HL7 Europe Laboratory Report
0.2.0-ci - ci-build 150

HL7 Europe Laboratory Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.2.0-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/laboratory/ and changes regularly. See the Directory of published versions

Resource Profile: ObservationEuObligations - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the Observation-obl-eu-lab resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Observation
2. Observation.extension:supportingInfo
Slice NamesupportingInfo
Obligations
    ObligationsActor
    SHALL:handle
    SHALL:handle
    SHOULD:able-to-populate
    4. Observation.extension:triggeredBy-r5
    Slice NametriggeredBy-r5
    Obligations
      ObligationsActor
      SHALL:handle
      SHALL:handle
      SHOULD:able-to-populate
      6. Observation.extension:triggeredBy-r5.extension:observation
      Slice Nameobservation
      Obligations
        ObligationsActor
        SHALL:handle
        SHALL:handle
        SHALL:able-to-populate
        8. Observation.extension:triggeredBy-r5.extension:type
        Slice Nametype
        Obligations
          ObligationsActor
          SHALL:handle
          SHALL:handle
          SHALL:able-to-populate
          10. Observation.status
          Obligations
            ObligationsActor
            SHALL:handle
            SHALL:handle
            SHALL:able-to-populate
            12. Observation.category
            Obligations
              ObligationsActor
              SHALL:handle
              SHALL:handle
              SHALL:able-to-populate
              14. Observation.code
              Obligations
                ObligationsActor
                SHALL:handle
                SHALL:handle
                SHALL:able-to-populate
                16. Observation.subject
                Obligations
                  ObligationsActor
                  SHALL:handle
                  SHALL:handle
                  SHALL:able-to-populate
                  18. Observation.effective[x]
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Obligations
                    ObligationsActor
                    SHALL:handle
                    SHALL:handle
                    SHALL:able-to-populate
                    20. Observation.effective[x].extension:data-absent-reason
                    Slice Namedata-absent-reason
                    Obligations
                      ObligationsActor
                      SHALL:handle
                      SHALL:handle
                      SHALL:able-to-populate
                      22. Observation.issued
                      Obligations
                        ObligationsActor
                        SHALL:handle
                        SHALL:handle
                        SHOULD:able-to-populate
                        24. Observation.performer
                        Obligations
                          ObligationsActor
                          SHALL:handle
                          SHALL:handle
                          SHALL:able-to-populate
                          26. Observation.performer.extension:performerFunction
                          Slice NameperformerFunction
                          Obligations
                            ObligationsActor
                            SHALL:handle
                            SHALL:handle
                            SHOULD:able-to-populate
                            28. Observation.value[x]
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Obligations
                              ObligationsActor
                              SHALL:handle
                              SHALL:handle
                              SHALL:able-to-populate
                              30. Observation.interpretation
                              Obligations
                                ObligationsActor
                                SHALL:handle
                                SHALL:handle
                                SHALL:able-to-populate
                                32. Observation.method
                                Obligations
                                  ObligationsActor
                                  SHALL:handle
                                  SHALL:handle
                                  SHALL:able-to-populate
                                  34. Observation.specimen
                                  Obligations
                                    ObligationsActor
                                    SHALL:handle
                                    SHALL:handle
                                    SHALL:able-to-populate
                                    36. Observation.hasMember
                                    Obligations
                                      ObligationsActor
                                      SHALL:handle
                                      SHALL:handle
                                      SHALL:able-to-populate
                                      38. Observation.component
                                      Obligations
                                        ObligationsActor
                                        SHALL:handle
                                        SHALL:handle
                                        SHALL:able-to-populate
                                        40. Observation.component.code
                                        Obligations
                                          ObligationsActor
                                          SHALL:handle
                                          SHALL:handle
                                          SHALL:able-to-populate
                                          42. Observation.component.value[x]
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Obligations
                                            ObligationsActor
                                            SHALL:handle
                                            SHALL:handle
                                            SHALL:able-to-populate

                                            Guidance on how to interpret the contents of this table can be found here

                                            0. Observation
                                            Definition

                                            This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and references the atomic results of the study as "has-member" child observations


                                            Measurements and simple assertions made about a patient, device or other subject.

                                            ShortLaboratory result for a simple test or for a panel/studyMeasurements and simple assertions
                                            Comments

                                            Represents either a lab simple observation or the group of observations produced by a laboratory study.


                                            Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

                                            Control0..*
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate NamesVital Signs, Measurement, Results, Tests
                                            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                            dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                            dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                            obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                            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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                            eu-lab-1: If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component" ((status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists())
                                            eu-lab-2: If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason" (component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists())
                                            obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                            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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                            2. Observation.implicitRules
                                            Definition

                                            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                            ShortA set of rules under which this content was created
                                            Comments

                                            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                            Control0..1
                                            Typeuri
                                            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            4. Observation.extension:supportingInfo
                                            Slice NamesupportingInfo
                                            Definition

                                            Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use Observation.hasMember instead of supportingInformation for representing the members of an Observation panel.

                                            ShortOther information that may be relevant to this event.
                                            Control0..*
                                            TypeExtension(Supporting info) (Extension Type: Reference(Resource))
                                            Is Modifierfalse
                                            Obligations
                                              ObligationsActor
                                              SHALL:handle
                                              SHALL:handle
                                              SHOULD:able-to-populate
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              6. Observation.extension:triggeredBy-r5
                                              Slice NametriggeredBy-r5
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Extension Definition for Observation.triggeredBy for Version 5.0) (Complex Extension)
                                              Is Modifierfalse
                                              Obligations
                                                ObligationsActor
                                                SHALL:handle
                                                SHALL:handle
                                                SHOULD:able-to-populate
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                8. Observation.extension:triggeredBy-r5.extension:observation
                                                Slice Nameobservation
                                                Definition

                                                An Extension

                                                ShortExtensionAdditional content defined by implementations
                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handle
                                                  SHALL:handle
                                                  SHALL:able-to-populate
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  10. Observation.extension:triggeredBy-r5.extension:observation.extension
                                                  Definition

                                                  An Extension


                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortExtensionAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..0*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Observation.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 12. Observation.extension:triggeredBy-r5.extension:observation.url
                                                    Definition

                                                    Source of the definition for the extension code - a logical name or a URL.

                                                    Shortidentifies the meaning of the extension
                                                    Comments

                                                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                    Control1..1
                                                    Typeuri
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    Fixed Valueobservation
                                                    14. Observation.extension:triggeredBy-r5.extension:observation.value[x]
                                                    Definition

                                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                    ShortValue of extension
                                                    Control10..1
                                                    TypeReference(Observation), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    16. Observation.extension:triggeredBy-r5.extension:type
                                                    Slice Nametype
                                                    Definition

                                                    An Extension

                                                    ShortExtensionAdditional content defined by implementations
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handle
                                                      SHALL:handle
                                                      SHALL:able-to-populate
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      18. Observation.extension:triggeredBy-r5.extension:type.extension
                                                      Definition

                                                      An Extension


                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortExtensionAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..0*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Observation.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 20. Observation.extension:triggeredBy-r5.extension:type.url
                                                        Definition

                                                        Source of the definition for the extension code - a logical name or a URL.

                                                        Shortidentifies the meaning of the extension
                                                        Comments

                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                        Control1..1
                                                        Typeuri
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        Fixed Valuetype
                                                        22. Observation.extension:triggeredBy-r5.extension:type.value[x]
                                                        Definition

                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                        ShortValue of extension
                                                        Control10..1
                                                        Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        24. Observation.extension:triggeredBy-r5.extension:reason
                                                        Slice Namereason
                                                        Definition

                                                        An Extension

                                                        ShortExtensionAdditional content defined by implementations
                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        26. Observation.extension:triggeredBy-r5.extension:reason.extension
                                                        Definition

                                                        An Extension


                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                        ShortExtensionAdditional content defined by implementations
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..0*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Observation.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 28. Observation.extension:triggeredBy-r5.extension:reason.url
                                                          Definition

                                                          Source of the definition for the extension code - a logical name or a URL.

                                                          Shortidentifies the meaning of the extension
                                                          Comments

                                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                          Control1..1
                                                          Typeuri
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          Fixed Valuereason
                                                          30. Observation.extension:triggeredBy-r5.extension:reason.value[x]
                                                          Definition

                                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                          ShortValue of extension
                                                          Control10..1
                                                          Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          32. Observation.extension:triggeredBy-r5.url
                                                          Definition

                                                          Source of the definition for the extension code - a logical name or a URL.

                                                          Shortidentifies the meaning of the extension
                                                          Comments

                                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                          Control1..1
                                                          Typeuri
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
                                                          34. Observation.extension:triggeredBy-r5.value[x]
                                                          Definition

                                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                          ShortValue of extension
                                                          Control0..01
                                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          36. Observation.extension:certifiedRefMaterialCodeable
                                                          Slice NamecertifiedRefMaterialCodeable
                                                          Definition

                                                          This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using a CodeableConcept. This extension should be used when the unit is UCUM [IU].

                                                          ShortCertified Reference Material: CodeableConcept
                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Certified Reference Material: CodeableConcept) (Extension Type: CodeableConcept)
                                                          Is Modifierfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          38. Observation.extension:certifiedRefMaterialIdentifer
                                                          Slice NamecertifiedRefMaterialIdentifer
                                                          Definition

                                                          This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using an Identifier. This extension should be used when the unit is UCUM [IU].

                                                          ShortCertified Reference Material: Identifier
                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Certified Reference Material: Identifier) (Extension Type: Identifier)
                                                          Is Modifierfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          40. Observation.extension:labTestKit
                                                          Slice NamelabTestKit
                                                          Definition

                                                          This extension links this observation with the laboratory test kit used for this test. Usually only one laboratory test kit is referred

                                                          ShortDevice Laboratory Test Kit
                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Device Laboratory Test Kit) (Extension Type: Reference(Device))
                                                          Is Modifierfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          42. Observation.extension:value-r5
                                                          Slice Namevalue-r5
                                                          Definition

                                                          Optional Extension Element - found in all resources.

                                                          Shortonly for result of type Attachment
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
                                                          Is Modifierfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          44. Observation.extension:value-r5.extension
                                                          Definition

                                                          An Extension


                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortExtensionAdditional content defined by implementations
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..0*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on Observation.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 46. Observation.extension:value-r5.url
                                                            Definition

                                                            Source of the definition for the extension code - a logical name or a URL.

                                                            Shortidentifies the meaning of the extension
                                                            Comments

                                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                            Control1..1
                                                            Typeuri
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]
                                                            48. Observation.extension:value-r5.value[x]
                                                            Definition

                                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                            ShortValue of extension
                                                            Control10..1
                                                            TypeAttachment, date, Meta, Address, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            50. Observation.modifierExtension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                            ShortExtensions that cannot be ignored
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                            Summaryfalse
                                                            Requirements

                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            52. Observation.status
                                                            Definition

                                                            The status of the result value.

                                                            ShortStatus of this observation (e.g. preliminary, final,...)registered | preliminary | final | amended +
                                                            Comments

                                                            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                            Control1..1
                                                            BindingThe codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
                                                            (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

                                                            Codes providing the status of an observation.

                                                            Typecode
                                                            Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:handle
                                                              SHALL:handle
                                                              SHALL:able-to-populate
                                                              Summarytrue
                                                              Requirements

                                                              Need to track the status of individual results. Some results are finalized before the whole report is finalized.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              54. Observation.category
                                                              Definition

                                                              A code that classifies the general type of observation being made.

                                                              ShortClassification of type of observation
                                                              Comments

                                                              "laboratory" includes laboratory medicine and pathology


                                                              In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                              Control10..*
                                                              BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category
                                                              (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                              Codes for high level observation categories.

                                                              TypeCodeableConcept(Codeable Concept (IPS))
                                                              Is Modifierfalse
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:handle
                                                                SHALL:handle
                                                                SHALL:able-to-populate
                                                                Summaryfalse
                                                                Requirements

                                                                Used for filtering what observations are retrieved and displayed.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • pattern @ $this
                                                                • 56. Observation.category:laboratory
                                                                  Slice Namelaboratory
                                                                  Definition

                                                                  A code that classifies the general type of observation being made.

                                                                  ShortClassification of type of observation
                                                                  Comments

                                                                  In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                  Control10..1*
                                                                  BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category
                                                                  (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                                  Codes for high level observation categories.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Used for filtering what observations are retrieved and displayed.

                                                                  Pattern Value{
                                                                    "coding" : [{
                                                                      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                                                      "code" : "laboratory"
                                                                    }]
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  58. Observation.category:studyType
                                                                  Slice NamestudyType
                                                                  Definition

                                                                  A code that classifies the general type of observation being made.

                                                                  ShortThe way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)Classification of type of observation
                                                                  Comments

                                                                  In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                  Control0..*
                                                                  BindingThe codes SHALL be taken from The codes SHOULD be taken from Laboratory Study Typeshttp://hl7.org/fhir/ValueSet/observation-category
                                                                  (required to http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Used for filtering what observations are retrieved and displayed.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  60. Observation.category:specialty
                                                                  Slice Namespecialty
                                                                  Definition

                                                                  A code that classifies the general type of observation being made.

                                                                  ShortThe clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)Classification of type of observation
                                                                  Comments

                                                                  In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                  Control0..*
                                                                  BindingThe codes SHALL be taken from The codes SHOULD be taken from Laboratory Specialtyhttp://hl7.org/fhir/ValueSet/observation-category
                                                                  (required to http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Used for filtering what observations are retrieved and displayed.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  62. Observation.code
                                                                  Definition

                                                                  Describes what was observed. Sometimes this is called the observation "name". In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations


                                                                  Describes what was observed. Sometimes this is called the observation "name".

                                                                  ShortConcept - reference to a terminology or just textType of observation (code / type)
                                                                  Comments

                                                                  In the context of this Observation-laboratory-uv-ips profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided.


                                                                  All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                  Control1..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingThe codes SHOULD be taken from For example codes, see Laboratory Codehttp://hl7.org/fhir/ValueSet/observation-codes
                                                                  (preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab)
                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                  Is Modifierfalse
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:handle
                                                                    SHALL:handle
                                                                    SHALL:able-to-populate
                                                                    Requirements

                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                    Alternate NamesName
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    64. Observation.subject
                                                                    Definition

                                                                    The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

                                                                    ShortWho and/or what the observation is about
                                                                    Comments

                                                                    One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

                                                                    Control10..1
                                                                    TypeReference(Patient: Animal, Patient: Person, Group, Device, Location, Patient)
                                                                    Is Modifierfalse
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:handle
                                                                      SHALL:handle
                                                                      SHALL:able-to-populate
                                                                      Summarytrue
                                                                      Requirements

                                                                      Observations have no value if you don't know who or what they're about.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      66. Observation.subject.reference
                                                                      Definition

                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                      Comments

                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                      Control10..1
                                                                      This element is affected by the following invariants: ref-1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      68. Observation.effective[x]
                                                                      Definition

                                                                      The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                                                                      ShortClinically relevant time/time-period for observation
                                                                      Comments

                                                                      At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                      Control10..1
                                                                      TypeChoice of: dateTime, Period, Timing, instant
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:handle
                                                                        SHALL:handle
                                                                        SHALL:able-to-populate
                                                                        Summarytrue
                                                                        Requirements

                                                                        Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                        Alternate NamesOccurrence
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        70. Observation.effective[x].extension:data-absent-reason
                                                                        Slice Namedata-absent-reason
                                                                        Definition

                                                                        Provides a reason why the expected value or elements in the element that is extended are missing.

                                                                        Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
                                                                        Control0..1
                                                                        TypeExtension(Data Absent Reason) (Extension Type: code)
                                                                        Is Modifierfalse
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:handle
                                                                          SHALL:handle
                                                                          SHALL:able-to-populate
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          72. Observation.issued
                                                                          Definition

                                                                          The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

                                                                          ShortDate/Time this result was made availableDate/Time this version was made available
                                                                          Comments

                                                                          For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

                                                                          Control0..1
                                                                          Typeinstant
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:handle
                                                                            SHALL:handle
                                                                            SHOULD:able-to-populate
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            74. Observation.performer
                                                                            Definition

                                                                            Who was responsible for asserting the observed value as "true".

                                                                            ShortWho is responsible for the observation
                                                                            Control10..*
                                                                            TypeReference(PractitionerRole: Laboratory Report, Practitioner: Laboratory Report, Organization (IPS), CareTeam, Patient: Person, RelatedPerson, Practitioner, PractitionerRole, Organization, Patient)
                                                                            Is Modifierfalse
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handle
                                                                              SHALL:handle
                                                                              SHALL:able-to-populate
                                                                              Summarytrue
                                                                              Requirements

                                                                              May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              76. Observation.performer.extension:performerFunction
                                                                              Slice NameperformerFunction
                                                                              Definition

                                                                              Distinguishes the type of involvement of the performer in the event. For example, 'author', 'verifier' or 'responsible party'.

                                                                              ShortType of performance
                                                                              Control0..*
                                                                              TypeExtension(Performer function) (Extension Type: CodeableConcept)
                                                                              Is Modifierfalse
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:handle
                                                                                SHALL:handle
                                                                                SHOULD:able-to-populate
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                78. Observation.value[x]
                                                                                Definition

                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                ShortActual result
                                                                                Comments

                                                                                An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: obs-7
                                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handle
                                                                                  SHALL:handle
                                                                                  SHALL:able-to-populate
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                  • type @ $this
                                                                                  • 80. Observation.value[x]:valueString
                                                                                    Slice NamevalueString
                                                                                    Definition

                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortActual result
                                                                                    Comments

                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: obs-7
                                                                                    Typestring, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    82. Observation.value[x]:valueRange
                                                                                    Slice NamevalueRange
                                                                                    Definition

                                                                                    A set of ordered Quantities defined by a low and high limit.


                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortSet of values bounded by low and highActual result
                                                                                    Comments

                                                                                    The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.


                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1, obs-7
                                                                                    TypeRange(Range (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    rng-2: If present, low SHALL have a lower value than high (low.empty() or high.empty() or (low <= high))
                                                                                    84. Observation.value[x]:valueRatio
                                                                                    Slice NamevalueRatio
                                                                                    Definition

                                                                                    A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM.


                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortA measured ratio using UCUMActual result
                                                                                    Comments

                                                                                    The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.


                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1, obs-7
                                                                                    TypeRatio(Ratio (Eu Lab)), dateTime, boolean, string, SampledData, Quantity, Period, integer, time, Range, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                    86. Observation.value[x]:valueTime
                                                                                    Slice NamevalueTime
                                                                                    Definition

                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortActual result
                                                                                    Comments

                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: obs-7
                                                                                    Typetime, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, Range, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    88. Observation.value[x]:valueDateTime
                                                                                    Slice NamevalueDateTime
                                                                                    Definition

                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortActual result
                                                                                    Comments

                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: obs-7
                                                                                    TypedateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    90. Observation.value[x]:valuePeriod
                                                                                    Slice NamevaluePeriod
                                                                                    Definition

                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortActual result
                                                                                    Comments

                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: obs-7
                                                                                    TypePeriod, dateTime, boolean, string, SampledData, Quantity, Ratio, integer, time, Range, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    92. Observation.value[x]:valueQuantity
                                                                                    Slice NamevalueQuantity
                                                                                    Definition

                                                                                    A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.


                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortA measured amount using UCUMActual result
                                                                                    Comments

                                                                                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.


                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1, obs-7
                                                                                    TypeQuantity(Quantity (Eu Lab)), dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                    94. Observation.value[x]:valueCodeableConcept
                                                                                    Slice NamevalueCodeableConcept
                                                                                    Definition

                                                                                    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortConcept - reference to a terminology or just textActual result
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.


                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1, obs-7
                                                                                    BindingThe codes SHOULD be taken from For codes, see Results Coded Values Laboratory - IPS
                                                                                    (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-uv-ips)
                                                                                    Additional BindingsPurposeDocumentation
                                                                                    Results Blood Group - SNOMED CT IPS Free Setcandidate

                                                                                    Additional conformance binding to a blood group findings value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                    Results Presence Absence - SNOMED CT IPS Free Setcandidate

                                                                                    Additional conformance binding to a presence and absence findings (qualifier values) value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                    Results Microorganism - SNOMED CT IPS Free Setcandidate

                                                                                    Additional conformance binding to a microorganisms value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                    TypeCodeableConcept(Codeable Concept (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    96. Observation.interpretation
                                                                                    Definition

                                                                                    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                    ShortConcept - reference to a terminology or just textHigh, low, normal, etc.
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.


                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretation
                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                    Codes identifying interpretations of observations.

                                                                                    TypeCodeableConcept(Codeable Concept (IPS))
                                                                                    Is Modifierfalse
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:handle
                                                                                      SHALL:handle
                                                                                      SHALL:able-to-populate
                                                                                      Requirements

                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                      Alternate NamesAbnormal Flag
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      98. Observation.method
                                                                                      Definition

                                                                                      Laboratory technigue that has been used


                                                                                      Indicates the mechanism used to perform the observation.

                                                                                      ShortConcept - reference to a terminology or just textHow it was done
                                                                                      Comments

                                                                                      Laboratory technique (method of measurement) are integral parts of the test specification of some laboratory test coding systems (e.g. NPU), in LOINC hovewer measurement principle is not always present in the test definition. In some cases however knowledge of the used measurment techique is important for proper interpretation of the test result. That's why it is important to explicitly include informaiton about measurement method is such cases.


                                                                                      Only used if not implicit in code for Observation.code.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingThe codes SHOULD be taken from For example codes, see Laboratory Techniqueshttp://hl7.org/fhir/ValueSet/observation-methods
                                                                                      (preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-technique-eu-lab)
                                                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                                                      Is Modifierfalse
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:handle
                                                                                        SHALL:handle
                                                                                        SHALL:able-to-populate
                                                                                        Requirements

                                                                                        In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        100. Observation.specimen
                                                                                        Definition

                                                                                        The specimen that was used when this observation was made.

                                                                                        ShortSpecimen used for this observation
                                                                                        Comments

                                                                                        When the specimen is applicable and known it shall be documented


                                                                                        Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

                                                                                        Control0..1
                                                                                        TypeReference(Specimen: Laboratory, Specimen)
                                                                                        Is Modifierfalse
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:handle
                                                                                          SHALL:handle
                                                                                          SHALL:able-to-populate
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          102. Observation.hasMember
                                                                                          Definition

                                                                                          A reference to another Observation profiled by Observation-results-laboratory-uv-ips. The target observation (for instance an individual test member of a panel) is considered as a sub-observation of the current one, which plays the role of a grouper.


                                                                                          This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

                                                                                          ShortRelated resource that belongs to the Observation group
                                                                                          Comments

                                                                                          This element is used in the context of international patient summary when there is a need to group a collection of observations, because they belong to the same panel, or because they share a common interpretation comment, or a common media attachment (illustrative image or graph). In these cases, the current observation is the grouper, and its set of sub-observations are related observations using the type "has-member". For a discussion on the ways Observations can be assembled in groups together see Observation Grouping.


                                                                                          When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

                                                                                          Control0..*
                                                                                          TypeReference(Observation Results: laboratory, Observation, QuestionnaireResponse, MolecularSequence)
                                                                                          Is Modifierfalse
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:handle
                                                                                            SHALL:handle
                                                                                            SHALL:able-to-populate
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            104. Observation.component
                                                                                            Definition

                                                                                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                            ShortLaboratory resultComponent results
                                                                                            Comments

                                                                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                            Control0..*
                                                                                            TypeBackboneElement
                                                                                            Is Modifierfalse
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:handle
                                                                                              SHALL:handle
                                                                                              SHALL:able-to-populate
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              106. Observation.component.extension:value-r5
                                                                                              Slice Namevalue-r5
                                                                                              Definition

                                                                                              Optional Extension Element - found in all resources.

                                                                                              Shortonly for result of type Attachment
                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
                                                                                              Is Modifierfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              108. Observation.component.extension:value-r5.extension
                                                                                              Definition

                                                                                              An Extension


                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                              ShortExtensionAdditional content defined by implementations
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..0*
                                                                                              TypeExtension
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 110. Observation.component.extension:value-r5.url
                                                                                                Definition

                                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                                Shortidentifies the meaning of the extension
                                                                                                Comments

                                                                                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                Control1..1
                                                                                                Typeuri
                                                                                                Is Modifierfalse
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                Summaryfalse
                                                                                                Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]
                                                                                                112. Observation.component.extension:value-r5.value[x]
                                                                                                Definition

                                                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                ShortValue of extension
                                                                                                Control10..1
                                                                                                TypeAttachment, date, Meta, Address, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                114. Observation.component.modifierExtension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                116. Observation.component.code
                                                                                                Definition

                                                                                                A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                ShortConcept - reference to a terminology or just textType of component observation (code / type)
                                                                                                Comments

                                                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.


                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingThe codes SHOULD be taken from For example codes, see Results Laboratory Observation - IPShttp://hl7.org/fhir/ValueSet/observation-codes
                                                                                                (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-laboratory-observations-uv-ips)
                                                                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                Is Modifierfalse
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:handle
                                                                                                  SHALL:handle
                                                                                                  SHALL:able-to-populate
                                                                                                  Requirements

                                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  118. Observation.component.value[x]
                                                                                                  Definition

                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                  ShortActual component result
                                                                                                  Comments

                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                  Control0..1
                                                                                                  TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:handle
                                                                                                    SHALL:handle
                                                                                                    SHALL:able-to-populate
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                    • type @ $this
                                                                                                    • 120. Observation.component.value[x]:valueString
                                                                                                      Slice NamevalueString
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      Typestring, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      122. Observation.component.value[x]:valueRange
                                                                                                      Slice NamevalueRange
                                                                                                      Definition

                                                                                                      A set of ordered Quantities defined by a low and high limit.


                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortSet of values bounded by low and highActual component result
                                                                                                      Comments

                                                                                                      The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.


                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeRange(Range (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      rng-2: If present, low SHALL have a lower value than high (low.empty() or high.empty() or (low <= high))
                                                                                                      124. Observation.component.value[x]:valueRatio
                                                                                                      Slice NamevalueRatio
                                                                                                      Definition

                                                                                                      A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM.


                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortA measured ratio using UCUMActual component result
                                                                                                      Comments

                                                                                                      The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.


                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeRatio(Ratio (Eu Lab)), dateTime, boolean, string, SampledData, Quantity, Period, integer, time, Range, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                                      126. Observation.component.value[x]:valueTime
                                                                                                      Slice NamevalueTime
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      Typetime, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, Range, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      128. Observation.component.value[x]:valueDateTime
                                                                                                      Slice NamevalueDateTime
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      TypedateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      130. Observation.component.value[x]:valuePeriod
                                                                                                      Slice NamevaluePeriod
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortActual component result
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      TypePeriod, dateTime, boolean, string, SampledData, Quantity, Ratio, integer, time, Range, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      132. Observation.component.value[x]:valueQuantity
                                                                                                      Slice NamevalueQuantity
                                                                                                      Definition

                                                                                                      A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.


                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortA measured amount using UCUMActual component result
                                                                                                      Comments

                                                                                                      The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.


                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeQuantity(Quantity (Eu Lab)), dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                      134. Observation.component.value[x]:valueCodeableConcept
                                                                                                      Slice NamevalueCodeableConcept
                                                                                                      Definition

                                                                                                      A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortConcept - reference to a terminology or just textActual component result
                                                                                                      Comments

                                                                                                      Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.


                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      BindingThe codes SHOULD be taken from For codes, see Results Coded Values Laboratory - IPS
                                                                                                      (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-uv-ips)
                                                                                                      Additional BindingsPurposeDocumentation
                                                                                                      Results Blood Group - SNOMED CT IPS Free Setcandidate

                                                                                                      Additional conformance binding to a blood group findings value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                      Results Presence Absence - SNOMED CT IPS Free Setcandidate

                                                                                                      Additional conformance binding to a presence and absence findings (qualifier values) value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                      Results Microorganism - SNOMED CT IPS Free Setcandidate

                                                                                                      Additional conformance binding to a microorganisms value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                      TypeCodeableConcept(Codeable Concept (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                                                                                      Guidance on how to interpret the contents of this table can be found here

                                                                                                      0. Observation
                                                                                                      Definition

                                                                                                      This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and references the atomic results of the study as "has-member" child observations

                                                                                                      ShortLaboratory result for a simple test or for a panel/study
                                                                                                      Comments

                                                                                                      Represents either a lab simple observation or the group of observations produced by a laboratory study.

                                                                                                      Control0..*
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate NamesVital Signs, Measurement, Results, Tests
                                                                                                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                                      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                                                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                                                      obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                                                                                      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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                                                                                      eu-lab-1: If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component" ((status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists())
                                                                                                      eu-lab-2: If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason" (component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists())
                                                                                                      2. Observation.id
                                                                                                      Definition

                                                                                                      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                                                                      ShortLogical id of this artifact
                                                                                                      Comments

                                                                                                      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                                                                      Control0..1
                                                                                                      Typeid
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      4. Observation.meta
                                                                                                      Definition

                                                                                                      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                                                      ShortMetadata about the resource
                                                                                                      Control0..1
                                                                                                      TypeMeta
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      6. Observation.implicitRules
                                                                                                      Definition

                                                                                                      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                                                      ShortA set of rules under which this content was created
                                                                                                      Comments

                                                                                                      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                                                                      Control0..1
                                                                                                      Typeuri
                                                                                                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      8. Observation.language
                                                                                                      Definition

                                                                                                      The base language in which the resource is written.

                                                                                                      ShortLanguage of the resource content
                                                                                                      Comments

                                                                                                      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                                                                      Control0..1
                                                                                                      BindingThe codes SHOULD be taken from CommonLanguages
                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                                                                      A human language.

                                                                                                      Additional BindingsPurpose
                                                                                                      AllLanguagesMax Binding
                                                                                                      Typecode
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      10. Observation.text
                                                                                                      Definition

                                                                                                      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                      ShortText summary of the resource, for human interpretation
                                                                                                      Comments

                                                                                                      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                                                                      Control0..1
                                                                                                      TypeNarrative
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesnarrative, html, xhtml, display
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      12. Observation.contained
                                                                                                      Definition

                                                                                                      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                                                                      ShortContained, inline Resources
                                                                                                      Comments

                                                                                                      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                                                                      Control0..*
                                                                                                      TypeResource
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesinline resources, anonymous resources, contained resources
                                                                                                      14. Observation.extension
                                                                                                      Definition

                                                                                                      The laboratory test kit used for this test.

                                                                                                      ShortLaboratory Test Kit
                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      SlicingThis element introduces a set of slices on Observation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 16. Observation.extension:supportingInfo
                                                                                                        Slice NamesupportingInfo
                                                                                                        Definition

                                                                                                        Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use Observation.hasMember instead of supportingInformation for representing the members of an Observation panel.

                                                                                                        ShortOther information that may be relevant to this event.
                                                                                                        Control0..*
                                                                                                        TypeExtension(Supporting info) (Extension Type: Reference(Resource))
                                                                                                        Is Modifierfalse
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:handle
                                                                                                          SHALL:handle
                                                                                                          SHOULD:able-to-populate
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          18. Observation.extension:triggeredBy-r5
                                                                                                          Slice NametriggeredBy-r5
                                                                                                          Definition

                                                                                                          An Extension

                                                                                                          ShortExtension
                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension(Extension Definition for Observation.triggeredBy for Version 5.0) (Complex Extension)
                                                                                                          Is Modifierfalse
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:handle
                                                                                                            SHALL:handle
                                                                                                            SHOULD:able-to-populate
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            20. Observation.extension:triggeredBy-r5.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            Summaryfalse
                                                                                                            22. Observation.extension:triggeredBy-r5.extension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            SlicingThis element introduces a set of slices on Observation.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 24. Observation.extension:triggeredBy-r5.extension:observation
                                                                                                              Slice Nameobservation
                                                                                                              Definition

                                                                                                              An Extension

                                                                                                              ShortExtension
                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:handle
                                                                                                                SHALL:handle
                                                                                                                SHALL:able-to-populate
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                26. Observation.extension:triggeredBy-r5.extension:observation.id
                                                                                                                Definition

                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                Control0..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                Summaryfalse
                                                                                                                28. Observation.extension:triggeredBy-r5.extension:observation.extension
                                                                                                                Definition

                                                                                                                An Extension

                                                                                                                ShortExtension
                                                                                                                Control0..0
                                                                                                                TypeExtension
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                SlicingThis element introduces a set of slices on Observation.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 30. Observation.extension:triggeredBy-r5.extension:observation.url
                                                                                                                  Definition

                                                                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                                                                  Shortidentifies the meaning of the extension
                                                                                                                  Comments

                                                                                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                  Control1..1
                                                                                                                  Typeuri
                                                                                                                  Is Modifierfalse
                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                  Summaryfalse
                                                                                                                  Fixed Valueobservation
                                                                                                                  32. Observation.extension:triggeredBy-r5.extension:observation.value[x]
                                                                                                                  Definition

                                                                                                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                  ShortValue of extension
                                                                                                                  Control1..1
                                                                                                                  TypeReference(Observation)
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  34. Observation.extension:triggeredBy-r5.extension:type
                                                                                                                  Slice Nametype
                                                                                                                  Definition

                                                                                                                  An Extension

                                                                                                                  ShortExtension
                                                                                                                  Control0..*
                                                                                                                  TypeExtension
                                                                                                                  Is Modifierfalse
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:handle
                                                                                                                    SHALL:handle
                                                                                                                    SHALL:able-to-populate
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    36. Observation.extension:triggeredBy-r5.extension:type.id
                                                                                                                    Definition

                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                    Summaryfalse
                                                                                                                    38. Observation.extension:triggeredBy-r5.extension:type.extension
                                                                                                                    Definition

                                                                                                                    An Extension

                                                                                                                    ShortExtension
                                                                                                                    Control0..0
                                                                                                                    TypeExtension
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    SlicingThis element introduces a set of slices on Observation.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 40. Observation.extension:triggeredBy-r5.extension:type.url
                                                                                                                      Definition

                                                                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                                                                      Shortidentifies the meaning of the extension
                                                                                                                      Comments

                                                                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                      Control1..1
                                                                                                                      Typeuri
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      Fixed Valuetype
                                                                                                                      42. Observation.extension:triggeredBy-r5.extension:type.value[x]
                                                                                                                      Definition

                                                                                                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                      ShortValue of extension
                                                                                                                      Control1..1
                                                                                                                      Typecode
                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      44. Observation.extension:triggeredBy-r5.extension:reason
                                                                                                                      Slice Namereason
                                                                                                                      Definition

                                                                                                                      An Extension

                                                                                                                      ShortExtension
                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      46. Observation.extension:triggeredBy-r5.extension:reason.id
                                                                                                                      Definition

                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                      Control0..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      48. Observation.extension:triggeredBy-r5.extension:reason.extension
                                                                                                                      Definition

                                                                                                                      An Extension

                                                                                                                      ShortExtension
                                                                                                                      Control0..0
                                                                                                                      TypeExtension
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      SlicingThis element introduces a set of slices on Observation.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • value @ url
                                                                                                                      • 50. Observation.extension:triggeredBy-r5.extension:reason.url
                                                                                                                        Definition

                                                                                                                        Source of the definition for the extension code - a logical name or a URL.

                                                                                                                        Shortidentifies the meaning of the extension
                                                                                                                        Comments

                                                                                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                        Control1..1
                                                                                                                        Typeuri
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        Fixed Valuereason
                                                                                                                        52. Observation.extension:triggeredBy-r5.extension:reason.value[x]
                                                                                                                        Definition

                                                                                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                        ShortValue of extension
                                                                                                                        Control1..1
                                                                                                                        Typestring
                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        54. Observation.extension:triggeredBy-r5.url
                                                                                                                        Definition

                                                                                                                        Source of the definition for the extension code - a logical name or a URL.

                                                                                                                        Shortidentifies the meaning of the extension
                                                                                                                        Comments

                                                                                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                        Control1..1
                                                                                                                        Typeuri
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
                                                                                                                        56. Observation.extension:triggeredBy-r5.value[x]
                                                                                                                        Definition

                                                                                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                        ShortValue of extension
                                                                                                                        Control0..0
                                                                                                                        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        58. Observation.extension:certifiedRefMaterialCodeable
                                                                                                                        Slice NamecertifiedRefMaterialCodeable
                                                                                                                        Definition

                                                                                                                        This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using a CodeableConcept. This extension should be used when the unit is UCUM [IU].

                                                                                                                        ShortCertified Reference Material: CodeableConcept
                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeExtension(Certified Reference Material: CodeableConcept) (Extension Type: CodeableConcept)
                                                                                                                        Is Modifierfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        60. Observation.extension:certifiedRefMaterialIdentifer
                                                                                                                        Slice NamecertifiedRefMaterialIdentifer
                                                                                                                        Definition

                                                                                                                        This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using an Identifier. This extension should be used when the unit is UCUM [IU].

                                                                                                                        ShortCertified Reference Material: Identifier
                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeExtension(Certified Reference Material: Identifier) (Extension Type: Identifier)
                                                                                                                        Is Modifierfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        62. Observation.extension:labTestKit
                                                                                                                        Slice NamelabTestKit
                                                                                                                        Definition

                                                                                                                        This extension links this observation with the laboratory test kit used for this test. Usually only one laboratory test kit is referred

                                                                                                                        ShortDevice Laboratory Test Kit
                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeExtension(Device Laboratory Test Kit) (Extension Type: Reference(Device))
                                                                                                                        Is Modifierfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        64. Observation.extension:value-r5
                                                                                                                        Slice Namevalue-r5
                                                                                                                        Definition

                                                                                                                        Optional Extension Element - found in all resources.

                                                                                                                        Shortonly for result of type Attachment
                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeExtension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
                                                                                                                        Is Modifierfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        66. Observation.extension:value-r5.id
                                                                                                                        Definition

                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                        Control0..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        68. Observation.extension:value-r5.extension
                                                                                                                        Definition

                                                                                                                        An Extension

                                                                                                                        ShortExtension
                                                                                                                        Control0..0
                                                                                                                        TypeExtension
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        SlicingThis element introduces a set of slices on Observation.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • value @ url
                                                                                                                        • 70. Observation.extension:value-r5.url
                                                                                                                          Definition

                                                                                                                          Source of the definition for the extension code - a logical name or a URL.

                                                                                                                          Shortidentifies the meaning of the extension
                                                                                                                          Comments

                                                                                                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                          Control1..1
                                                                                                                          Typeuri
                                                                                                                          Is Modifierfalse
                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                          Summaryfalse
                                                                                                                          Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]
                                                                                                                          72. Observation.extension:value-r5.value[x]
                                                                                                                          Definition

                                                                                                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                          ShortValue of extension
                                                                                                                          Control1..1
                                                                                                                          TypeAttachment
                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          74. Observation.modifierExtension
                                                                                                                          Definition

                                                                                                                          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                          ShortExtensions that cannot be ignored
                                                                                                                          Comments

                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                          Control0..*
                                                                                                                          TypeExtension
                                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                          Alternate Namesextensions, user content
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          76. Observation.identifier
                                                                                                                          Definition

                                                                                                                          A unique identifier assigned to this observation.

                                                                                                                          ShortBusiness Identifier for observation
                                                                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                          Control0..*
                                                                                                                          TypeIdentifier
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Allows observations to be distinguished and referenced.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          78. Observation.basedOn
                                                                                                                          Definition

                                                                                                                          A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

                                                                                                                          ShortFulfills plan, proposal or order
                                                                                                                          Control0..*
                                                                                                                          TypeReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                                                                                                                          Alternate NamesFulfills
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          80. Observation.partOf
                                                                                                                          Definition

                                                                                                                          A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

                                                                                                                          ShortPart of referenced event
                                                                                                                          Comments

                                                                                                                          To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

                                                                                                                          Control0..*
                                                                                                                          TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Alternate NamesContainer
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          82. Observation.status
                                                                                                                          Definition

                                                                                                                          The status of the result value.

                                                                                                                          ShortStatus of this observation (e.g. preliminary, final,...)
                                                                                                                          Comments

                                                                                                                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                                                                                          Control1..1
                                                                                                                          BindingThe codes SHALL be taken from ObservationStatus
                                                                                                                          (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

                                                                                                                          Codes providing the status of an observation.

                                                                                                                          Typecode
                                                                                                                          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:handle
                                                                                                                            SHALL:handle
                                                                                                                            SHALL:able-to-populate
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            Need to track the status of individual results. Some results are finalized before the whole report is finalized.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            84. Observation.category
                                                                                                                            Definition

                                                                                                                            A code that classifies the general type of observation being made.

                                                                                                                            ShortClassification of type of observation
                                                                                                                            Comments

                                                                                                                            "laboratory" includes laboratory medicine and pathology

                                                                                                                            Control1..*
                                                                                                                            BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                                                                                            Codes for high level observation categories.

                                                                                                                            TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                            Is Modifierfalse
                                                                                                                            Obligations
                                                                                                                              ObligationsActor
                                                                                                                              SHALL:handle
                                                                                                                              SHALL:handle
                                                                                                                              SHALL:able-to-populate
                                                                                                                              Summaryfalse
                                                                                                                              Requirements

                                                                                                                              Used for filtering what observations are retrieved and displayed.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • pattern @ $this
                                                                                                                              • 86. Observation.category:laboratory
                                                                                                                                Slice Namelaboratory
                                                                                                                                Definition

                                                                                                                                A code that classifies the general type of observation being made.

                                                                                                                                ShortClassification of type of observation
                                                                                                                                Comments

                                                                                                                                In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                                                                                Control1..1
                                                                                                                                BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                                                                                                (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                                                                                                Codes for high level observation categories.

                                                                                                                                TypeCodeableConcept
                                                                                                                                Is Modifierfalse
                                                                                                                                Summaryfalse
                                                                                                                                Requirements

                                                                                                                                Used for filtering what observations are retrieved and displayed.

                                                                                                                                Pattern Value{
                                                                                                                                  "coding" : [{
                                                                                                                                    "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                                                                                                                    "code" : "laboratory"
                                                                                                                                  }]
                                                                                                                                }
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                88. Observation.category:studyType
                                                                                                                                Slice NamestudyType
                                                                                                                                Definition

                                                                                                                                A code that classifies the general type of observation being made.

                                                                                                                                ShortThe way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)
                                                                                                                                Comments

                                                                                                                                In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                                                                                Control0..*
                                                                                                                                BindingThe codes SHALL be taken from Laboratory Study Types
                                                                                                                                (required to http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab)
                                                                                                                                TypeCodeableConcept
                                                                                                                                Is Modifierfalse
                                                                                                                                Summaryfalse
                                                                                                                                Requirements

                                                                                                                                Used for filtering what observations are retrieved and displayed.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                90. Observation.category:specialty
                                                                                                                                Slice Namespecialty
                                                                                                                                Definition

                                                                                                                                A code that classifies the general type of observation being made.

                                                                                                                                ShortThe clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)
                                                                                                                                Comments

                                                                                                                                In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                                                                                                Control0..*
                                                                                                                                BindingThe codes SHALL be taken from Laboratory Specialty
                                                                                                                                (required to http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab)
                                                                                                                                TypeCodeableConcept
                                                                                                                                Is Modifierfalse
                                                                                                                                Summaryfalse
                                                                                                                                Requirements

                                                                                                                                Used for filtering what observations are retrieved and displayed.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                92. Observation.code
                                                                                                                                Definition

                                                                                                                                Describes what was observed. Sometimes this is called the observation "name". In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations

                                                                                                                                ShortConcept - reference to a terminology or just text
                                                                                                                                Comments

                                                                                                                                In the context of this Observation-laboratory-uv-ips profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided.

                                                                                                                                Control1..1
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                BindingThe codes SHOULD be taken from Laboratory Code
                                                                                                                                (preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab)
                                                                                                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                                Is Modifierfalse
                                                                                                                                Obligations
                                                                                                                                  ObligationsActor
                                                                                                                                  SHALL:handle
                                                                                                                                  SHALL:handle
                                                                                                                                  SHALL:able-to-populate
                                                                                                                                  Requirements

                                                                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                  Alternate NamesName
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  94. Observation.subject
                                                                                                                                  Definition

                                                                                                                                  The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

                                                                                                                                  ShortWho and/or what the observation is about
                                                                                                                                  Comments

                                                                                                                                  One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

                                                                                                                                  Control1..1
                                                                                                                                  TypeReference(Patient: Animal, Patient: Person, Group, Device, Location)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:handle
                                                                                                                                    SHALL:handle
                                                                                                                                    SHALL:able-to-populate
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Observations have no value if you don't know who or what they're about.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    96. Observation.subject.id
                                                                                                                                    Definition

                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                    Control0..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    Summaryfalse
                                                                                                                                    98. Observation.subject.extension
                                                                                                                                    Definition

                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                    Comments

                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                    Control0..*
                                                                                                                                    TypeExtension
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Summaryfalse
                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                    SlicingThis element introduces a set of slices on Observation.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                    • value @ url
                                                                                                                                    • 100. Observation.subject.reference
                                                                                                                                      Definition

                                                                                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                                                                                      Comments

                                                                                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                                                                      Control1..1
                                                                                                                                      This element is affected by the following invariants: ref-1
                                                                                                                                      Typestring
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      102. Observation.subject.type
                                                                                                                                      Definition

                                                                                                                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                                                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                                                                      ShortType the reference refers to (e.g. "Patient")
                                                                                                                                      Comments

                                                                                                                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                                                                      Control0..1
                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                                                                      Aa resource (or, for logical models, the URI of the logical model).

                                                                                                                                      Typeuri
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      104. Observation.subject.identifier
                                                                                                                                      Definition

                                                                                                                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                                                                      ShortLogical reference, when literal reference is not known
                                                                                                                                      Comments

                                                                                                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                                                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                                      Control0..1
                                                                                                                                      TypeIdentifier
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      106. Observation.subject.display
                                                                                                                                      Definition

                                                                                                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                                                                      ShortText alternative for the resource
                                                                                                                                      Comments

                                                                                                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                                                                      Control0..1
                                                                                                                                      Typestring
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      108. Observation.focus
                                                                                                                                      Definition

                                                                                                                                      The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

                                                                                                                                      ShortWhat the observation is about, when it is not about the subject of record
                                                                                                                                      Comments

                                                                                                                                      Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

                                                                                                                                      Control0..*
                                                                                                                                      TypeReference(Resource)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      110. Observation.encounter
                                                                                                                                      Definition

                                                                                                                                      The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

                                                                                                                                      ShortHealthcare event during which this observation is made
                                                                                                                                      Comments

                                                                                                                                      This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

                                                                                                                                      Control0..1
                                                                                                                                      TypeReference(Encounter)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      For some observations it may be important to know the link between an observation and a particular encounter.

                                                                                                                                      Alternate NamesContext
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      112. Observation.effective[x]
                                                                                                                                      Definition

                                                                                                                                      The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

                                                                                                                                      ShortClinically relevant time/time-period for observation
                                                                                                                                      Comments

                                                                                                                                      At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                                                                                      Control1..1
                                                                                                                                      TypeChoice of: dateTime, Period
                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActor
                                                                                                                                        SHALL:handle
                                                                                                                                        SHALL:handle
                                                                                                                                        SHALL:able-to-populate
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                                                                                        Alternate NamesOccurrence
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        114. Observation.effective[x].id
                                                                                                                                        Definition

                                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                                        Control0..1
                                                                                                                                        Typestring
                                                                                                                                        Is Modifierfalse
                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                        Summaryfalse
                                                                                                                                        116. Observation.effective[x].extension
                                                                                                                                        Definition

                                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                                        Comments

                                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                        Control0..*
                                                                                                                                        TypeExtension
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Summaryfalse
                                                                                                                                        Alternate Namesextensions, user content
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                        SlicingThis element introduces a set of slices on Observation.effective[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                        • value @ url
                                                                                                                                        • 118. Observation.effective[x].extension:data-absent-reason
                                                                                                                                          Slice Namedata-absent-reason
                                                                                                                                          Definition

                                                                                                                                          Provides a reason why the expected value or elements in the element that is extended are missing.

                                                                                                                                          Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
                                                                                                                                          Control0..1
                                                                                                                                          TypeExtension(Data Absent Reason) (Extension Type: code)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            SHALL:handle
                                                                                                                                            SHALL:handle
                                                                                                                                            SHALL:able-to-populate
                                                                                                                                            Summaryfalse
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                            120. Observation.issued
                                                                                                                                            Definition

                                                                                                                                            The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

                                                                                                                                            ShortDate/Time this result was made available
                                                                                                                                            Comments

                                                                                                                                            For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

                                                                                                                                            Control0..1
                                                                                                                                            Typeinstant
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActor
                                                                                                                                              SHALL:handle
                                                                                                                                              SHALL:handle
                                                                                                                                              SHOULD:able-to-populate
                                                                                                                                              Summarytrue
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              122. Observation.performer
                                                                                                                                              Definition

                                                                                                                                              Who was responsible for asserting the observed value as "true".

                                                                                                                                              ShortWho is responsible for the observation
                                                                                                                                              Control1..*
                                                                                                                                              TypeReference(PractitionerRole: Laboratory Report, Practitioner: Laboratory Report, Organization (IPS), CareTeam, Patient: Person, RelatedPerson)
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActor
                                                                                                                                                SHALL:handle
                                                                                                                                                SHALL:handle
                                                                                                                                                SHALL:able-to-populate
                                                                                                                                                Summarytrue
                                                                                                                                                Requirements

                                                                                                                                                May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                124. Observation.performer.id
                                                                                                                                                Definition

                                                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                                                Control0..1
                                                                                                                                                Typestring
                                                                                                                                                Is Modifierfalse
                                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                Summaryfalse
                                                                                                                                                126. Observation.performer.extension
                                                                                                                                                Definition

                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                                Comments

                                                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                Control0..*
                                                                                                                                                TypeExtension
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Summaryfalse
                                                                                                                                                Alternate Namesextensions, user content
                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                SlicingThis element introduces a set of slices on Observation.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                • value @ url
                                                                                                                                                • 128. Observation.performer.extension:performerFunction
                                                                                                                                                  Slice NameperformerFunction
                                                                                                                                                  Definition

                                                                                                                                                  Distinguishes the type of involvement of the performer in the event. For example, 'author', 'verifier' or 'responsible party'.

                                                                                                                                                  ShortType of performance
                                                                                                                                                  Control0..*
                                                                                                                                                  TypeExtension(Performer function) (Extension Type: CodeableConcept)
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:handle
                                                                                                                                                    SHALL:handle
                                                                                                                                                    SHOULD:able-to-populate
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    130. Observation.performer.reference
                                                                                                                                                    Definition

                                                                                                                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                                                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                                                                                                                    Comments

                                                                                                                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                                                                                    Control0..1
                                                                                                                                                    This element is affected by the following invariants: ref-1
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summarytrue
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    132. Observation.performer.type
                                                                                                                                                    Definition

                                                                                                                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                                                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                                                                                    ShortType the reference refers to (e.g. "Patient")
                                                                                                                                                    Comments

                                                                                                                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                                                                                    Control0..1
                                                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                                                                                                    Aa resource (or, for logical models, the URI of the logical model).

                                                                                                                                                    Typeuri
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summarytrue
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    134. Observation.performer.identifier
                                                                                                                                                    Definition

                                                                                                                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                                                                                    ShortLogical reference, when literal reference is not known
                                                                                                                                                    Comments

                                                                                                                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                                                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                                                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                                                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                                                    Control0..1
                                                                                                                                                    TypeIdentifier
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summarytrue
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    136. Observation.performer.display
                                                                                                                                                    Definition

                                                                                                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                                                                                    ShortText alternative for the resource
                                                                                                                                                    Comments

                                                                                                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                                                                                    Control0..1
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summarytrue
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    138. Observation.value[x]
                                                                                                                                                    Definition

                                                                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                    ShortActual result
                                                                                                                                                    Comments

                                                                                                                                                    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                    Control0..1
                                                                                                                                                    This element is affected by the following invariants: obs-7
                                                                                                                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActor
                                                                                                                                                      SHALL:handle
                                                                                                                                                      SHALL:handle
                                                                                                                                                      SHALL:able-to-populate
                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                                                      • type @ $this
                                                                                                                                                      • 140. Observation.value[x]:valueString
                                                                                                                                                        Slice NamevalueString
                                                                                                                                                        Definition

                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                        ShortActual result
                                                                                                                                                        Comments

                                                                                                                                                        An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: obs-7
                                                                                                                                                        Typestring
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        142. Observation.value[x]:valueRange
                                                                                                                                                        Slice NamevalueRange
                                                                                                                                                        Definition

                                                                                                                                                        A set of ordered Quantities defined by a low and high limit.

                                                                                                                                                        ShortSet of values bounded by low and high
                                                                                                                                                        Comments

                                                                                                                                                        The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        TypeRange(Range (IPS))
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        rng-2: If present, low SHALL have a lower value than high (low.empty() or high.empty() or (low <= high))
                                                                                                                                                        144. Observation.value[x]:valueRatio
                                                                                                                                                        Slice NamevalueRatio
                                                                                                                                                        Definition

                                                                                                                                                        A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM.

                                                                                                                                                        ShortA measured ratio using UCUM
                                                                                                                                                        Comments

                                                                                                                                                        The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        TypeRatio(Ratio (Eu Lab))
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                                                                                        146. Observation.value[x]:valueTime
                                                                                                                                                        Slice NamevalueTime
                                                                                                                                                        Definition

                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                        ShortActual result
                                                                                                                                                        Comments

                                                                                                                                                        An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: obs-7
                                                                                                                                                        Typetime
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        148. Observation.value[x]:valueDateTime
                                                                                                                                                        Slice NamevalueDateTime
                                                                                                                                                        Definition

                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                        ShortActual result
                                                                                                                                                        Comments

                                                                                                                                                        An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: obs-7
                                                                                                                                                        TypedateTime
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        150. Observation.value[x]:valuePeriod
                                                                                                                                                        Slice NamevaluePeriod
                                                                                                                                                        Definition

                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                        ShortActual result
                                                                                                                                                        Comments

                                                                                                                                                        An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: obs-7
                                                                                                                                                        TypePeriod
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        152. Observation.value[x]:valueQuantity
                                                                                                                                                        Slice NamevalueQuantity
                                                                                                                                                        Definition

                                                                                                                                                        A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.

                                                                                                                                                        ShortA measured amount using UCUM
                                                                                                                                                        Comments

                                                                                                                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        TypeQuantity(Quantity (Eu Lab))
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                                                        154. Observation.value[x]:valueCodeableConcept
                                                                                                                                                        Slice NamevalueCodeableConcept
                                                                                                                                                        Definition

                                                                                                                                                        A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

                                                                                                                                                        ShortConcept - reference to a terminology or just text
                                                                                                                                                        Comments

                                                                                                                                                        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        BindingThe codes SHOULD be taken from Results Coded Values Laboratory - IPS
                                                                                                                                                        (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-uv-ips)
                                                                                                                                                        Additional BindingsPurposeDocumentation
                                                                                                                                                        Results Blood Group - SNOMED CT IPS Free Setcandidate

                                                                                                                                                        Additional conformance binding to a blood group findings value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                                                                        Results Presence Absence - SNOMED CT IPS Free Setcandidate

                                                                                                                                                        Additional conformance binding to a presence and absence findings (qualifier values) value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                                                                        Results Microorganism - SNOMED CT IPS Free Setcandidate

                                                                                                                                                        Additional conformance binding to a microorganisms value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                                                                        TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        156. Observation.dataAbsentReason
                                                                                                                                                        Definition

                                                                                                                                                        Provides a reason why the expected value in the element Observation.value[x] is missing.

                                                                                                                                                        ShortProvides a reason why the expected value is missing.
                                                                                                                                                        Comments

                                                                                                                                                        Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

                                                                                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: obs-6
                                                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Summaryfalse
                                                                                                                                                        Requirements

                                                                                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        158. Observation.interpretation
                                                                                                                                                        Definition

                                                                                                                                                        A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

                                                                                                                                                        ShortConcept - reference to a terminology or just text
                                                                                                                                                        Comments

                                                                                                                                                        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                                                                        Control0..*
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                        Codes identifying interpretations of observations.

                                                                                                                                                        TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActor
                                                                                                                                                          SHALL:handle
                                                                                                                                                          SHALL:handle
                                                                                                                                                          SHALL:able-to-populate
                                                                                                                                                          Requirements

                                                                                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                          Alternate NamesAbnormal Flag
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          160. Observation.note
                                                                                                                                                          Definition

                                                                                                                                                          Comments about the observation or the results.

                                                                                                                                                          ShortComments about the observation
                                                                                                                                                          Comments

                                                                                                                                                          May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

                                                                                                                                                          Control0..*
                                                                                                                                                          TypeAnnotation
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Requirements

                                                                                                                                                          Need to be able to provide free text additional information.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          162. Observation.bodySite
                                                                                                                                                          Definition

                                                                                                                                                          Indicates the site on the subject's body where the observation was made (i.e. the target site).

                                                                                                                                                          ShortObserved body part
                                                                                                                                                          Comments

                                                                                                                                                          Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

                                                                                                                                                          If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

                                                                                                                                                          Control0..1
                                                                                                                                                          BindingFor example codes, see SNOMEDCTBodyStructures
                                                                                                                                                          (example to http://hl7.org/fhir/ValueSet/body-site)

                                                                                                                                                          Codes describing anatomical locations. May include laterality.

                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          164. Observation.method
                                                                                                                                                          Definition

                                                                                                                                                          Laboratory technigue that has been used

                                                                                                                                                          ShortConcept - reference to a terminology or just text
                                                                                                                                                          Comments

                                                                                                                                                          Laboratory technique (method of measurement) are integral parts of the test specification of some laboratory test coding systems (e.g. NPU), in LOINC hovewer measurement principle is not always present in the test definition. In some cases however knowledge of the used measurment techique is important for proper interpretation of the test result. That's why it is important to explicitly include informaiton about measurement method is such cases.

                                                                                                                                                          Control0..1
                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                          BindingThe codes SHOULD be taken from Laboratory Techniques
                                                                                                                                                          (preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-technique-eu-lab)
                                                                                                                                                          TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Obligations
                                                                                                                                                            ObligationsActor
                                                                                                                                                            SHALL:handle
                                                                                                                                                            SHALL:handle
                                                                                                                                                            SHALL:able-to-populate
                                                                                                                                                            Requirements

                                                                                                                                                            In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            166. Observation.specimen
                                                                                                                                                            Definition

                                                                                                                                                            The specimen that was used when this observation was made.

                                                                                                                                                            ShortSpecimen used for this observation
                                                                                                                                                            Comments

                                                                                                                                                            When the specimen is applicable and known it shall be documented

                                                                                                                                                            Control0..1
                                                                                                                                                            TypeReference(Specimen: Laboratory)
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Obligations
                                                                                                                                                              ObligationsActor
                                                                                                                                                              SHALL:handle
                                                                                                                                                              SHALL:handle
                                                                                                                                                              SHALL:able-to-populate
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              168. Observation.device
                                                                                                                                                              Definition

                                                                                                                                                              The device used to generate the observation data.

                                                                                                                                                              ShortMeasuring instrument
                                                                                                                                                              Comments

                                                                                                                                                              Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

                                                                                                                                                              Control0..1
                                                                                                                                                              TypeReference(Device, DeviceMetric)
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              170. Observation.referenceRange
                                                                                                                                                              Definition

                                                                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

                                                                                                                                                              ShortProvides guide for interpretation
                                                                                                                                                              Comments

                                                                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                              Control0..*
                                                                                                                                                              TypeBackboneElement
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Requirements

                                                                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
                                                                                                                                                              172. Observation.referenceRange.id
                                                                                                                                                              Definition

                                                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                                                              Control0..1
                                                                                                                                                              Typestring
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                              Summaryfalse
                                                                                                                                                              174. Observation.referenceRange.extension
                                                                                                                                                              Definition

                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                                                              Comments

                                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                              Control0..*
                                                                                                                                                              TypeExtension
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Alternate Namesextensions, user content
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                              176. Observation.referenceRange.modifierExtension
                                                                                                                                                              Definition

                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                              Comments

                                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                              Control0..*
                                                                                                                                                              TypeExtension
                                                                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                              178. Observation.referenceRange.low
                                                                                                                                                              Definition

                                                                                                                                                              The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

                                                                                                                                                              ShortLow Range, if relevant
                                                                                                                                                              Control0..1
                                                                                                                                                              This element is affected by the following invariants: obs-3
                                                                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              180. Observation.referenceRange.high
                                                                                                                                                              Definition

                                                                                                                                                              The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

                                                                                                                                                              ShortHigh Range, if relevant
                                                                                                                                                              Control0..1
                                                                                                                                                              This element is affected by the following invariants: obs-3
                                                                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              182. Observation.referenceRange.type
                                                                                                                                                              Definition

                                                                                                                                                              Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

                                                                                                                                                              ShortReference range qualifier
                                                                                                                                                              Comments

                                                                                                                                                              This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

                                                                                                                                                              Control0..1
                                                                                                                                                              BindingThe codes SHOULD be taken from ObservationReferenceRangeMeaningCodes
                                                                                                                                                              (preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning)

                                                                                                                                                              Code for the meaning of a reference range.

                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Requirements

                                                                                                                                                              Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              184. Observation.referenceRange.appliesTo
                                                                                                                                                              Definition

                                                                                                                                                              Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

                                                                                                                                                              ShortReference range population
                                                                                                                                                              Comments

                                                                                                                                                              This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

                                                                                                                                                              Control0..*
                                                                                                                                                              BindingFor example codes, see ObservationReferenceRangeAppliesToCodes
                                                                                                                                                              (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto)

                                                                                                                                                              Codes identifying the population the reference range applies to.

                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Requirements

                                                                                                                                                              Need to be able to identify the target population for proper interpretation.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              186. Observation.referenceRange.age
                                                                                                                                                              Definition

                                                                                                                                                              The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

                                                                                                                                                              ShortApplicable age range, if relevant
                                                                                                                                                              Control0..1
                                                                                                                                                              TypeRange
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Requirements

                                                                                                                                                              Some analytes vary greatly over age.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              188. Observation.referenceRange.text
                                                                                                                                                              Definition

                                                                                                                                                              Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

                                                                                                                                                              ShortText based reference range in an observation
                                                                                                                                                              Control0..1
                                                                                                                                                              Typestring
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              190. Observation.hasMember
                                                                                                                                                              Definition

                                                                                                                                                              A reference to another Observation profiled by Observation-results-laboratory-uv-ips. The target observation (for instance an individual test member of a panel) is considered as a sub-observation of the current one, which plays the role of a grouper.

                                                                                                                                                              ShortRelated resource that belongs to the Observation group
                                                                                                                                                              Comments

                                                                                                                                                              This element is used in the context of international patient summary when there is a need to group a collection of observations, because they belong to the same panel, or because they share a common interpretation comment, or a common media attachment (illustrative image or graph). In these cases, the current observation is the grouper, and its set of sub-observations are related observations using the type "has-member". For a discussion on the ways Observations can be assembled in groups together see Observation Grouping.

                                                                                                                                                              Control0..*
                                                                                                                                                              TypeReference(Observation Results: laboratory)
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Obligations
                                                                                                                                                                ObligationsActor
                                                                                                                                                                SHALL:handle
                                                                                                                                                                SHALL:handle
                                                                                                                                                                SHALL:able-to-populate
                                                                                                                                                                Summarytrue
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                192. Observation.derivedFrom
                                                                                                                                                                Definition

                                                                                                                                                                The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

                                                                                                                                                                ShortRelated measurements the observation is made from
                                                                                                                                                                Comments

                                                                                                                                                                All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

                                                                                                                                                                Control0..*
                                                                                                                                                                TypeReference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Summarytrue
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                194. Observation.component
                                                                                                                                                                Definition

                                                                                                                                                                Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                                ShortLaboratory result
                                                                                                                                                                Comments

                                                                                                                                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                                Control0..*
                                                                                                                                                                TypeBackboneElement
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Obligations
                                                                                                                                                                  ObligationsActor
                                                                                                                                                                  SHALL:handle
                                                                                                                                                                  SHALL:handle
                                                                                                                                                                  SHALL:able-to-populate
                                                                                                                                                                  Summarytrue
                                                                                                                                                                  Requirements

                                                                                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  196. Observation.component.id
                                                                                                                                                                  Definition

                                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                                  Control0..1
                                                                                                                                                                  Typestring
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                  Summaryfalse
                                                                                                                                                                  198. Observation.component.extension
                                                                                                                                                                  Definition

                                                                                                                                                                  An Extension

                                                                                                                                                                  ShortExtension
                                                                                                                                                                  Control0..*
                                                                                                                                                                  TypeExtension
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Summaryfalse
                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                  • value @ url
                                                                                                                                                                  • 200. Observation.component.extension:value-r5
                                                                                                                                                                    Slice Namevalue-r5
                                                                                                                                                                    Definition

                                                                                                                                                                    Optional Extension Element - found in all resources.

                                                                                                                                                                    Shortonly for result of type Attachment
                                                                                                                                                                    Control0..1
                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                    TypeExtension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                    202. Observation.component.extension:value-r5.id
                                                                                                                                                                    Definition

                                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                                    Control0..1
                                                                                                                                                                    Typestring
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                    Summaryfalse
                                                                                                                                                                    204. Observation.component.extension:value-r5.extension
                                                                                                                                                                    Definition

                                                                                                                                                                    An Extension

                                                                                                                                                                    ShortExtension
                                                                                                                                                                    Control0..0
                                                                                                                                                                    TypeExtension
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    Summaryfalse
                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                    SlicingThis element introduces a set of slices on Observation.component.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                    • value @ url
                                                                                                                                                                    • 206. Observation.component.extension:value-r5.url
                                                                                                                                                                      Definition

                                                                                                                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                                                      Shortidentifies the meaning of the extension
                                                                                                                                                                      Comments

                                                                                                                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                                                      Control1..1
                                                                                                                                                                      Typeuri
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                      Summaryfalse
                                                                                                                                                                      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]
                                                                                                                                                                      208. Observation.component.extension:value-r5.value[x]
                                                                                                                                                                      Definition

                                                                                                                                                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                                                                      ShortValue of extension
                                                                                                                                                                      Control1..1
                                                                                                                                                                      TypeAttachment
                                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Summaryfalse
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      210. Observation.component.modifierExtension
                                                                                                                                                                      Definition

                                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                      Comments

                                                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                      Control0..*
                                                                                                                                                                      TypeExtension
                                                                                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                      Summarytrue
                                                                                                                                                                      Requirements

                                                                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                      212. Observation.component.code
                                                                                                                                                                      Definition

                                                                                                                                                                      A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

                                                                                                                                                                      ShortConcept - reference to a terminology or just text
                                                                                                                                                                      Comments

                                                                                                                                                                      Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                                                                                      Control1..1
                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                      BindingThe codes SHOULD be taken from Results Laboratory Observation - IPS
                                                                                                                                                                      (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-laboratory-observations-uv-ips)
                                                                                                                                                                      TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Obligations
                                                                                                                                                                        ObligationsActor
                                                                                                                                                                        SHALL:handle
                                                                                                                                                                        SHALL:handle
                                                                                                                                                                        SHALL:able-to-populate
                                                                                                                                                                        Requirements

                                                                                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        214. Observation.component.value[x]
                                                                                                                                                                        Definition

                                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                        ShortActual component result
                                                                                                                                                                        Comments

                                                                                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                        Control0..1
                                                                                                                                                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                        Obligations
                                                                                                                                                                          ObligationsActor
                                                                                                                                                                          SHALL:handle
                                                                                                                                                                          SHALL:handle
                                                                                                                                                                          SHALL:able-to-populate
                                                                                                                                                                          Summarytrue
                                                                                                                                                                          Requirements

                                                                                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                                                                          • type @ $this
                                                                                                                                                                          • 216. Observation.component.value[x]:valueString
                                                                                                                                                                            Slice NamevalueString
                                                                                                                                                                            Definition

                                                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                            ShortActual component result
                                                                                                                                                                            Comments

                                                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            Typestring
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            218. Observation.component.value[x]:valueRange
                                                                                                                                                                            Slice NamevalueRange
                                                                                                                                                                            Definition

                                                                                                                                                                            A set of ordered Quantities defined by a low and high limit.

                                                                                                                                                                            ShortSet of values bounded by low and high
                                                                                                                                                                            Comments

                                                                                                                                                                            The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            TypeRange(Range (IPS))
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            rng-2: If present, low SHALL have a lower value than high (low.empty() or high.empty() or (low <= high))
                                                                                                                                                                            220. Observation.component.value[x]:valueRatio
                                                                                                                                                                            Slice NamevalueRatio
                                                                                                                                                                            Definition

                                                                                                                                                                            A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM.

                                                                                                                                                                            ShortA measured ratio using UCUM
                                                                                                                                                                            Comments

                                                                                                                                                                            The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            TypeRatio(Ratio (Eu Lab))
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                                                                                                            222. Observation.component.value[x]:valueTime
                                                                                                                                                                            Slice NamevalueTime
                                                                                                                                                                            Definition

                                                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                            ShortActual component result
                                                                                                                                                                            Comments

                                                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            Typetime
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            224. Observation.component.value[x]:valueDateTime
                                                                                                                                                                            Slice NamevalueDateTime
                                                                                                                                                                            Definition

                                                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                            ShortActual component result
                                                                                                                                                                            Comments

                                                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            TypedateTime
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            226. Observation.component.value[x]:valuePeriod
                                                                                                                                                                            Slice NamevaluePeriod
                                                                                                                                                                            Definition

                                                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                            ShortActual component result
                                                                                                                                                                            Comments

                                                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            TypePeriod
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            228. Observation.component.value[x]:valueQuantity
                                                                                                                                                                            Slice NamevalueQuantity
                                                                                                                                                                            Definition

                                                                                                                                                                            A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.

                                                                                                                                                                            ShortA measured amount using UCUM
                                                                                                                                                                            Comments

                                                                                                                                                                            The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            TypeQuantity(Quantity (Eu Lab))
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                                                                            230. Observation.component.value[x]:valueCodeableConcept
                                                                                                                                                                            Slice NamevalueCodeableConcept
                                                                                                                                                                            Definition

                                                                                                                                                                            A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

                                                                                                                                                                            ShortConcept - reference to a terminology or just text
                                                                                                                                                                            Comments

                                                                                                                                                                            Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            BindingThe codes SHOULD be taken from Results Coded Values Laboratory - IPS
                                                                                                                                                                            (preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-uv-ips)
                                                                                                                                                                            Additional BindingsPurposeDocumentation
                                                                                                                                                                            Results Blood Group - SNOMED CT IPS Free Setcandidate

                                                                                                                                                                            Additional conformance binding to a blood group findings value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                                                                                            Results Presence Absence - SNOMED CT IPS Free Setcandidate

                                                                                                                                                                            Additional conformance binding to a presence and absence findings (qualifier values) value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                                                                                            Results Microorganism - SNOMED CT IPS Free Setcandidate

                                                                                                                                                                            Additional conformance binding to a microorganisms value set for laboratory result values from the SNOMED CT IPS free set for use globally (in SNOMED member and non-member jurisdictions).

                                                                                                                                                                            TypeCodeableConcept(Codeable Concept (IPS))
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            232. Observation.component.dataAbsentReason
                                                                                                                                                                            Definition

                                                                                                                                                                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                            ShortWhy the component result is missing
                                                                                                                                                                            Comments

                                                                                                                                                                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            This element is affected by the following invariants: obs-6
                                                                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                            Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            234. Observation.component.interpretation
                                                                                                                                                                            Definition

                                                                                                                                                                            A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                            ShortHigh, low, normal, etc.
                                                                                                                                                                            Comments

                                                                                                                                                                            Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                            Control0..*
                                                                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                            Codes identifying interpretations of observations.

                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                            Alternate NamesAbnormal Flag
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            236. Observation.component.referenceRange
                                                                                                                                                                            Definition

                                                                                                                                                                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                            ShortProvides guide for interpretation of component result
                                                                                                                                                                            Comments

                                                                                                                                                                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                            Control0..*
                                                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))