Point-of-Care Device Implementation Guide
current - CI Build

Point-of-Care Device Implementation Guide, published by HL7 International - Devices Work Group. This is not an authorized publication; it is the continuous build for version current). 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: Numeric Observation profile

Official URL: http://hl7.org/fhir/uv/pocd/StructureDefinition/NumericObservation | Version: current
Draft as of 2022-01-21 | Computable Name: NumericObservation

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

### Scope and Usage

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

Usage:

- Examples for this Resource Profile: Observation/HeartRateNumericObservation

### Formal Views of Profile Content

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

- Differential Table
- Key Elements Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions pocd-obs-1: If there is no value a dataAbsentReason shall be present
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
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding |  | 0..* | Coding | Code defined by a terminology system
system |  | 0..1 | uri | Identity of the terminology system
version |  | 0..1 | string | Version of the system - if relevant
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:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime |  | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod |  | 0..1 | Period | Clinically relevant time/time-period for observation
start |  | 0..1 | dateTime | Starting time with inclusive boundary
end |  | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
Slices for value[x] | S C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueRatio |  |  | Ratio |
value[x]:valueQuantity |  | 0..1 | Quantity | Actual 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
value[x]:valueRatio |  | 0..1 | Ratio | Actual result
numerator |  | 0..1 | Quantity | Numerator value
value |  | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
denominator |  | 0..1 | Quantity | Denominator value
value |  | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Observation interpretation codes (extensible)
bodySite | S | 0..1 | CodeableConcept | Observed body part
coding |  | 0..* | Coding | Code defined by a terminology system
system |  | 0..1 | uri | Identity of the terminology system
version |  | 0..1 | string | Version of the system - if relevant
code |  | 0..1 | code | Symbol in syntax defined by the system
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
referenceRange | S | 0..* | BackboneElement | Provides guide for interpretation
low |  | 0..1 | SimpleQuantity | Low Range, if relevant
high |  | 0..1 | SimpleQuantity | High Range, if relevant
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet
Observation.code | extensible | MdcMetric
Observation.interpretation | extensible | ObservationInterpretation

#### Constraints

Id | Grade | Path(s) | Details | Requirements
pocd-obs-1 | error | Observation | If there is no value a dataAbsentReason shall be present : value.exists() or dataAbsentReason.exists() |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions pocd-obs-1: If there is no value a dataAbsentReason shall be present
meta | Σ | 0..1 | Meta | Metadata about the resource
security | S Σ | 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
status | ?!S Σ | 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 | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
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
subject | S Σ | 1..1 | Reference(Patient | MDS Device profile) | Who and/or what the observation is about
Slices for effective[x] | S Σ | 1..1 |  | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | Σ | 0..1 | Period | Clinically relevant time/time-period for observation
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueRatio |  |  | Ratio |
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual 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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code | Σ | 0..1 | code | Coded form of the unit
value[x]:valueRatio | Σ C | 0..1 | Ratio | Actual result
numerator | Σ | 0..1 | Quantity | Numerator value
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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
denominator | Σ | 0..1 | Quantity | Denominator value
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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Observation interpretation codes (extensible)
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
coding | Σ | 0..* | Coding | Code defined by a terminology system
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
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.meta.security | extensible | All Security Labels
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | extensible | MdcMetric
Observation.value[x]:valueQuantity.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.numerator.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.denominator.comparator | required | QuantityComparator
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretation
Observation.bodySite | example | SNOMEDCTBodyStructures

#### Constraints

Id | Grade | Path(s) | Details | Requirements
pocd-obs-1 | error | Observation | If there is no value a dataAbsentReason shall be present : value.exists() or dataAbsentReason.exists() |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions pocd-obs-1: If there is no value a dataAbsentReason shall be present
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 | S Σ | 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 Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!S Σ | 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 | S Σ | 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 | S Σ | 1..1 | Reference(Patient | MDS Device profile) | Who and/or what the observation is about
focus | Σ TU | 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] | S Σ | 1..1 |  | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | Σ | 0..1 | Period | Clinically relevant time/time-period for observation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueRatio |  |  | Ratio |
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual 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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code | Σ | 0..1 | code | Coded form of the unit
value[x]:valueRatio | Σ C | 0..1 | Ratio | Actual 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
numerator | Σ | 0..1 | Quantity | Numerator value
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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code | Σ | 0..1 | code | Coded form of the unit
denominator | Σ | 0..1 | Quantity | Denominator value
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 | Σ C | 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 | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Observation interpretation codes (extensible)
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.
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
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 | S C | 0..* | BackboneElement | Provides guide for interpretation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.meta.security | extensible | All Security Labels
Observation.meta.tag | example | CommonTags
Observation.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | extensible | MdcMetric
Observation.value[x]:valueQuantity.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.numerator.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.denominator.comparator | required | QuantityComparator
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretation
Observation.bodySite | example | SNOMEDCTBodyStructures
Observation.method | example | ObservationMethods
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes
Observation.component.code | example | LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason | extensible | DataAbsentReason
Observation.component.interpretation | extensible | ObservationInterpretationCodes

This structure is derived from Observation

The profile defines the following rules:

- `Observation.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 an additional LOINC code.
- `Observation.subject` shall be present and refer to a Patient resource or MDS Device resource.
- Either `Observation.effectiveDateTime` or `Observation.effectivePeriod` shall be present.
- Either `Observation.valueQuantity` or `Observation.valueRatio` or, if there is no value, `Observation.dataAbsentReason` shall be present. Values shall have a UCUM unit code.
- `Observation.interpretation` coding includes measurement status.
- `Observation.device` shall be present and refer to the Numeric DeviceMetric resource which this observation belongs to.

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions pocd-obs-1: If there is no value a dataAbsentReason shall be present
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
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding |  | 0..* | Coding | Code defined by a terminology system
system |  | 0..1 | uri | Identity of the terminology system
version |  | 0..1 | string | Version of the system - if relevant
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:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime |  | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod |  | 0..1 | Period | Clinically relevant time/time-period for observation
start |  | 0..1 | dateTime | Starting time with inclusive boundary
end |  | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
Slices for value[x] | S C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueRatio |  |  | Ratio |
value[x]:valueQuantity |  | 0..1 | Quantity | Actual 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
value[x]:valueRatio |  | 0..1 | Ratio | Actual result
numerator |  | 0..1 | Quantity | Numerator value
value |  | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
denominator |  | 0..1 | Quantity | Denominator value
value |  | 1..1 | decimal | Numerical value (with implicit precision)
system |  | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Observation interpretation codes (extensible)
bodySite | S | 0..1 | CodeableConcept | Observed body part
coding |  | 0..* | Coding | Code defined by a terminology system
system |  | 0..1 | uri | Identity of the terminology system
version |  | 0..1 | string | Version of the system - if relevant
code |  | 0..1 | code | Symbol in syntax defined by the system
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
referenceRange | S | 0..* | BackboneElement | Provides guide for interpretation
low |  | 0..1 | SimpleQuantity | Low Range, if relevant
high |  | 0..1 | SimpleQuantity | High Range, if relevant
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet
Observation.code | extensible | MdcMetric
Observation.interpretation | extensible | ObservationInterpretation

#### Constraints

Id | Grade | Path(s) | Details | Requirements
pocd-obs-1 | error | Observation | If there is no value a dataAbsentReason shall be present : value.exists() or dataAbsentReason.exists() |

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions pocd-obs-1: If there is no value a dataAbsentReason shall be present
meta | Σ | 0..1 | Meta | Metadata about the resource
security | S Σ | 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
status | ?!S Σ | 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 | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
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
subject | S Σ | 1..1 | Reference(Patient | MDS Device profile) | Who and/or what the observation is about
Slices for effective[x] | S Σ | 1..1 |  | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | Σ | 0..1 | Period | Clinically relevant time/time-period for observation
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueRatio |  |  | Ratio |
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual 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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code | Σ | 0..1 | code | Coded form of the unit
value[x]:valueRatio | Σ C | 0..1 | Ratio | Actual result
numerator | Σ | 0..1 | Quantity | Numerator value
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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
denominator | Σ | 0..1 | Quantity | Denominator value
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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Observation interpretation codes (extensible)
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
coding | Σ | 0..* | Coding | Code defined by a terminology system
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
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.meta.security | extensible | All Security Labels
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | extensible | MdcMetric
Observation.value[x]:valueQuantity.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.numerator.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.denominator.comparator | required | QuantityComparator
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretation
Observation.bodySite | example | SNOMEDCTBodyStructures

#### Constraints

Id | Grade | Path(s) | Details | Requirements
pocd-obs-1 | error | Observation | If there is no value a dataAbsentReason shall be present : value.exists() or dataAbsentReason.exists() |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions pocd-obs-1: If there is no value a dataAbsentReason shall be present
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 | S Σ | 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 Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!S Σ | 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 | S Σ | 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 | S Σ | 1..1 | Reference(Patient | MDS Device profile) | Who and/or what the observation is about
focus | Σ TU | 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] | S Σ | 1..1 |  | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | Σ | 0..1 | Period | Clinically relevant time/time-period for observation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed by type:$this
valueQuantity |  |  | Quantity |
valueRatio |  |  | Ratio |
value[x]:valueQuantity | Σ C | 0..1 | Quantity | Actual 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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code | Σ | 0..1 | code | Coded form of the unit
value[x]:valueRatio | Σ C | 0..1 | Ratio | Actual 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
numerator | Σ | 0..1 | Quantity | Numerator value
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 | Σ C | 0..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code | Σ | 0..1 | code | Coded form of the unit
denominator | Σ | 0..1 | Quantity | Denominator value
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 | Σ C | 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 | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: Observation interpretation codes (extensible)
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.
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
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 | S C | 0..* | BackboneElement | Provides guide for interpretation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.meta.security | extensible | All Security Labels
Observation.meta.tag | example | CommonTags
Observation.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | extensible | MdcMetric
Observation.value[x]:valueQuantity.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.numerator.comparator | required | QuantityComparator
Observation.value[x]:valueRatio.denominator.comparator | required | QuantityComparator
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretation
Observation.bodySite | example | SNOMEDCTBodyStructures
Observation.method | example | ObservationMethods
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes
Observation.component.code | example | LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason | extensible | DataAbsentReason
Observation.component.interpretation | extensible | ObservationInterpretationCodes

This structure is derived from Observation

The profile defines the following rules:

- `Observation.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 an additional LOINC code.
- `Observation.subject` shall be present and refer to a Patient resource or MDS Device resource.
- Either `Observation.effectiveDateTime` or `Observation.effectivePeriod` shall be present.
- Either `Observation.valueQuantity` or `Observation.valueRatio` or, if there is no value, `Observation.dataAbsentReason` shall be present. Values shall have a UCUM unit code.
- `Observation.interpretation` coding includes measurement status.
- `Observation.device` shall be present and refer to the Numeric DeviceMetric resource which this observation belongs to.

Other representations of profile: CSV, Excel, Schematron