CH ELM (R4), published by Federal Office of Public Health FOPH. This guide is not an authorized publication; it is the continuous build for version 1.3.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/ch-elm/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
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Resource Profile: CH ELM Observation Results: Laboratory

This CH ELM base profile constrains the Observation resource for the purpose of laboratory test reports.

Usage:

• Derived from this Resource Profile: CH ELM Observation Results: Laboratory (strict)
• Use this Resource Profile: CH ELM Document: Laboratory Report
• Refer to this Resource Profile: CH ELM Composition: Laboratory Report and CH ELM DiagnosticReport: Laboratory Report

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 ChLabObservationResultsLaboratory

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory ch-elm-expecting-specimen-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs ch-elm-expecting-organism-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs ch-elm-interpretation-code-loinc: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet ch-elm-interpretation-code-snomedct: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet
status		1..1	code	registered | preliminary | final | amended + Required Pattern: final
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Results Laboratory Observation (extensible)
subject		1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
Slices for effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	C	1..1	dateTime	Clinically relevant time/time-period for observation ch-elm-dateTime: At least the format YYYY-MM-DD is required.
performer		1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Actual result
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
interpretation		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Observation Interpretation Codes (required)
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	extensible	ChElmResultsLaboratoryObservation http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-laboratory-observation from this IG
Observation.value[x]:valueCodeableConcept	preferred	ChElmResultsCodedValuesLaboratory http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-coded-values-laboratory from this IG
Observation.interpretation	required	ChElmObservationInterpretationCodes http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-observation-interpretation-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required. : $this.toString().length() >= 10
ch-elm-expecting-organism-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification') implies (value.exists() and (value as CodeableConcept).exists() and (value as CodeableConcept).memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-interpretation-code-loinc	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code)
ch-elm-interpretation-code-snomedct	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code)

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ch-lab-obs1: The resource should be conform to the corresponding EU LAB profile ch-elm-expecting-specimen-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs ch-elm-expecting-organism-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs ch-elm-interpretation-code-loinc: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet ch-elm-interpretation-code-snomedct: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
observation-instantiates-r5		0..1	Reference(ChLabObservationDefinition)	instantiate observationDefinition r5 URL: http://fhir.ch/ig/ch-lab-report/StructureDefinition/observation-instantiates
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConceptIPS	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
category:studyType		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Results Laboratory Observation (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation ch-elm-dateTime: At least the format YYYY-MM-DD is required.
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
interpretation		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Observation Interpretation Codes (required)
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	Pattern: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:laboratory	preferred	Pattern: laboratory http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
Observation.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
Observation.code	extensible	ChElmResultsLaboratoryObservation http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-laboratory-observation from this IG
Observation.value[x]:valueCodeableConcept	preferred	ChElmResultsCodedValuesLaboratory http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-coded-values-laboratory from this IG
Observation.interpretation	required	ChElmObservationInterpretationCodes http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-observation-interpretation-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required. : $this.toString().length() >= 10
ch-elm-expecting-organism-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification') implies (value.exists() and (value as CodeableConcept).exists() and (value as CodeableConcept).memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-interpretation-code-loinc	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code)
ch-elm-interpretation-code-snomedct	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code)
ch-lab-obs1	warning	Observation	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab')
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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ch-lab-obs1: The resource should be conform to the corresponding EU LAB profile ch-elm-expecting-specimen-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs ch-elm-expecting-organism-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs ch-elm-interpretation-code-loinc: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet ch-elm-interpretation-code-snomedct: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
observation-instantiates-r5		0..1	Reference(ChLabObservationDefinition)	instantiate observationDefinition r5 URL: http://fhir.ch/ig/ch-lab-report/StructureDefinition/observation-instantiates
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	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConceptIPS	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Results Laboratory Observation (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	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]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation ch-elm-dateTime: At least the format YYYY-MM-DD is required.
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Observation Interpretation Codes (required)
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
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 / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	Pattern: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:laboratory	preferred	Pattern: laboratory http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
Observation.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
Observation.code	extensible	ChElmResultsLaboratoryObservation http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-laboratory-observation from this IG
Observation.value[x]:valueCodeableConcept	preferred	ChElmResultsCodedValuesLaboratory http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-coded-values-laboratory from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	required	ChElmObservationInterpretationCodes http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-observation-interpretation-codes from this IG
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required. : $this.toString().length() >= 10
ch-elm-expecting-organism-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification') implies (value.exists() and (value as CodeableConcept).exists() and (value as CodeableConcept).memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-interpretation-code-loinc	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code)
ch-elm-interpretation-code-snomedct	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code)
ch-lab-obs1	warning	Observation	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab')
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()

This structure is derived from ChLabObservationResultsLaboratory

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

• CH ELM CodeableConcept (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-codeableconcept)
• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Lab (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab)
• CH ELM Specimen: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.effective[x]
• The element 1 is sliced based on the value of Observation.value[x]

Differential View

This structure is derived from ChLabObservationResultsLaboratory

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory ch-elm-expecting-specimen-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs ch-elm-expecting-organism-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs ch-elm-interpretation-code-loinc: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet ch-elm-interpretation-code-snomedct: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet
status		1..1	code	registered | preliminary | final | amended + Required Pattern: final
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Results Laboratory Observation (extensible)
subject		1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
Slices for effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	C	1..1	dateTime	Clinically relevant time/time-period for observation ch-elm-dateTime: At least the format YYYY-MM-DD is required.
performer		1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Actual result
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
interpretation		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Observation Interpretation Codes (required)
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	extensible	ChElmResultsLaboratoryObservation http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-laboratory-observation from this IG
Observation.value[x]:valueCodeableConcept	preferred	ChElmResultsCodedValuesLaboratory http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-coded-values-laboratory from this IG
Observation.interpretation	required	ChElmObservationInterpretationCodes http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-observation-interpretation-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required. : $this.toString().length() >= 10
ch-elm-expecting-organism-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification') implies (value.exists() and (value as CodeableConcept).exists() and (value as CodeableConcept).memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-interpretation-code-loinc	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code)
ch-elm-interpretation-code-snomedct	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ch-lab-obs1: The resource should be conform to the corresponding EU LAB profile ch-elm-expecting-specimen-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs ch-elm-expecting-organism-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs ch-elm-interpretation-code-loinc: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet ch-elm-interpretation-code-snomedct: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
observation-instantiates-r5		0..1	Reference(ChLabObservationDefinition)	instantiate observationDefinition r5 URL: http://fhir.ch/ig/ch-lab-report/StructureDefinition/observation-instantiates
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConceptIPS	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
category:studyType		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Results Laboratory Observation (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation ch-elm-dateTime: At least the format YYYY-MM-DD is required.
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
interpretation		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Observation Interpretation Codes (required)
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	Pattern: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:laboratory	preferred	Pattern: laboratory http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
Observation.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
Observation.code	extensible	ChElmResultsLaboratoryObservation http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-laboratory-observation from this IG
Observation.value[x]:valueCodeableConcept	preferred	ChElmResultsCodedValuesLaboratory http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-coded-values-laboratory from this IG
Observation.interpretation	required	ChElmObservationInterpretationCodes http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-observation-interpretation-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required. : $this.toString().length() >= 10
ch-elm-expecting-organism-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification') implies (value.exists() and (value as CodeableConcept).exists() and (value as CodeableConcept).memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-interpretation-code-loinc	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code)
ch-elm-interpretation-code-snomedct	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code)
ch-lab-obs1	warning	Observation	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab')
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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ch-lab-obs1: The resource should be conform to the corresponding EU LAB profile ch-elm-expecting-specimen-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs ch-elm-expecting-organism-specification: If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs ch-elm-interpretation-code-loinc: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet ch-elm-interpretation-code-snomedct: If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
observation-instantiates-r5		0..1	Reference(ChLabObservationDefinition)	instantiate observationDefinition r5 URL: http://fhir.ch/ig/ch-lab-report/StructureDefinition/observation-instantiates
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	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConceptIPS	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Lab Study Types in Switzerland (required)
category:specialty		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful groups (e.g. liver test; minerals; glucose profiles) Binding: Laboratory Specialty (required)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Results Laboratory Observation (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	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]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation ch-elm-dateTime: At least the format YYYY-MM-DD is required.
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: CH ELM Observation Interpretation Codes (required)
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
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 / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	Pattern: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:laboratory	preferred	Pattern: laboratory http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:studyType	required	LabStudyTypesEuVs http://fhir.ch/ig/ch-lab-report/ValueSet/ch-lab-report-lab-study-types
Observation.category:specialty	required	LabSpecialtyEuVs http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab
Observation.code	extensible	ChElmResultsLaboratoryObservation http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-laboratory-observation from this IG
Observation.value[x]:valueCodeableConcept	preferred	ChElmResultsCodedValuesLaboratory http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-results-coded-values-laboratory from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	required	ChElmObservationInterpretationCodes http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-observation-interpretation-codes from this IG
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required. : $this.toString().length() >= 10
ch-elm-expecting-organism-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification, then Observation.valueCodeableConcept must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-organism-specification') implies (value.exists() and (value as CodeableConcept).exists() and (value as CodeableConcept).memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-organism-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs : code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-interpretation-code-loinc	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code)
ch-elm-interpretation-code-snomedct	error	Observation	If Observation.code is a mapped in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code', then the interpretation code must be a member of the mapped ValueSet : 'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).exists() implies interpretation.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-interpretation-code'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code)
ch-lab-obs1	warning	Observation	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab')
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()

This structure is derived from ChLabObservationResultsLaboratory

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

• CH ELM CodeableConcept (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-codeableconcept)
• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Lab (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab)
• CH ELM Specimen: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.effective[x]
• The element 1 is sliced based on the value of Observation.value[x]

Other representations of profile: CSV, Excel, Schematron