HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.1.0 - STU1 Release 1.1 - Standard for Trial-Use
HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.1.0 - STU1 Release 1.1 - Standard for Trial-Use
HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG, published by HRSA BPHC. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/drajer-health/uds-plus/ and changes regularly. See the Directory of published versions
| Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-income-observation | Version: 1.1.0 | |||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: UDSPlusIncome | ||
The UDS+ profile is based on the Observation resource and establishes the core elements, extensions, vocabularies and value sets for representing Income ranges for UDS+ program.
This profile is used to represent de-identified Income information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.
The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.
In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Income Observation resource text element may contain Patient information such as names. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.
Ids and References
The original Observation resource id should not be included in the De-identified Observation instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original Income Observation. All resource references to the Income Observation submitted as part of the UDS+ report should refer to newly generated id.
Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed
Representing Income Ranges
Income ranges are represented using the Observation.valueRange or Observation.valueQuanity element. The following values can be used to represent the Income ranges:
* 100% and below : use valueRange.high to represent 100% (Includes 100)
* 101–150% : use valueRange.low to represent 101, valueRange.high to represent 150 (Includes 101 and 150)
* 151–200% : use valueRange.low to represent 151, valueRange.high to represent 200 (Includes 151 and 200)
* Over 200% : use valueQuantity.value to represent 200, units of % and comparator of ">", valueRange cannot be used for representing more than 200%.
* For unknown use the dataAbsentReason
Date Truncation
The Data Submitter has to truncate the following dates to only have a precision of year
Examples
Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Observation |
0..* | Observation | De-Identified UDS Plus Income | |
  id |
S | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver |
| text |
0..0 | |||
| contained |
0..0 | |||
  Slices for extension |
Content/Rules for all slices | |||
   deidentifiedIssuedTime |
0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension | |
| status |
S | 1..1 | code | registered | preliminary | final | amended + Fixed Value: final |
| code |
S | 1..1 | CodeableConcept | Type of observation (code / type) Required Pattern: At least the following |
  coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
 system |
1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
 code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2 | |
 subject |
S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about |
| display |
0..0 | |||
| encounter |
||||
| display |
0..0 | |||
 effective[x] |
SC | 0..1 | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. | |
 effectiveDateTime |
dateTime S | |||
 effectivePeriod |
Period | |||
| effectiveTiming |
Timing | |||
| issued |
S | 0..0 | ||
| performer |
||||
| display |
0..0 | |||
| value[x] |
S | 0..1 | Actual result | |
| value[x]All Types |
Content/Rules for all Types | |||
 Slices for extension |
Content/Rules for all slices | |||
| dataAbsentReason |
S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) |
| valueRange |
Range | |||
| valueQuantity |
Quantity | |||
| note |
0..0 | |||
| bodySite |
0..0 | |||
| specimen |
0..0 | |||
| device |
0..0 | |||
| hasMember |
0..0 | |||
| derivedFrom |
0..0 | |||
| component |
0..0 | |||
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| uds-plus-inc-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-inc-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-inc-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-inc-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-inc-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation |
C | 0..* | Observation | De-Identified UDS Plus Income 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 |
| id |
SΣ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for extension |
Content/Rules for all slices | |||
| deidentifiedIssuedTime |
0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension | |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final |
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2 | |
| subject |
SΣ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about |
| effective[x] |
SΣC | 0..1 | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. | |
| effectiveDateTime |
dateTime | |||
| value[x] |
SΣC | 0..1 | Actual result | |
| value[x]All Types |
Content/Rules for all Types | |||
| Slices for extension |
Content/Rules for all slices | |||
| dataAbsentReason |
S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) |
| valueRange |
Range | |||
| valueQuantity |
Quantity | |||
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Observation.status | required | Fixed Value: finalhttp://hl7.org/fhir/ValueSet/observation-status|4.0.1from the FHIR Standard | |
| Observation.code | example | Pattern: LOINC Code 63058-2http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard | |
| Observation.component.code | example | LOINCCodes (a valid code from LOINC)http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| 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() | |
| uds-plus-inc-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-inc-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-inc-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-inc-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-inc-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | Observation | De-Identified UDS Plus Income 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 | ||||
| id |
SΣ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver | ||||
| 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.
| |||||
 Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| deidentifiedIssuedTime |
0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn |
Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
| partOf |
Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final | ||||
| category |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subject |
SΣ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| 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 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| effective[x] |
SΣC | 0..1 | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. | |||||
| effectiveDateTime |
dateTime S | |||||||
| effectivePeriod |
Period | |||||||
| effectiveTiming |
Timing | |||||||
| performer |
Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the 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 | |||||
| reference |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| value[x] |
SΣC | 0..1 | Actual result | |||||
| value[x]All Types |
Content/Rules for all Types | |||||||
 id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| dataAbsentReason |
S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) | ||||
| valueRange |
Range | |||||||
| valueQuantity |
Quantity | |||||||
| 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. | |||||
| method |
0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
| 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 | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| Observation.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Observation.status | required | Fixed Value: finalhttp://hl7.org/fhir/ValueSet/observation-status|4.0.1from the FHIR Standard | ||||
| Observation.category | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | ||||
| Observation.code | example | Pattern: LOINC Code 63058-2http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard | ||||
| Observation.subject.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.encounter.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.performer.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard | ||||
| Observation.method | example | ObservationMethodshttp://hl7.org/fhir/ValueSet/observation-methodsfrom the FHIR Standard | ||||
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodeshttp://hl7.org/fhir/ValueSet/referencerange-meaningfrom the FHIR Standard | ||||
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodeshttp://hl7.org/fhir/ValueSet/referencerange-appliestofrom the FHIR Standard | ||||
| Observation.component.code | example | LOINCCodes (a valid code from LOINC)http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard | ||||
| Observation.component.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.component.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| 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() | |
| uds-plus-inc-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-inc-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-inc-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-inc-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-inc-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
This structure is derived from Observation
Summary
Mandatory: 3 elements
Must-Support: 8 elements
Fixed: 1 element
Prohibited: 13 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 2
Differential View
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation |
0..* | Observation | De-Identified UDS Plus Income | |
| id |
S | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver |
| text |
0..0 | |||
| contained |
0..0 | |||
| Slices for extension |
Content/Rules for all slices | |||
| deidentifiedIssuedTime |
0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension | |
| status |
S | 1..1 | code | registered | preliminary | final | amended + Fixed Value: final |
| code |
S | 1..1 | CodeableConcept | Type of observation (code / type) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2 | |
| subject |
S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about |
| display |
0..0 | |||
| encounter |
||||
| display |
0..0 | |||
| effective[x] |
SC | 0..1 | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. | |
| effectiveDateTime |
dateTime S | |||
| effectivePeriod |
Period | |||
| effectiveTiming |
Timing | |||
| issued |
S | 0..0 | ||
| performer |
||||
| display |
0..0 | |||
| value[x] |
S | 0..1 | Actual result | |
| value[x]All Types |
Content/Rules for all Types | |||
| Slices for extension |
Content/Rules for all slices | |||
| dataAbsentReason |
S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) |
| valueRange |
Range | |||
| valueQuantity |
Quantity | |||
| note |
0..0 | |||
| bodySite |
0..0 | |||
| specimen |
0..0 | |||
| device |
0..0 | |||
| hasMember |
0..0 | |||
| derivedFrom |
0..0 | |||
| component |
0..0 | |||
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| uds-plus-inc-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-inc-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-inc-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-inc-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-inc-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation |
C | 0..* | Observation | De-Identified UDS Plus Income 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 |
| id |
SΣ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for extension |
Content/Rules for all slices | |||
| deidentifiedIssuedTime |
0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension | |
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final |
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2 | |
| subject |
SΣ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about |
| effective[x] |
SΣC | 0..1 | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. | |
| effectiveDateTime |
dateTime | |||
| value[x] |
SΣC | 0..1 | Actual result | |
| value[x]All Types |
Content/Rules for all Types | |||
| Slices for extension |
Content/Rules for all slices | |||
| dataAbsentReason |
S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) |
| valueRange |
Range | |||
| valueQuantity |
Quantity | |||
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Observation.status | required | Fixed Value: finalhttp://hl7.org/fhir/ValueSet/observation-status|4.0.1from the FHIR Standard | |
| Observation.code | example | Pattern: LOINC Code 63058-2http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard | |
| Observation.component.code | example | LOINCCodes (a valid code from LOINC)http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| 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() | |
| uds-plus-inc-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-inc-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-inc-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-inc-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-inc-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | Observation | De-Identified UDS Plus Income 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 | ||||
| id |
SΣ | 0..1 | id | The de-identified Observation identifier created by the health center to send data to UDS+ Data Receiver | ||||
| 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.
| |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| deidentifiedIssuedTime |
0..1 | dateTime | Indicates the time with a precision of only Year. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-deidentified-instant-extension | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn |
Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
| partOf |
Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final | ||||
| category |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 63058-2 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subject |
SΣ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who and/or what the observation is about | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| 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 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| effective[x] |
SΣC | 0..1 | Clinically relevant time/time-period for observation uds-plus-inc-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-inc-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-inc-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-inc-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-inc-5: All Timing.event data elements should be truncated to a year only for de-identified resources. | |||||
| effectiveDateTime |
dateTime S | |||||||
| effectivePeriod |
Period | |||||||
| effectiveTiming |
Timing | |||||||
| performer |
Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the 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 | |||||
| reference |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| value[x] |
SΣC | 0..1 | Actual result | |||||
| value[x]All Types |
Content/Rules for all Types | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| dataAbsentReason |
S | 0..1 | code | Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) | ||||
| valueRange |
Range | |||||||
| valueQuantity |
Quantity | |||||||
| 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. | |||||
| method |
0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
| 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 | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| Observation.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Observation.status | required | Fixed Value: finalhttp://hl7.org/fhir/ValueSet/observation-status|4.0.1from the FHIR Standard | ||||
| Observation.category | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | ||||
| Observation.code | example | Pattern: LOINC Code 63058-2http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard | ||||
| Observation.subject.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.encounter.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.performer.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard | ||||
| Observation.method | example | ObservationMethodshttp://hl7.org/fhir/ValueSet/observation-methodsfrom the FHIR Standard | ||||
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodeshttp://hl7.org/fhir/ValueSet/referencerange-meaningfrom the FHIR Standard | ||||
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodeshttp://hl7.org/fhir/ValueSet/referencerange-appliestofrom the FHIR Standard | ||||
| Observation.component.code | example | LOINCCodes (a valid code from LOINC)http://hl7.org/fhir/ValueSet/observation-codesfrom the FHIR Standard | ||||
| Observation.component.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.component.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| 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() | |
| uds-plus-inc-1 | error | Observation.effective[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-inc-2 | error | Observation.effective[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-inc-3 | error | Observation.effective[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-inc-4 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-inc-5 | error | Observation.effective[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 |
This structure is derived from Observation
Summary
Mandatory: 3 elements
Must-Support: 8 elements
Fixed: 1 element
Prohibited: 13 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 2
Other representations of profile: CSV, Excel, Schematron