SDOH Clinical Care
​3.0.0-draft - United States of America flag

SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 3.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions

Resource Profile: SDOHCC Observation Gender Identity

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationGenderIdentity Version: 3.0.0-draft
Standards status: Trial-use Active as of 2025-10-27 Maturity Level: 2 Computable Name: SDOHCCObservationGenderIdentity

Profile for gender identity observations which are based on a person’s inner sense of being a girl/woman/female/feminine, boy/man/male/masculine, nonbinary, something else, or having no gender. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* SDOHCCObservationPersonalCharacteristic Profile for observations about gender identity.
Constraints: obs-6, obs-7, SDOH-Obs-1, SDOH-Obs-2, SDOH-Obs-3
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 76691-5
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus ΣC 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] SΣC 1..1 CodeableConcept S Actual result
Binding: GenderIdentity (20240215) . (preferred): Codes for self-identified gender, plus unknown and other
.... Slices for extension Content/Rules for all slices
..... extension:DataAbsentReasonMasked 0..1 (Complex) unknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
...... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Fixed Value: masked
.... coding SΣ 0..* Coding Code defined by a terminology system
... method S 1..1 CodeableConcept How it was done
Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required SDOHCC ValueSet Observation Status 📦3.0.0-draft This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍7.0.0 US Core v7.0
Observation.category:PersonalCharacteristic Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base preferred LOINC Codes 📦4.0.1 FHIR Std.
Observation.value[x] Base preferred Gender Identity . 📍20240215 VSAC v0.21
Observation.value[x].​extension:DataAbsentReasonMasked.​value[x] Base required DataAbsentReason 📍4.0.1 FHIR Std.
Observation.method Base extensible SDOHCC ValueSet Observation Method 📦3.0.0-draft This IG

Constraints

Id Grade Path(s) Description Expression
SDOH-Obs-1 error Observation Either subject or extension-Observation.subject must exist but not both subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2 error Observation Focus is only allowed if subject is present focus.exists() implies subject.exists()
SDOH-Obs-3 error Observation Must have either performer or derivedFrom performer.exists() or derivedFrom.exists()
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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* SDOHCCObservationPersonalCharacteristic Profile for observations about gender identity.
... code 1..1 CodeableConcept Type of observation (code / type)
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 76691-5
... value[x] 1..1 CodeableConcept Actual result
Binding: GenderIdentity (20240215) . (preferred): Codes for self-identified gender, plus unknown and other
.... Slices for extension Content/Rules for all slices
..... extension:DataAbsentReasonMasked 0..1 (Complex) unknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
...... value[x] S 1..1 code Value of extension
Fixed Value: masked
.... coding S 0..* Coding Code defined by a terminology system
... dataAbsentReason 0..0

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x] Base preferred Gender Identity . 📍20240215 VSAC v0.21
Observation.method Base extensible SDOHCC ValueSet Observation Method 📦3.0.0-draft This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* SDOHCCObservationPersonalCharacteristic Profile for observations about gender identity.
Constraints: obs-6, obs-7, SDOH-Obs-1, SDOH-Obs-2, SDOH-Obs-3
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... 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 ?!SΣ 1..1 code final | corrected | entered-in-error | unknown
Binding: SDOHCC ValueSet Observation Status (required)
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 76691-5
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus ΣC 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] SΣC 1..1 CodeableConcept S Actual result
Binding: GenderIdentity (20240215) . (preferred): Codes for self-identified gender, plus unknown and other
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:DataAbsentReasonMasked 0..1 (Complex) unknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
...... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Fixed Value: masked
.... coding SΣ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... note 0..* Annotation Comments about the observation
... method S 1..1 CodeableConcept How it was done
Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Observation.status Base required SDOHCC ValueSet Observation Status 📦3.0.0-draft This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍7.0.0 US Core v7.0
Observation.category:PersonalCharacteristic Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base preferred LOINC Codes 📦4.0.1 FHIR Std.
Observation.value[x] Base preferred Gender Identity . 📍20240215 VSAC v0.21
Observation.value[x].​extension:DataAbsentReasonMasked.​value[x] Base required DataAbsentReason 📍4.0.1 FHIR Std.
Observation.method Base extensible SDOHCC ValueSet Observation Method 📦3.0.0-draft This IG
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📦4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📦4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📦4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
SDOH-Obs-1 error Observation Either subject or extension-Observation.subject must exist but not both subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2 error Observation Focus is only allowed if subject is present focus.exists() implies subject.exists()
SDOH-Obs-3 error Observation Must have either performer or derivedFrom performer.exists() or derivedFrom.exists()
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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()

Summary

Mandatory: 2 elements
Must-Support: 3 elements
Fixed: 1 element
Prohibited: 1 element

Extensions

This structure refers to these extensions:

Maturity: 2

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* SDOHCCObservationPersonalCharacteristic Profile for observations about gender identity.
Constraints: obs-6, obs-7, SDOH-Obs-1, SDOH-Obs-2, SDOH-Obs-3
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 76691-5
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus ΣC 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] SΣC 1..1 CodeableConcept S Actual result
Binding: GenderIdentity (20240215) . (preferred): Codes for self-identified gender, plus unknown and other
.... Slices for extension Content/Rules for all slices
..... extension:DataAbsentReasonMasked 0..1 (Complex) unknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
...... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Fixed Value: masked
.... coding SΣ 0..* Coding Code defined by a terminology system
... method S 1..1 CodeableConcept How it was done
Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required SDOHCC ValueSet Observation Status 📦3.0.0-draft This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍7.0.0 US Core v7.0
Observation.category:PersonalCharacteristic Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base preferred LOINC Codes 📦4.0.1 FHIR Std.
Observation.value[x] Base preferred Gender Identity . 📍20240215 VSAC v0.21
Observation.value[x].​extension:DataAbsentReasonMasked.​value[x] Base required DataAbsentReason 📍4.0.1 FHIR Std.
Observation.method Base extensible SDOHCC ValueSet Observation Method 📦3.0.0-draft This IG

Constraints

Id Grade Path(s) Description Expression
SDOH-Obs-1 error Observation Either subject or extension-Observation.subject must exist but not both subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2 error Observation Focus is only allowed if subject is present focus.exists() implies subject.exists()
SDOH-Obs-3 error Observation Must have either performer or derivedFrom performer.exists() or derivedFrom.exists()
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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* SDOHCCObservationPersonalCharacteristic Profile for observations about gender identity.
... code 1..1 CodeableConcept Type of observation (code / type)
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 76691-5
... value[x] 1..1 CodeableConcept Actual result
Binding: GenderIdentity (20240215) . (preferred): Codes for self-identified gender, plus unknown and other
.... Slices for extension Content/Rules for all slices
..... extension:DataAbsentReasonMasked 0..1 (Complex) unknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
...... value[x] S 1..1 code Value of extension
Fixed Value: masked
.... coding S 0..* Coding Code defined by a terminology system
... dataAbsentReason 0..0

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x] Base preferred Gender Identity . 📍20240215 VSAC v0.21
Observation.method Base extensible SDOHCC ValueSet Observation Method 📦3.0.0-draft This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* SDOHCCObservationPersonalCharacteristic Profile for observations about gender identity.
Constraints: obs-6, obs-7, SDOH-Obs-1, SDOH-Obs-2, SDOH-Obs-3
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... 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 ?!SΣ 1..1 code final | corrected | entered-in-error | unknown
Binding: SDOHCC ValueSet Observation Status (required)
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 76691-5
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus ΣC 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] SΣC 1..1 CodeableConcept S Actual result
Binding: GenderIdentity (20240215) . (preferred): Codes for self-identified gender, plus unknown and other
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:DataAbsentReasonMasked 0..1 (Complex) unknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
...... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Fixed Value: masked
.... coding SΣ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... note 0..* Annotation Comments about the observation
... method S 1..1 CodeableConcept How it was done
Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Observation.status Base required SDOHCC ValueSet Observation Status 📦3.0.0-draft This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍7.0.0 US Core v7.0
Observation.category:PersonalCharacteristic Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.code Base preferred LOINC Codes 📦4.0.1 FHIR Std.
Observation.value[x] Base preferred Gender Identity . 📍20240215 VSAC v0.21
Observation.value[x].​extension:DataAbsentReasonMasked.​value[x] Base required DataAbsentReason 📍4.0.1 FHIR Std.
Observation.method Base extensible SDOHCC ValueSet Observation Method 📦3.0.0-draft This IG
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📦4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📦4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📦4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
SDOH-Obs-1 error Observation Either subject or extension-Observation.subject must exist but not both subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2 error Observation Focus is only allowed if subject is present focus.exists() implies subject.exists()
SDOH-Obs-3 error Observation Must have either performer or derivedFrom performer.exists() or derivedFrom.exists()
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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()

Summary

Mandatory: 2 elements
Must-Support: 3 elements
Fixed: 1 element
Prohibited: 1 element

Extensions

This structure refers to these extensions:

Maturity: 2

 

Other representations of profile: CSV, Excel, Schematron