                              BindingFor example codes, see ObservationMethods
                                                                              (example to http://hl7.org/fhir/ValueSet/observation-methods)

                                                                              Methods for simple observations.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              72. Observation.specimen
                                                                              Definition

                                                                              The specimen that was used when this observation was made.

                                                                              ShortSpecimen used for this observation
                                                                              Comments

                                                                              Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases 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 may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

                                                                              Control0..1
                                                                              TypeReference(Specimen)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              74. Observation.device
                                                                              Definition

                                                                              The device used to generate the observation data.

                                                                              Short(Measurement) Device
                                                                              Comments

                                                                              Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

                                                                              Control0..1
                                                                              TypeReference(Device - Performer or Observer (IPS))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              76. Observation.referenceRange
                                                                              Definition

                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

                                                                              ShortProvides guide for interpretation
                                                                              Comments

                                                                              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 might 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.

                                                                              Control0..*
                                                                              TypeBackboneElement
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
                                                                              78. Observation.referenceRange.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              80. Observation.referenceRange.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

                                                                              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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              82. Observation.referenceRange.modifierExtension
                                                                              Definition

                                                                              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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                              Comments

                                                                              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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                              Summarytrue
                                                                              Requirements

                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                              Alternate Namesextensions, user content, modifiers
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              84. Observation.referenceRange.low
                                                                              Definition

                                                                              The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

                                                                              ShortLow Range, if relevant
                                                                              Control0..1
                                                                              This element is affected by the following invariants: obs-3
                                                                              TypeQuantity(SimpleQuantity)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              86. Observation.referenceRange.high
                                                                              Definition

                                                                              The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

                                                                              ShortHigh Range, if relevant
                                                                              Control0..1
                                                                              This element is affected by the following invariants: obs-3
                                                                              TypeQuantity(SimpleQuantity)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              88. Observation.referenceRange.type
                                                                              Definition

                                                                              Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

                                                                              ShortReference range qualifier
                                                                              Comments

                                                                              This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

                                                                              Control0..1
                                                                              BindingThe codes SHOULD be taken from ObservationReferenceRangeMeaningCodes
                                                                              (preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning)

                                                                              Code for the meaning of a reference range.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              90. Observation.referenceRange.appliesTo
                                                                              Definition

                                                                              Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

                                                                              ShortReference range population
                                                                              Comments

                                                                              This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

                                                                              Control0..*
                                                                              BindingFor example codes, see ObservationReferenceRangeAppliesToCodes
                                                                              (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto)

                                                                              Codes identifying the population the reference range applies to.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Need to be able to identify the target population for proper interpretation.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              92. Observation.referenceRange.age
                                                                              Definition

                                                                              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.

                                                                              ShortApplicable age range, if relevant
                                                                              Control0..1
                                                                              TypeRange
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Some analytes vary greatly over age.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              94. Observation.referenceRange.text
                                                                              Definition

                                                                              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 "Negative" or a list or table of "normals".

                                                                              ShortText based reference range in an observation
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              96. Observation.hasMember
                                                                              Definition

                                                                              This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

                                                                              ShortRelated resource that belongs to the Observation group
                                                                              Comments

                                                                              When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

                                                                              Control0..*
                                                                              TypeReference(Observation Results - Radiology (IPS))
                                                                              Is Modifierfalse
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              98. Observation.derivedFrom
                                                                              Definition

                                                                              The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

                                                                              ShortRelated measurements the observation is made from
                                                                              Comments

                                                                              All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

                                                                              Control0..*
                                                                              TypeReference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
                                                                              Is Modifierfalse
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              100. Observation.component
                                                                              Definition

                                                                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                              ShortComponent results
                                                                              Comments

                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                              Control0..*
                                                                              TypeBackboneElement
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:populate-if-knownProducer (IPS)
                                                                                SHALL:handleConsumer (IPS)
                                                                                SHOULD:displayConsumer (IPS)
                                                                                Summarytrue
                                                                                Requirements

                                                                                Required if not(exists(Observation.valueString))

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                • type @ value
                                                                                • 102. Observation.component.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  104. Observation.component.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  106. Observation.component.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  108. Observation.component.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingFor example codes, see LOINCCodes
                                                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                  Codes identifying names of simple observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  110. Observation.component.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control0..1
                                                                                  TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  112. Observation.component.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  114. Observation.component.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  116. Observation.component.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  118. Observation.component:observationText
                                                                                  Slice NameobservationText
                                                                                  Definition

                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                  ShortObservation Text
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  120. Observation.component:observationText.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  122. Observation.component:observationText.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  124. Observation.component:observationText.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  126. Observation.component:observationText.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Results Radiology Textual Observation - IPS
                                                                                  (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-txtobs-uv-ips)
                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  128. Observation.component:observationText.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  Typestring
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  130. Observation.component:observationText.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  132. Observation.component:observationText.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  134. Observation.component:observationText.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  136. Observation.component:observationCode
                                                                                  Slice NameobservationCode
                                                                                  Definition

                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                  ShortObservation Code
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  138. Observation.component:observationCode.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  140. Observation.component:observationCode.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  142. Observation.component:observationCode.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  144. Observation.component:observationCode.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Results Radiology Observation - IPS
                                                                                  (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-observations-uv-ips)
                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  146. Observation.component:observationCode.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  148. Observation.component:observationCode.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  150. Observation.component:observationCode.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  152. Observation.component:observationCode.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  154. Observation.component:numericQuantityMeasurement
                                                                                  Slice NamenumericQuantityMeasurement
                                                                                  Definition

                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                  ShortObservation Measurement, including linear, area and volume quantity measurements
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  156. Observation.component:numericQuantityMeasurement.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  158. Observation.component:numericQuantityMeasurement.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  160. Observation.component:numericQuantityMeasurement.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  162. Observation.component:numericQuantityMeasurement.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                                                  (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                                                  Codes identifying numeric measurements

                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  164. Observation.component:numericQuantityMeasurement.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  TypeQuantity(Quantity (IPS))
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  166. Observation.component:numericQuantityMeasurement.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  168. Observation.component:numericQuantityMeasurement.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  170. Observation.component:numericQuantityMeasurement.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  172. Observation.component:numericRangeMeasurement
                                                                                  Slice NamenumericRangeMeasurement
                                                                                  Definition

                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                  ShortObservation Measurement, including linear, area and volume range measurements
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  174. Observation.component:numericRangeMeasurement.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  176. Observation.component:numericRangeMeasurement.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  178. Observation.component:numericRangeMeasurement.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  180. Observation.component:numericRangeMeasurement.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                                                  (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                                                  Codes identifying numeric measurements

                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  182. Observation.component:numericRangeMeasurement.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  TypeRange(Range (IPS))
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  184. Observation.component:numericRangeMeasurement.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  186. Observation.component:numericRangeMeasurement.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  188. Observation.component:numericRangeMeasurement.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  190. Observation.component:numericRatioMeasurement
                                                                                  Slice NamenumericRatioMeasurement
                                                                                  Definition

                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                  ShortObservation Measurement, including linear, area and volume ratio measurements
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  192. Observation.component:numericRatioMeasurement.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  194. Observation.component:numericRatioMeasurement.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  196. Observation.component:numericRatioMeasurement.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  198. Observation.component:numericRatioMeasurement.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                                                  (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                                                  Codes identifying numeric measurements

                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  200. Observation.component:numericRatioMeasurement.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  TypeRatio(Ratio (IPS))
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  202. Observation.component:numericRatioMeasurement.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  204. Observation.component:numericRatioMeasurement.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  206. Observation.component:numericRatioMeasurement.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  208. Observation.component:numericSampledDataMeasurement
                                                                                  Slice NamenumericSampledDataMeasurement
                                                                                  Definition

                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                  ShortObservation Measurement, including linear, area and volume sampled data measurements
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  210. Observation.component:numericSampledDataMeasurement.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  212. Observation.component:numericSampledDataMeasurement.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  214. Observation.component:numericSampledDataMeasurement.modifierExtension
                                                                                  Definition

                                                                                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  216. Observation.component:numericSampledDataMeasurement.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  ShortType of component observation (code / type)
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Results Radiology Measurement Observation - IPS
                                                                                  (extensible to http://hl7.org/fhir/uv/ips/ValueSet/results-radiology-numobs-uv-ips)

                                                                                  Codes identifying numeric measurements

                                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  218. Observation.component:numericSampledDataMeasurement.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortActual component result
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was 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 additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  TypeSampledData
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  220. Observation.component:numericSampledDataMeasurement.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" 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 "detected", "not detected", "inconclusive", or "test not done".

                                                                                  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 "error" 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.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  222. Observation.component:numericSampledDataMeasurement.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  224. Observation.component:numericSampledDataMeasurement.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  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 might 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.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))