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Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Mappings for the observation resource (see Mappings to Other Standards for further information & status).

Observation
    identifierFiveWs.identifier
    statusFiveWs.status
    categoryFiveWs.class
    codeFiveWs.what[x]
    subjectFiveWs.subject[x]
    focusFiveWs.subject[x]
    encounterFiveWs.context
    effective[x]FiveWs.done[x]
    issuedFiveWs.recorded
    performerFiveWs.actor
        codeFiveWs.what[x]
ObservationEvent
    identifierEvent.identifier
    basedOnEvent.basedOn
    partOfEvent.partOf
    statusEvent.status
    codeEvent.code
    subjectEvent.subject
    encounterEvent.context
    effective[x]Event.occurrence[x]
    performerEvent.performer.actor
ObservationOBX
    identifierOBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
    basedOnORC
    partOfVaries by domain
    statusOBX-11
    category
    codeOBX-3
    subjectPID-3
    focusOBX-3
    encounterPV1
    effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
    issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
    performerOBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
    value[x]OBX.2, OBX.5, OBX.6
    dataAbsentReasonN/A
    interpretationOBX-8
    noteNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
    bodySiteOBX-20
    methodOBX-17
    specimenSPM segment
    deviceOBX-17 / PRT -10
    referenceRangeOBX.7
        lowOBX-7
        highOBX-7
        typeOBX-10
        appliesToOBX-10
        age
        textOBX-7
    hasMemberRelationships established by OBX-4 usage
    derivedFromRelationships established by OBX-4 usage
    componentcontainment by OBX-4?
        codeOBX-3
        value[x]OBX.2, OBX.5, OBX.6
        dataAbsentReasonN/A
        interpretationOBX-8
        referenceRangeOBX.7

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
Observation
    identifier
    basedOn
    partOf
    status
    category
    code116680003 |Is a|
    subject
    focus
    encounter
    effective[x]
    issued
    performer
    value[x]363714003 |Interprets|
    dataAbsentReason
    interpretation363713009 |Has interpretation|
    note
    bodySite718497002 |Inherent location|
    method
    specimen704319004 |Inherent in|
    device424226004 |Using device|
    referenceRange
        low
        high
        type
        appliesTo
        age
        text
    hasMember
    derivedFrom
    component
        code
        value[x]363714003 |Interprets|
        dataAbsentReason
        interpretation363713009 |Has interpretation|
        referenceRange

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
Observation< 363787002 |Observable entity|
    identifier
    basedOn
    partOf
    status< 445584004 |Report by finality status|
    category
    code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
    subject
    focus
    encounter
    effective[x]
    issued
    performer
    value[x]< 441742003 |Evaluation finding|
    dataAbsentReason
    interpretation< 260245000 |Findings values|
    note
    bodySite< 123037004 |Body structure|
    method
    specimen< 123038009 |Specimen|
    device< 49062001 |Device|
    referenceRange
        low
        high
        type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
        appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
        age
        text
    hasMember
    derivedFrom
    component
        code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
        value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
        dataAbsentReason
        interpretation< 260245000 |Findings values|
        referenceRange
ObservationObservation[classCode=OBS, moodCode=EVN]
    identifierid
    basedOn.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
    partOf.outboundRelationship[typeCode=FLFS].target
    statusstatus Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
    category.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
    codecode
    subjectparticipation[typeCode=RTGT]
    focusparticipation[typeCode=SBJ]
    encounterinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
    effective[x]effectiveTime
    issuedparticipation[typeCode=AUT].time
    performerparticipation[typeCode=PRF]
    value[x]value
    dataAbsentReasonvalue.nullFlavor
    interpretationinterpretationCode
    notesubjectOf.observationEvent[code="annotation"].value
    bodySitetargetSiteCode
    methodmethodCode
    specimenparticipation[typeCode=SPC].specimen
    deviceparticipation[typeCode=DEV]
    referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
        lowvalue:IVL_PQ.low
        highvalue:IVL_PQ.high
        typeinterpretationCode
        appliesTointerpretationCode
        ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
        textvalue:ST
    hasMemberoutBoundRelationship
    derivedFrom.targetObservation
    componentoutBoundRelationship[typeCode=COMP]
        codecode
        value[x]value
        dataAbsentReasonvalue.nullFlavor
        interpretationinterpretationCode
        referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]