Point-of-Care Device Implementation Guide
1.0.0 - STU 1

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 1.0.0 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: 1.0.0
Standards status: Trial-use | 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:

- Examples for this Profile: Observation/NBPCompoundNumericObservation
- CapabilityStatements using this Profile: Server capability requirements

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.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
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
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:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | S Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | S Σ | 0..1 | Period | Clinically relevant time/time-period for observation
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
component | Σ C | 1..* | BackboneElement | Component results Constraints: pocd-obs-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
code | Σ | 0..1 | code | Symbol in syntax defined by the system
Slices for value[x] | S Σ C | 0..1 | Quantity | Actual component result Slice: Unordered, Closed by type:$this
value[x]:valueQuantity | S Σ | 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 | 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 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
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 | 📦1.0.0 | This IG
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | extensible | MDC Metric nomenclature | 📦1.0.0 | 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 | 📦1.0.0 | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
code | S | 1..1 | CodeableConcept | Type of 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
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:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | S | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | S | 0..1 | Period | Clinically relevant time/time-period for observation
start |  | 0..1 | dateTime | Starting time with inclusive boundary
end |  | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
value[x] |  | 0..0 |  | Actual result
bodySite | S | 0..1 | CodeableConcept | Observed body part
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
component | C | 1..* | BackboneElement | Component results Constraints: pocd-obs-1
code | S | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding |  | 0..* | Coding | Code defined by a terminology system
code |  | 0..1 | code | Symbol in syntax defined by the system
Slices for value[x] | S C | 0..1 | Quantity | Actual component result Slice: Unordered, Closed by type:$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 | S C | 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
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.code | Base | extensible | MDC Metric nomenclature | 📦1.0.0 | This IG
Observation.component.​code | Base | extensible | MDC Metric nomenclature | 📦1.0.0 | This IG
Observation.component.​interpretation | Base | extensible | Observation interpretation codes | 📦1.0.0 | 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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 | 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 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 | ?!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 | 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 | S Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | S 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
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 | Σ C | 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 | S Σ | 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] | S Σ C | 0..1 | Quantity | Actual component result Slice: Unordered, Closed by type:$this
value[x]:valueQuantity | S Σ | 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 | 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 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
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 | 📦1.0.0 | 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 | 📦1.0.0 | 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 | 📦1.0.0 | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
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
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:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | S Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | S Σ | 0..1 | Period | Clinically relevant time/time-period for observation
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
component | Σ C | 1..* | BackboneElement | Component results Constraints: pocd-obs-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
code | Σ | 0..1 | code | Symbol in syntax defined by the system
Slices for value[x] | S Σ C | 0..1 | Quantity | Actual component result Slice: Unordered, Closed by type:$this
value[x]:valueQuantity | S Σ | 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 | 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 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
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 | 📦1.0.0 | This IG
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | extensible | MDC Metric nomenclature | 📦1.0.0 | 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 | 📦1.0.0 | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
code | S | 1..1 | CodeableConcept | Type of 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
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:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | S | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | S | 0..1 | Period | Clinically relevant time/time-period for observation
start |  | 0..1 | dateTime | Starting time with inclusive boundary
end |  | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
value[x] |  | 0..0 |  | Actual result
bodySite | S | 0..1 | CodeableConcept | Observed body part
device | S | 1..1 | Reference(Numeric DeviceMetric profile) | (Measurement) Device
component | C | 1..* | BackboneElement | Component results Constraints: pocd-obs-1
code | S | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: MDC Metric nomenclature (extensible)
coding |  | 0..* | Coding | Code defined by a terminology system
code |  | 0..1 | code | Symbol in syntax defined by the system
Slices for value[x] | S C | 0..1 | Quantity | Actual component result Slice: Unordered, Closed by type:$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 | S C | 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
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.code | Base | extensible | MDC Metric nomenclature | 📦1.0.0 | This IG
Observation.component.​code | Base | extensible | MDC Metric nomenclature | 📦1.0.0 | This IG
Observation.component.​interpretation | Base | extensible | Observation interpretation codes | 📦1.0.0 | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 | 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 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 | ?!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 | 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 | S Σ | 0..1 | dateTime | Clinically relevant time/time-period for observation
effective[x]:effectivePeriod | S 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
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 | Σ C | 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 | S Σ | 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] | S Σ C | 0..1 | Quantity | Actual component result Slice: Unordered, Closed by type:$this
value[x]:valueQuantity | S Σ | 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 | 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 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
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 | 📦1.0.0 | 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 | 📦1.0.0 | 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 | 📦1.0.0 | 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