This structure is derived from Observation.

Summary

10.1.18.2.2 Complete Summary of the Mandatory Requirements

1. One status in Observation.status which has a required binding to:

   • ObservationStatus value set.

2. A category in Observation.category which must have:

   • a fixed Observation.category.coding.system="http://terminology.hl7.org/CodeSystem/observation-category"
   • a fixed Observation.category.coding.code= "vital-signs"

3. A code in Observation.code

   • a fixed Observation.code.coding.system= "http://loinc.org""
   • a LOINC code in Observation.code.coding.code which has an extensible binding to:
     • Vital Signs value set.

4. One patient in Observation.subject

5. A date and time in effectiveDateTime or effectivePeriod

6. Either one Observation.value[x] or a populated component (with component.code and either component.value[x] or component.dataAbsentReason) or hasMember relationship. If there are none of those, then one code in Observation.DataAbsentReason

   • if a vital sign measure then:
     • One numeric value in Observation.valueQuantity.value
     • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
     • a UCUM unit code in Observation.valueQuantity.code which has a required binding to the Vital Signs Units value set.
   • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.

7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

   • a fixed Observation.component.code.coding.system =""http://loinc.org""
     • a LOINC code in Observation.code.coding.code which has an extensible binding to:
       • Vital Signs Units value set.

8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

   • Observation.component.DataAbsentReason is bound to Observation Value Absent Reason value set.

9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

   • a fixed Observation.related.type= "has-member""

Mandatory: 5 elements
Must-Support: 6 elements

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this

This indicates the differences between this profile and the base Observation structure.

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	FHIR Vital Signs Base Profile vsp-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day vsp-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
status	S	1..1	code	registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: Vital Signs Category (preferred): This value set includes the required vital sign interoperability categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
code	S	1..1	CodeableConcept	Vital Sign Measurement Binding: Vital Signs Measurement (preferred): This identifies the vital sign measurement.
subject	S	1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]	SC	1..1		Often just a dateTime for Vital Signs
effectiveDateTime			dateTime
effectivePeriod			Period
value[x]	C	0..1	Quantity	Vital Signs values are recorded using the Quantity data type. For supporting observations recorded as a component, such as blood pressure cuff size, other datatypes such as CodeableConcept could be used.
valueQuantity		0..1	Quantity	Vital Sign value recorded with UCUM (preferred) Binding: Vital Signs Units (preferred): Commonly encountered UCUM units for recording Vital Signs.
dataAbsentReason	C	0..1	CodeableConcept	Why the result value is missing
hasMember		0..*	Reference(Observation)	Used when reporting observations included in a vital signs panel
derivedFrom		0..*	Reference(DocumentReference | Observation)	Related resource from which the observation is made
component		0..*	BackboneElement	Component results
code		1..1	CodeableConcept	Vital Sign measurement or component
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment, Reference(MolecularSequence)	Vital Signs values are recorded using the Quantity data type. For supporting observations, such as blood pressure cuff size, other datatypes such as CodeableConcept could be used.
valueQuantity		0..1	Quantity	Vital Sign value recorded as a component with UCUM (preferred) Binding: UCUM units - for recording Vital Signs and components. (preferred): UCUM units - for recording Vital Signs and components.
dataAbsentReason		0..1	CodeableConcept	Why the component result value is missing
Documentation for this format

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observation structure.

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	FHIR Vital Signs Base Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present obs-10: dataAbsentReason SHALL only be present if Observation.component.value[x] is not present vsp-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day vsp-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: All Languages (required): IETF language tag for a human language Additional Bindings Purpose Common Languages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
instantiates[x]	Σ	0..1	canonical(ObservationDefinition), Reference(ObservationDefinition)	Instantiates FHIR ObservationDefinition
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
triggeredBy		0..*	BackboneElement	Triggering observation(s)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
observation	Σ	1..1	Reference(Observation)	Triggering observation
type	Σ	1..1	code	reflex | repeat | re-run Binding: triggered Bytype (required): The type of TriggeredBy Observation.
reason		0..1	string	Reason that the observation was triggered
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained Binding: Observation Status (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: Vital Signs Category (preferred): This value set includes the required vital sign interoperability categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣC	1..1	CodeableConcept	Vital Sign Measurement Binding: Vital Signs Measurement (preferred): This identifies the vital sign measurement.
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	?!Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		Often just a dateTime for Vital Signs
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1	Quantity	Vital Signs values are recorded using the Quantity data type. For supporting observations recorded as a component, such as blood pressure cuff size, other datatypes such as CodeableConcept could be used. Slice: Unordered, Closed by type:$this
value[x]:valueQuantity	ΣC	0..1	Quantity	Vital Sign value recorded with UCUM (preferred) Binding: Vital Signs Units (preferred): Commonly encountered UCUM units for recording Vital Signs.
dataAbsentReason	C	0..1	CodeableConcept	Why the result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	C	0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts
bodyStructure	C	0..1	Reference(BodyStructure)	Observed body structure
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen	C	0..1	Reference(Specimen | Group)	Specimen used for this observation obs-9: If Observation.specimen is a reference to Group, the group can only have specimens
device		0..1	Reference(Device | DeviceMetric)	A reference to the device that generates the measurements or the device settings for the device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
normalValue		0..1	CodeableConcept	Normal value, if relevant Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation.
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	C	0..1	markdown	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation)	Used when reporting observations included in a vital signs panel
derivedFrom	Σ	0..*	Reference(DocumentReference | Observation)	Related resource from which the observation is made
component	ΣC	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	1..1	CodeableConcept	Vital Sign measurement or component Binding: LOINC Codes (example): Codes identifying names of simple observations.
Slices for value[x]	Σ	0..1		Vital Signs values are recorded using the Quantity data type. For supporting observations, such as blood pressure cuff size, other datatypes such as CodeableConcept could be used. Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	Σ	0..1	Quantity	Vital Sign value recorded as a component with UCUM (preferred) Binding: UCUM units - for recording Vital Signs and components. (preferred): UCUM units - for recording Vital Signs and components.
dataAbsentReason		0..1	CodeableConcept	Why the component result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result value
Documentation for this format

<!-- Observationvitalsignsbase -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- I 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- I 0..1 Language of the resource content   -->
 <text><!-- I 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- I 0..* Identifier 
     Business Identifier for observation --></identifier>
 <instantiates[x]><!-- I 0..1 canonical|Reference(ObservationDefinition) 
     Instantiates FHIR ObservationDefinition --></instantiates[x]>
 <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <triggeredBy> I 0..* BackboneElement  <!-- I 0..* Triggering observation(s) -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <observation><!-- I 1..1 Reference(Observation) 
      Triggering observation --></observation>
  <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run   -->
  <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered -->
 </triggeredBy>
 <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- I 1..1 registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained   -->
 <-- category sliced by pattern:$this  in the specified orderOpen-->
 <category><!-- I 1..1 CodeableConcept Classification of  type of observation   --></category>
 <code><!-- I 1..1 CodeableConcept Vital Sign Measurement   --></code>
 <subject><!-- I 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- I 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- I 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- I 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available -->
 <performer><!-- I 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- I 0..1 Quantity Vital Sign value recorded with UCUM (preferred)   --></valueQuantity>
 <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result value is missing   --></dataAbsentReason>
 <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
 <note><!-- I 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- I 0..1 CodeableConcept Observed body part   --></bodySite>
 <bodyStructure><!-- I 0..1 Reference(BodyStructure) Observed body structure --></bodyStructure>
 <method><!-- I 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- I 0..1 Reference(Device) 
     A reference to the device that generates the measurements or the device settings for the device --></device>
 <referenceRange> I 0..* BackboneElement  <!-- I 0..* Provides guide for interpretation -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- I 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- I 0..1 Quantity 
      High Range, if relevant --></high>
  <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant   --></normalValue>
  <type><!-- I 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- I 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- I 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[markdown]"/><!-- I 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- I 0..* Reference(Observation) 
     Used when reporting observations included in a vital signs panel --></hasMember>
 <derivedFrom><!-- I 0..* Reference(DocumentReference) 
     Related resource from which the observation is made --></derivedFrom>
 <component> I 0..* BackboneElement  <!-- I 0..* Component results -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- I 1..1 CodeableConcept Vital Sign measurement or component   --></code>
  <-- value[x] sliced by type:$this  in the specified orderOpen-->
  <valueQuantity><!-- I 0..1 Quantity Vital Sign value recorded as a component with UCUM (preferred)    --></valueQuantity>
  <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result value is missing   --></dataAbsentReason>
  <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result value --></referenceRange>
 </component>
</Observation>

{ // Observationvitalsignsbase
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
    "category" : [ //  sliced by pattern:$this  in the specified order, Open 
      { // Classification of  type of observation // I R! 
        // from Element: extension
      }
    ],
    "code" : { CodeableConcept }, // I R! Vital Sign Measurement
    "subject" : { Reference(Patient) }, // I R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // I R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // I R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Sign value recorded with UCUM (preferred) // I
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result value is missing
    "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc
    "note" : [{ Annotation }], // IComments about the observation
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // IA reference to the device that generates the measurements or the device settings for the device
    "referenceRange" : [{ BackboneElement }], // IProvides guide for interpretation
    "hasMember" : [{ Reference(Observation) }], // IUsed when reporting observations included in a vital signs panel
    "derivedFrom" : [{ Reference(DocumentReference) }], // IRelated resource from which the observation is made
    "component" : [{ BackboneElement }], // IComponent results
  }

Summary

10.1.18.2.3 Complete Summary of the Mandatory Requirements

1. One status in Observation.status which has a required binding to:

   • ObservationStatus value set.

2. A category in Observation.category which must have:

   • a fixed Observation.category.coding.system="http://terminology.hl7.org/CodeSystem/observation-category"
   • a fixed Observation.category.coding.code= "vital-signs"

3. A code in Observation.code

   • a fixed Observation.code.coding.system= "http://loinc.org""
   • a LOINC code in Observation.code.coding.code which has an extensible binding to:
     • Vital Signs value set.

4. One patient in Observation.subject

5. A date and time in effectiveDateTime or effectivePeriod

6. Either one Observation.value[x] or a populated component (with component.code and either component.value[x] or component.dataAbsentReason) or hasMember relationship. If there are none of those, then one code in Observation.DataAbsentReason

   • if a vital sign measure then:
     • One numeric value in Observation.valueQuantity.value
     • a fixed Observation.valueQuantity.system="http://unitsofmeasure.org"
     • a UCUM unit code in Observation.valueQuantity.code which has a required binding to the Vital Signs Units value set.
   • Observation.DataAbsentReason is bound to Observation Value Absent Reason value set.

7. When using a panel code to group component observations (Note: See the comments regarding blood pressure in the table above), one or more Observation.component.code each of which must have:

   • a fixed Observation.component.code.coding.system =""http://loinc.org""
     • a LOINC code in Observation.code.coding.code which has an extensible binding to:
       • Vital Signs Units value set.

8. Either one Observation.component.valueQuantity or, if there is no value, one code in Observation.component.DataAbsentReason

   • Observation.component.DataAbsentReason is bound to Observation Value Absent Reason value set.

9. When using a panel code to group observations, one or more reference to Vitals Signs Observations in Observation.related.target

   • a fixed Observation.related.type= "has-member""

Mandatory: 5 elements
Must-Support: 6 elements

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observation structure.

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	FHIR Vital Signs Base Profile obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present obs-10: dataAbsentReason SHALL only be present if Observation.component.value[x] is not present vsp-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day vsp-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: All Languages (required): IETF language tag for a human language Additional Bindings Purpose Common Languages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
instantiates[x]	Σ	0..1	canonical(ObservationDefinition), Reference(ObservationDefinition)	Instantiates FHIR ObservationDefinition
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
triggeredBy		0..*	BackboneElement	Triggering observation(s)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
observation	Σ	1..1	Reference(Observation)	Triggering observation
type	Σ	1..1	code	reflex | repeat | re-run Binding: triggered Bytype (required): The type of TriggeredBy Observation.
reason		0..1	string	Reason that the observation was triggered
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained Binding: Observation Status (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: Vital Signs Category (preferred): This value set includes the required vital sign interoperability categories.
category:VSCat	S	1..1	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-signs
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣC	1..1	CodeableConcept	Vital Sign Measurement Binding: Vital Signs Measurement (preferred): This identifies the vital sign measurement.
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	?!Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		Often just a dateTime for Vital Signs
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1	Quantity	Vital Signs values are recorded using the Quantity data type. For supporting observations recorded as a component, such as blood pressure cuff size, other datatypes such as CodeableConcept could be used. Slice: Unordered, Closed by type:$this
value[x]:valueQuantity	ΣC	0..1	Quantity	Vital Sign value recorded with UCUM (preferred) Binding: Vital Signs Units (preferred): Commonly encountered UCUM units for recording Vital Signs.
dataAbsentReason	C	0..1	CodeableConcept	Why the result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	C	0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts
bodyStructure	C	0..1	Reference(BodyStructure)	Observed body structure
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen	C	0..1	Reference(Specimen | Group)	Specimen used for this observation obs-9: If Observation.specimen is a reference to Group, the group can only have specimens
device		0..1	Reference(Device | DeviceMetric)	A reference to the device that generates the measurements or the device settings for the device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
normalValue		0..1	CodeableConcept	Normal value, if relevant Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation.
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	C	0..1	markdown	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation)	Used when reporting observations included in a vital signs panel
derivedFrom	Σ	0..*	Reference(DocumentReference | Observation)	Related resource from which the observation is made
component	ΣC	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	1..1	CodeableConcept	Vital Sign measurement or component Binding: LOINC Codes (example): Codes identifying names of simple observations.
Slices for value[x]	Σ	0..1		Vital Signs values are recorded using the Quantity data type. For supporting observations, such as blood pressure cuff size, other datatypes such as CodeableConcept could be used. Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	Σ	0..1	Quantity	Vital Sign value recorded as a component with UCUM (preferred) Binding: UCUM units - for recording Vital Signs and components. (preferred): UCUM units - for recording Vital Signs and components.
dataAbsentReason		0..1	CodeableConcept	Why the component result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result value
Documentation for this format

<!-- Observationvitalsignsbase -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- I 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- I 0..1 Language of the resource content   -->
 <text><!-- I 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- I 0..* Identifier 
     Business Identifier for observation --></identifier>
 <instantiates[x]><!-- I 0..1 canonical|Reference(ObservationDefinition) 
     Instantiates FHIR ObservationDefinition --></instantiates[x]>
 <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <triggeredBy> I 0..* BackboneElement  <!-- I 0..* Triggering observation(s) -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <observation><!-- I 1..1 Reference(Observation) 
      Triggering observation --></observation>
  <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run   -->
  <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered -->
 </triggeredBy>
 <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- I 1..1 registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained   -->
 <-- category sliced by pattern:$this  in the specified orderOpen-->
 <category><!-- I 1..1 CodeableConcept Classification of  type of observation   --></category>
 <code><!-- I 1..1 CodeableConcept Vital Sign Measurement   --></code>
 <subject><!-- I 1..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- I 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- I 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- I 1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available -->
 <performer><!-- I 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity><!-- I 0..1 Quantity Vital Sign value recorded with UCUM (preferred)   --></valueQuantity>
 <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result value is missing   --></dataAbsentReason>
 <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
 <note><!-- I 0..* Annotation Comments about the observation --></note>
 <bodySite><!-- I 0..1 CodeableConcept Observed body part   --></bodySite>
 <bodyStructure><!-- I 0..1 Reference(BodyStructure) Observed body structure --></bodyStructure>
 <method><!-- I 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- I 0..1 Reference(Device) 
     A reference to the device that generates the measurements or the device settings for the device --></device>
 <referenceRange> I 0..* BackboneElement  <!-- I 0..* Provides guide for interpretation -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- I 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- I 0..1 Quantity 
      High Range, if relevant --></high>
  <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant   --></normalValue>
  <type><!-- I 0..1 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- I 0..* CodeableConcept Reference range population   --></appliesTo>
  <age><!-- I 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[markdown]"/><!-- I 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- I 0..* Reference(Observation) 
     Used when reporting observations included in a vital signs panel --></hasMember>
 <derivedFrom><!-- I 0..* Reference(DocumentReference) 
     Related resource from which the observation is made --></derivedFrom>
 <component> I 0..* BackboneElement  <!-- I 0..* Component results -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- I 1..1 CodeableConcept Vital Sign measurement or component   --></code>
  <-- value[x] sliced by type:$this  in the specified orderOpen-->
  <valueQuantity><!-- I 0..1 Quantity Vital Sign value recorded as a component with UCUM (preferred)    --></valueQuantity>
  <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result value is missing   --></dataAbsentReason>
  <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc   --></interpretation>
  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result value --></referenceRange>
 </component>
</Observation>

{ // Observationvitalsignsbase
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
    "category" : [ //  sliced by pattern:$this  in the specified order, Open 
      { // Classification of  type of observation // I R! 
        // from Element: extension
      }
    ],
    "code" : { CodeableConcept }, // I R! Vital Sign Measurement
    "subject" : { Reference(Patient) }, // I R! Who and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // I R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // I R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Vital Sign value recorded with UCUM (preferred) // I
        // from Element: extension
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result value is missing
    "interpretation" : [{ CodeableConcept }], // IHigh, low, normal, etc
    "note" : [{ Annotation }], // IComments about the observation
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // IA reference to the device that generates the measurements or the device settings for the device
    "referenceRange" : [{ BackboneElement }], // IProvides guide for interpretation
    "hasMember" : [{ Reference(Observation) }], // IUsed when reporting observations included in a vital signs panel
    "derivedFrom" : [{ Reference(DocumentReference) }], // IRelated resource from which the observation is made
    "component" : [{ BackboneElement }], // IComponent results
  }