Point-of-Care Device Implementation Guide
0.4.0 - CI Build International flag

Point-of-Care Device Implementation Guide, published by HL7 International / Devices. This guide is not an authorized publication; it is the continuous build for version 0.4.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/uv-pocd/ and changes regularly. See the Directory of published versions

Resource Profile: Compound Numeric Observation profile

Official URL: http://hl7.org/fhir/uv/pocd/StructureDefinition/CompoundNumericObservation Version: 0.4.0
Standards status: Draft Maturity Level: 2 Computable Name: CompoundNumericObservation

StructureDefinition for Observation resources that represent numerical measurements, calculations, or settings with multiple components.

Scope and Usage

This profile sets minimum expectations for the Observation resource that represents numerical measurement, calculation, or setting with multiple components.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... meta Σ 0..1 Meta Metadata about the resource
.... security SΣ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category S 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MDC Metric nomenclature (extensible)
.... coding Σ 0..* Coding Code defined by a terminology system
..... code Σ 0..1 code Symbol in syntax defined by the system
... subject SΣ 1..1 Reference(Patient | MDS Device profile) Who and/or what the observation is about
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime SΣ 0..1 dateTime Clinically relevant time/time-period for observation
.... effective[x]:effectivePeriod SΣ 0..1 Period Clinically relevant time/time-period for observation
..... start ΣC 0..1 dateTime Starting time with inclusive boundary
..... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... device S 1..1 Reference(Numeric DeviceMetric profile) (Measurement) Device
... component ΣC 1..* BackboneElement Component results
Constraints: pocd-obs-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: MDC Metric nomenclature (extensible)
..... coding Σ 0..* Coding Code defined by a terminology system
...... code Σ 0..1 code Symbol in syntax defined by the system
.... Slices for value[x] SΣC 0..1 Quantity Actual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ 0..1 Quantity Actual component result
...... value Σ 1..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
...... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 0..1 code Coded form of the unit
.... dataAbsentReason SC 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: Observation interpretation codes (extensible)
.... referenceRange S 0..* BackboneElement Provides guide for interpretation of component result
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
..... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.component.​code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation interpretation codes 📦0.4.0 This IG

Constraints

Id Grade Path(s) Description Expression
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()
pocd-obs-1 error Observation.component If there is no value a dataAbsentReason shall be present value.exists() or dataAbsentReason.exists()

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... meta 0..1 Meta Metadata about the resource
.... security S 0..* Coding Security Labels applied to this resource
... status S 1..1 code registered | preliminary | final | amended +
... category S 0..* CodeableConcept Classification of type of observation
.... coding 0..* Coding Code defined by a terminology system
..... code 0..1 code Symbol in syntax defined by the system
... subject S 1..1 Reference(Patient | MDS Device profile) Who and/or what the observation is about
... Slices for effective[x] S 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime S 0..1 dateTime Clinically relevant time/time-period for observation
.... effective[x]:effectivePeriod S 0..1 Period Clinically relevant time/time-period for observation
..... start 0..1 dateTime Starting time with inclusive boundary
..... end 0..1 dateTime End time with inclusive boundary, if not ongoing
... value[x] 0..0 Actual result
... bodySite S 0..1 CodeableConcept Observed body part
... device S 1..1 Reference(Numeric DeviceMetric profile) (Measurement) Device
... component C 1..* BackboneElement Component results
Constraints: pocd-obs-1
.... code S 1..1 CodeableConcept Type of component observation (code / type)
Binding: MDC Metric nomenclature (extensible)
..... coding 0..* Coding Code defined by a terminology system
...... code 0..1 code Symbol in syntax defined by the system
.... Slices for value[x] SC 0..1 Quantity Actual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity S 0..1 Quantity Actual component result
...... value 1..1 decimal Numerical value (with implicit precision)
...... system 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code 0..1 code Coded form of the unit
.... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
.... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: Observation interpretation codes (extensible)
.... referenceRange S 0..* BackboneElement Provides guide for interpretation of component result
..... low 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
..... high 0..1 SimpleQuantity(4.0.1) High Range, if relevant

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​interpretation Base extensible Observation interpretation codes 📦0.4.0 This IG

Constraints

Id Grade Path(s) Description Expression
pocd-obs-1 error Observation.component If there is no value a dataAbsentReason shall be present value.exists() or dataAbsentReason.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security SΣ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... 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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category S 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MDC Metric nomenclature (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 0..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 0..1 code Symbol in syntax defined by the system
..... display Σ 0..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Patient | MDS Device profile) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime SΣ 0..1 dateTime Clinically relevant time/time-period for observation
.... effective[x]:effectivePeriod SΣ 0..1 Period Clinically relevant time/time-period for observation
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... start ΣC 0..1 dateTime Starting time with inclusive boundary
..... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite S 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(Specimen) Specimen used for this observation
... device S 1..1 Reference(Numeric DeviceMetric profile) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component ΣC 1..* BackboneElement Component results
Constraints: pocd-obs-1
.... 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 SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: MDC Metric nomenclature (extensible)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... Slices for value[x] SΣC 0..1 Quantity Actual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ 0..1 Quantity Actual component result
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... value Σ 1..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
...... unit Σ 0..1 string Unit representation
...... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 0..1 code Coded form of the unit
.... dataAbsentReason SC 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: Observation interpretation codes (extensible)
.... referenceRange S 0..* BackboneElement Provides guide for interpretation of component result
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
..... high C 0..1 SimpleQuantity(4.0.1) 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Observation.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
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 extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation interpretation codes 📦0.4.0 This IG
Observation.component.​referenceRange.type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.component.​referenceRange.appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.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()
pocd-obs-1 error Observation.component If there is no value a dataAbsentReason shall be present value.exists() or dataAbsentReason.exists()

This structure is derived from Observation

The profile defines the following rules:

  • Observation.code and Observation.component.code shall have a coding from the ISO/IEEE 11073 MDC Metric nomenclature if there is an appropriate code available. Depending on the type of measurement, the Vital Signs profiles may require additional LOINC codes.
  • Observation.subject shall be present and refer to a Patient resource or MDS Device resource.
  • Either Observation.effectiveDateTime or Observation.effectivePeriod shall be present.
  • Observation.value[x] must not be present.
  • Observation.device shall be present and refer to the Numeric DeviceMetric resource which this observation belongs to.
  • For each component, Observation.component.valueQuantity or, if there is no value, Observation.component.dataAbsentReason shall be present. Values shall have a UCUM unit code.
  • Observation.component.interpretation coding includes measurement status.

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... meta Σ 0..1 Meta Metadata about the resource
.... security SΣ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category S 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MDC Metric nomenclature (extensible)
.... coding Σ 0..* Coding Code defined by a terminology system
..... code Σ 0..1 code Symbol in syntax defined by the system
... subject SΣ 1..1 Reference(Patient | MDS Device profile) Who and/or what the observation is about
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime SΣ 0..1 dateTime Clinically relevant time/time-period for observation
.... effective[x]:effectivePeriod SΣ 0..1 Period Clinically relevant time/time-period for observation
..... start ΣC 0..1 dateTime Starting time with inclusive boundary
..... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... bodySite S 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... device S 1..1 Reference(Numeric DeviceMetric profile) (Measurement) Device
... component ΣC 1..* BackboneElement Component results
Constraints: pocd-obs-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: MDC Metric nomenclature (extensible)
..... coding Σ 0..* Coding Code defined by a terminology system
...... code Σ 0..1 code Symbol in syntax defined by the system
.... Slices for value[x] SΣC 0..1 Quantity Actual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ 0..1 Quantity Actual component result
...... value Σ 1..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
...... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 0..1 code Coded form of the unit
.... dataAbsentReason SC 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: Observation interpretation codes (extensible)
.... referenceRange S 0..* BackboneElement Provides guide for interpretation of component result
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
..... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.component.​code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation interpretation codes 📦0.4.0 This IG

Constraints

Id Grade Path(s) Description Expression
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()
pocd-obs-1 error Observation.component If there is no value a dataAbsentReason shall be present value.exists() or dataAbsentReason.exists()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... meta 0..1 Meta Metadata about the resource
.... security S 0..* Coding Security Labels applied to this resource
... status S 1..1 code registered | preliminary | final | amended +
... category S 0..* CodeableConcept Classification of type of observation
.... coding 0..* Coding Code defined by a terminology system
..... code 0..1 code Symbol in syntax defined by the system
... subject S 1..1 Reference(Patient | MDS Device profile) Who and/or what the observation is about
... Slices for effective[x] S 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime S 0..1 dateTime Clinically relevant time/time-period for observation
.... effective[x]:effectivePeriod S 0..1 Period Clinically relevant time/time-period for observation
..... start 0..1 dateTime Starting time with inclusive boundary
..... end 0..1 dateTime End time with inclusive boundary, if not ongoing
... value[x] 0..0 Actual result
... bodySite S 0..1 CodeableConcept Observed body part
... device S 1..1 Reference(Numeric DeviceMetric profile) (Measurement) Device
... component C 1..* BackboneElement Component results
Constraints: pocd-obs-1
.... code S 1..1 CodeableConcept Type of component observation (code / type)
Binding: MDC Metric nomenclature (extensible)
..... coding 0..* Coding Code defined by a terminology system
...... code 0..1 code Symbol in syntax defined by the system
.... Slices for value[x] SC 0..1 Quantity Actual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity S 0..1 Quantity Actual component result
...... value 1..1 decimal Numerical value (with implicit precision)
...... system 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code 0..1 code Coded form of the unit
.... dataAbsentReason SC 0..1 CodeableConcept Why the component result is missing
.... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: Observation interpretation codes (extensible)
.... referenceRange S 0..* BackboneElement Provides guide for interpretation of component result
..... low 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
..... high 0..1 SimpleQuantity(4.0.1) High Range, if relevant

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​interpretation Base extensible Observation interpretation codes 📦0.4.0 This IG

Constraints

Id Grade Path(s) Description Expression
pocd-obs-1 error Observation.component If there is no value a dataAbsentReason shall be present value.exists() or dataAbsentReason.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security SΣ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... 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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category S 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MDC Metric nomenclature (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 0..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 0..1 code Symbol in syntax defined by the system
..... display Σ 0..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Patient | MDS Device profile) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... Slices for effective[x] SΣ 1..1 Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effective[x]:effectiveDateTime SΣ 0..1 dateTime Clinically relevant time/time-period for observation
.... effective[x]:effectivePeriod SΣ 0..1 Period Clinically relevant time/time-period for observation
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... start ΣC 0..1 dateTime Starting time with inclusive boundary
..... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite S 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(Specimen) Specimen used for this observation
... device S 1..1 Reference(Numeric DeviceMetric profile) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component ΣC 1..* BackboneElement Component results
Constraints: pocd-obs-1
.... 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 SΣ 1..1 CodeableConcept Type of component observation (code / type)
Binding: MDC Metric nomenclature (extensible)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... Slices for value[x] SΣC 0..1 Quantity Actual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ 0..1 Quantity Actual component result
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... value Σ 1..1 decimal Numerical value (with implicit precision)
...... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
...... unit Σ 0..1 string Unit representation
...... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
...... code Σ 0..1 code Coded form of the unit
.... dataAbsentReason SC 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: Observation interpretation codes (extensible)
.... referenceRange S 0..* BackboneElement Provides guide for interpretation of component result
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
..... high C 0..1 SimpleQuantity(4.0.1) 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Observation.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
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 extensible MDC Metric nomenclature 📦0.4.0 This IG
Observation.component.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation interpretation codes 📦0.4.0 This IG
Observation.component.​referenceRange.type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.component.​referenceRange.appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.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()
pocd-obs-1 error Observation.component If there is no value a dataAbsentReason shall be present value.exists() or dataAbsentReason.exists()

This structure is derived from Observation

The profile defines the following rules:

  • Observation.code and Observation.component.code shall have a coding from the ISO/IEEE 11073 MDC Metric nomenclature if there is an appropriate code available. Depending on the type of measurement, the Vital Signs profiles may require additional LOINC codes.
  • Observation.subject shall be present and refer to a Patient resource or MDS Device resource.
  • Either Observation.effectiveDateTime or Observation.effectivePeriod shall be present.
  • Observation.value[x] must not be present.
  • Observation.device shall be present and refer to the Numeric DeviceMetric resource which this observation belongs to.
  • For each component, Observation.component.valueQuantity or, if there is no value, Observation.component.dataAbsentReason shall be present. Values shall have a UCUM unit code.
  • Observation.component.interpretation coding includes measurement status.

 

Other representations of profile: CSV, Excel, Schematron