QI-Core Implementation Guide
4.1.0 - release

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## Resource Profile: QICoreObservation

Defining URL: | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation
Version: | 4.1.0
Name: | QICoreObservation
Status: | Draft as of 8/22/18
Definition: | Profile of Observation for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
Publisher: | http://www.hl7.org/Special/committees/cqi/index.cfm
Source Resource: | XML / JSON / Turtle

The official URL for this profile is:

    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation

Usage

Note: US-Core defines precise profiles for specific observations, as well as a general profile for LOINC-code laboratory result observations. QI-Core inherits these specific profiles directly. When creating expressions for eCQMs or CDS artifacts with QI-Core for the following clinical data, use the applicable profile directly rather than the generic QICore Observation profile:

- FHIR Vital Signs Profile
- Pediatric-BMI-for Age
- Pediatric Head Occipital-frontal Circumference Percentile
- Pediatric Weight for Height
- Pulse Oximetry
- Smoking Status
- Laboratory Result

To create an expression specifically requesting information that an observation intentionally did not occur for a medical, patient or system reason, use the profile QICore-observationnotdone.

The Observation and ObservationNotDone profiles represent the positive and negative statements for an observation. To ensure instances retrieved meet positive intent, applications should check the status element as illustrated in this example:

    define Observation:
      [Observation] O
        where O.status in { 'registered', 'preliminary', 'final', 'amended', 'corrected' }

The following example illustrates the use of the observation profile.

    define "Pap Test with Results":
    	[Observation: "Pap Test"] PapTest
    		where PapTest.value is not null
    			and PapTest.status in { 'final', 'amended', 'corrected', 'preliminary' }

See the patterns page for implementation and usage patterns.

### Examples

Decreased Hemoglobin Example

### Formal Views of Profile Content

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

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 17 elements

Structures

This structure refers to these other structures:

- QICorePatient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICoreDevice (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device)
- QICoreLocation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location)
- QICoreEncounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)
- QICorePractitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICoreOrganization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
- QICoreRelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
- QICoreSpecimen (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-specimen)
- QICoreObservation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
- http://hl7.org/fhir/StructureDefinition/observation-delta

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
observation-bodyPosition |  | 0..1 | CodeableConcept | The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition Binding: Body Position (preferred): SNOMED CT code system values descending from the following:'body position finding' 9851009
observation-delta |  | 0..1 | CodeableConcept | Qualitative change or trend in the measurement URL: http://hl7.org/fhir/StructureDefinition/observation-delta Binding: QICore Observation Delta Value Set Definition (example): Code system values for Observation Delta Value Set
basedOn |  | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
status | S | 1..1 | code | registered | preliminary | final | amended +
category | S | 1..* | CodeableConcept | Classification of type of observation
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
subject | S | 1..1 | Reference(QICorePatient | QICoreDevice | QICoreLocation) | Who and/or what the observation is about
encounter | S | 0..1 | Reference(QICoreEncounter) | Healthcare event during which this observation is made
effective[x] | S | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation
issued | S | 0..1 | instant | Date/Time this version was made available
performer |  | 0..* | Reference(QICorePractitioner | QICoreOrganization | QICorePatient | QICoreRelatedPerson) | Who is responsible for the observation
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
dataAbsentReason |  | 0..1 | CodeableConcept | Why the result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc.
bodySite | S | 0..1 | CodeableConcept | Observed body part
method | S | 0..1 | CodeableConcept | How it was done
specimen | S | 0..1 | Reference(QICoreSpecimen) | Specimen used for this observation
device |  | 0..1 | Reference(QICoreDevice | DeviceMetric) | (Measurement) Device
referenceRange |  | 0..* | BackboneElement | Provides guide for interpretation
low |  | 0..1 | SimpleQuantity | Low Range, if relevant
high |  | 0..1 | SimpleQuantity | High Range, if relevant
derivedFrom |  | 0..* | Reference(QICoreObservation | QuestionnaireResponse) | Related measurements the observation is made from
component | S | 0..* | BackboneElement | Component results
code | S | 1..1 | CodeableConcept | Type of component observation (code / type)
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result
dataAbsentReason | S | 0..1 | CodeableConcept | Why the component result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc.
referenceRange |  | 0..* |  | Provides guide for interpretation of component result
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | I | 0..* | Observation | Measurements and simple assertions
id | Σ | 0..1 | string | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
observation-bodyPosition |  | 0..1 | CodeableConcept | The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
observation-delta |  | 0..1 | CodeableConcept | Qualitative change or trend in the measurement URL: http://hl7.org/fhir/StructureDefinition/observation-delta
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
subject | S Σ | 1..1 | Reference(QICorePatient | QICoreDevice | QICoreLocation) | Who and/or what the observation is about
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | S Σ | 0..1 | Reference(QICoreEncounter) | Healthcare event during which this observation is made
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | S Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(QICorePractitioner | QICoreOrganization | QICorePatient | QICoreRelatedPerson) | Who is responsible for the observation
value[x] | S Σ I | 0..1 |  | Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note |  | 0..* | Annotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen | S | 0..1 | Reference(QICoreSpecimen) | Specimen used for this observation
device |  | 0..1 | Reference(QICoreDevice | DeviceMetric) | (Measurement) Device
referenceRange | I | 0..* | BackboneElement | Provides guide for interpretation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | I | 0..1 | SimpleQuantity | Low Range, if relevant
high | I | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(QICoreObservation | QuestionnaireResponse) | Related measurements the observation is made from
component | S Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | S Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | S I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | I | 0..* | Observation | Measurements and simple assertions
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
subject | Σ | 1..1 | Reference(QICorePatient | QICoreDevice | QICoreLocation) | Who and/or what the observation is about
encounter | Σ | 0..1 | Reference(QICoreEncounter) | Healthcare event during which this observation is made
effective[x] | Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | Σ | 0..1 | instant | Date/Time this version was made available
value[x] | Σ I | 0..1 |  | Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(QICoreSpecimen) | Specimen used for this observation
component | Σ | 0..* | BackboneElement | Component results
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Documentation for this format

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 17 elements

Structures

This structure refers to these other structures:

- QICorePatient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICoreDevice (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device)
- QICoreLocation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location)
- QICoreEncounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)
- QICorePractitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICoreOrganization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
- QICoreRelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
- QICoreSpecimen (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-specimen)
- QICoreObservation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
- http://hl7.org/fhir/StructureDefinition/observation-delta

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
observation-bodyPosition |  | 0..1 | CodeableConcept | The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition Binding: Body Position (preferred): SNOMED CT code system values descending from the following:'body position finding' 9851009
observation-delta |  | 0..1 | CodeableConcept | Qualitative change or trend in the measurement URL: http://hl7.org/fhir/StructureDefinition/observation-delta Binding: QICore Observation Delta Value Set Definition (example): Code system values for Observation Delta Value Set
basedOn |  | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
status | S | 1..1 | code | registered | preliminary | final | amended +
category | S | 1..* | CodeableConcept | Classification of type of observation
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
subject | S | 1..1 | Reference(QICorePatient | QICoreDevice | QICoreLocation) | Who and/or what the observation is about
encounter | S | 0..1 | Reference(QICoreEncounter) | Healthcare event during which this observation is made
effective[x] | S | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation
issued | S | 0..1 | instant | Date/Time this version was made available
performer |  | 0..* | Reference(QICorePractitioner | QICoreOrganization | QICorePatient | QICoreRelatedPerson) | Who is responsible for the observation
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
dataAbsentReason |  | 0..1 | CodeableConcept | Why the result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc.
bodySite | S | 0..1 | CodeableConcept | Observed body part
method | S | 0..1 | CodeableConcept | How it was done
specimen | S | 0..1 | Reference(QICoreSpecimen) | Specimen used for this observation
device |  | 0..1 | Reference(QICoreDevice | DeviceMetric) | (Measurement) Device
referenceRange |  | 0..* | BackboneElement | Provides guide for interpretation
low |  | 0..1 | SimpleQuantity | Low Range, if relevant
high |  | 0..1 | SimpleQuantity | High Range, if relevant
derivedFrom |  | 0..* | Reference(QICoreObservation | QuestionnaireResponse) | Related measurements the observation is made from
component | S | 0..* | BackboneElement | Component results
code | S | 1..1 | CodeableConcept | Type of component observation (code / type)
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result
dataAbsentReason | S | 0..1 | CodeableConcept | Why the component result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc.
referenceRange |  | 0..* |  | Provides guide for interpretation of component result
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | I | 0..* | Observation | Measurements and simple assertions
id | Σ | 0..1 | string | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
observation-bodyPosition |  | 0..1 | CodeableConcept | The body position during the observation URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
observation-delta |  | 0..1 | CodeableConcept | Qualitative change or trend in the measurement URL: http://hl7.org/fhir/StructureDefinition/observation-delta
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
subject | S Σ | 1..1 | Reference(QICorePatient | QICoreDevice | QICoreLocation) | Who and/or what the observation is about
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | S Σ | 0..1 | Reference(QICoreEncounter) | Healthcare event during which this observation is made
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | S Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(QICorePractitioner | QICoreOrganization | QICorePatient | QICoreRelatedPerson) | Who is responsible for the observation
value[x] | S Σ I | 0..1 |  | Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note |  | 0..* | Annotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen | S | 0..1 | Reference(QICoreSpecimen) | Specimen used for this observation
device |  | 0..1 | Reference(QICoreDevice | DeviceMetric) | (Measurement) Device
referenceRange | I | 0..* | BackboneElement | Provides guide for interpretation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | I | 0..1 | SimpleQuantity | Low Range, if relevant
high | I | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(QICoreObservation | QuestionnaireResponse) | Related measurements the observation is made from
component | S Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | S Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | S I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.language | preferred | CommonLanguages Max Binding: AllLanguages
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | preferred | LOINCCodes
Observation.value[x] | preferred | USCoreObservationValueCodes
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretationCodes
Observation.bodySite | example | SNOMEDCTBodyStructures
Observation.method | example | ObservationMethods
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes
Observation.component.code | example | LOINCCodes
Observation.component.dataAbsentReason | extensible | DataAbsentReason
Observation.component.interpretation | extensible | ObservationInterpretationCodes

#### Constraints

Id | Grade | Path | Details | Requirements
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Observation | 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 | error | Observation | 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 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | Best Practice | Observation | A resource should have narrative for robust management : text.`div`.exists() |
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty() |
obs-7 | error | Observation | 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() |
ele-1 | error | Observation.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.extension:bodyPosition | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.extension:bodyPosition | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.extension:delta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.extension:delta | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.basedOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.partOf | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.focus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.effective[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.issued | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.performer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.value[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.dataAbsentReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.interpretation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.bodySite | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.method | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.specimen | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.device | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.referenceRange | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text : low.exists() or high.exists() or text.exists() |
ele-1 | error | Observation.referenceRange.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.referenceRange.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.referenceRange.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.referenceRange.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.referenceRange.low | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.referenceRange.high | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.referenceRange.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.referenceRange.appliesTo | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.referenceRange.age | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.referenceRange.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.hasMember | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.derivedFrom | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.component | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.component.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.component.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.component.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Observation.component.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Observation.component.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.component.value[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.component.dataAbsentReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.component.interpretation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Observation.component.referenceRange | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |