Australian Digital Health Agency FHIR Implementation Guide

Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Examples
• XML
• JSON
• TTL

Resource Profile: ADHA APGAR Score Observation ( Experimental )

The purpose of this profile is to provide a representation of set of observations made on the baby following birth to check adaptation to life outside the womb, for the electronic exchange of health information between individuals, healthcare providers, and the My Health Record system infrastructure in Australia. This includes 1 minute, 5 minute and 10 minute observations.

Usage:

• Examples for this Resource Profile: Observation/apgarscore-01 and Observation/apgarscore-02

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	APGAR score observation inv-dh-apg-01: APGAR 1 minute component codes must match observation type inv-dh-apg-02: APGAR 5 minute component codes must match observation type inv-dh-apg-03: APGAR 10 minute component codes must match observation type
code		1..1	CodeableConcept	APGAR score observation type
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:scoreTypeLoinc		0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type LOINC (required): APGAR score type (LOINC)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
coding:scoreTypeSnomedCt		0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type SNOMED CT (required): APGAR score type (SNOMED CT)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
subject		1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation
value[x]		1..1		Actual result
valueInteger			integer
valueQuantity			Quantity
Slices for valueInteger				Content/Rules for all slices
valueInteger:valueInteger	C	0..1	integer	Actual result inv-dh-apg-04: The value shall be an integer from 0 to 10
Slices for valueQuantity				Content/Rules for all slices
valueQuantity:valueQuantity	C	0..1	Quantity	Actual result inv-dh-apg-05: The value shall be an integer from 0 to 10
Slices for component		0..5	BackboneElement	Component results Slice: Unordered, Open by value:code
component:colourScore		0..1	BackboneElement	APGAR colour
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249227004
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Colour Finding (required): Colour finding values
component:heartRateScore		0..1	BackboneElement	APGAR heart rate
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249223000
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Heart Rate Finding (required): Heart rate finding values
component:muscleToneScore		0..1	BackboneElement	APGAR muscle tone
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249225007
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Muscle Tone Finding (required): Muscle tone finding values
component:respiratoryEffortScore		0..1	BackboneElement	APGAR respiratory effort
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249224006
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Respiratory Effort Finding (required): Respiratory effort finding values
component:reflexIrritabilityScore		0..1	BackboneElement	APGAR reflex irritability
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249226008
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Reflex Irritability Finding (required): Reflex irritability finding values
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code.coding:scoreTypeLoinc	required	ApgarScoreTypeLoinc http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypeloinc-1 from this IG
Observation.code.coding:scoreTypeSnomedCt	required	ApgarScoreTypeSnomedCt http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypesnomedct-1 from this IG
Observation.component:colourScore.valueCodeableConcept:valueCodeableConcept	required	ApgarColourFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarcolourfinding-1 from this IG
Observation.component:heartRateScore.valueCodeableConcept:valueCodeableConcept	required	ApgarHeartRateFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarheartratefinding-1 from this IG
Observation.component:muscleToneScore.valueCodeableConcept:valueCodeableConcept	required	ApgarMuscleToneFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarmuscletonefinding-1 from this IG
Observation.component:respiratoryEffortScore.valueCodeableConcept:valueCodeableConcept	required	ApgarRespiratoryEffortFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarrespiratoryeffortfinding-1 from this IG
Observation.component:reflexIrritabilityScore.valueCodeableConcept:valueCodeableConcept	required	ApgarReflexIrritabilityFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarreflexirritabilityfinding-1 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-apg-01	error	Observation	APGAR 1 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-02	error	Observation	APGAR 5 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-03	error	Observation	APGAR 10 minute component codes must match observation type : (component.where(code.coding.where(code='32401-2').exists()).exists() or component.where(code.coding.where(code='32402-0').exists()).exists() or component.where(code.coding.where(code='32403-8').exists()).exists() or component.where(code.coding.where(code='32405-3').exists()).exists() or component.where(code.coding.where(code='32404-6').exists()).exists()) implies code.coding.where(code='9271-8').exists()
inv-dh-apg-04	error	Observation.valueInteger:valueInteger	The value shall be an integer from 0 to 10 : $this >= 0 and $this <= 10
inv-dh-apg-05	error	Observation.valueQuantity:valueQuantity	The value shall be an integer from 0 to 10 : value.value.toString().matches('^[0-9]$|^10$')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	APGAR score observation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present inv-dh-apg-01: APGAR 1 minute component codes must match observation type inv-dh-apg-02: APGAR 5 minute component codes must match observation type inv-dh-apg-03: APGAR 10 minute component codes must match observation type
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	CodeableConcept	APGAR score observation type Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children
coding:scoreTypeLoinc	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type LOINC (required): APGAR score type (LOINC) ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://loinc.org
coding:scoreTypeSnomedCt	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type SNOMED CT (required): APGAR score type (SNOMED CT) ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://snomed.info/sct
subject	Σ	1..1	Reference(Patient)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
valueInteger			integer
valueQuantity			Quantity
value[x]:valueInteger	ΣC	0..1	integer	Actual result ele-1: All FHIR elements must have a @value or children inv-dh-apg-04: The value shall be an integer from 0 to 10
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result ele-1: All FHIR elements must have a @value or children inv-dh-apg-05: The value shall be an integer from 0 to 10
Slices for component	Σ	0..5	BackboneElement	Component results Slice: Unordered, Open by value:code ele-1: All FHIR elements must have a @value or children
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children
component:colourScore	Σ	0..1	BackboneElement	APGAR colour ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249227004
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Colour Finding (required): Colour finding values ele-1: All FHIR elements must have a @value or children
component:heartRateScore	Σ	0..1	BackboneElement	APGAR heart rate ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249223000
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Heart Rate Finding (required): Heart rate finding values ele-1: All FHIR elements must have a @value or children
component:muscleToneScore	Σ	0..1	BackboneElement	APGAR muscle tone ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249225007
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Muscle Tone Finding (required): Muscle tone finding values ele-1: All FHIR elements must have a @value or children
component:respiratoryEffortScore	Σ	0..1	BackboneElement	APGAR respiratory effort ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249224006
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Respiratory Effort Finding (required): Respiratory effort finding values ele-1: All FHIR elements must have a @value or children
component:reflexIrritabilityScore	Σ	0..1	BackboneElement	APGAR reflex irritability ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249226008
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Reflex Irritability Finding (required): Reflex irritability finding values ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.code.coding:scoreTypeLoinc	required	ApgarScoreTypeLoinc http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypeloinc-1 from this IG
Observation.code.coding:scoreTypeSnomedCt	required	ApgarScoreTypeSnomedCt http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypesnomedct-1 from this IG
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:colourScore.code	example	Pattern: SNOMED-CT Code 249227004 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:colourScore.value[x]:valueCodeableConcept	required	ApgarColourFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarcolourfinding-1 from this IG
Observation.component:heartRateScore.code	example	Pattern: SNOMED-CT Code 249223000 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:heartRateScore.value[x]:valueCodeableConcept	required	ApgarHeartRateFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarheartratefinding-1 from this IG
Observation.component:muscleToneScore.code	example	Pattern: SNOMED-CT Code 249225007 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:muscleToneScore.value[x]:valueCodeableConcept	required	ApgarMuscleToneFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarmuscletonefinding-1 from this IG
Observation.component:respiratoryEffortScore.code	example	Pattern: SNOMED-CT Code 249224006 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:respiratoryEffortScore.value[x]:valueCodeableConcept	required	ApgarRespiratoryEffortFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarrespiratoryeffortfinding-1 from this IG
Observation.component:reflexIrritabilityScore.code	example	Pattern: SNOMED-CT Code 249226008 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:reflexIrritabilityScore.value[x]:valueCodeableConcept	required	ApgarReflexIrritabilityFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarreflexirritabilityfinding-1 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-apg-01	error	Observation	APGAR 1 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-02	error	Observation	APGAR 5 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-03	error	Observation	APGAR 10 minute component codes must match observation type : (component.where(code.coding.where(code='32401-2').exists()).exists() or component.where(code.coding.where(code='32402-0').exists()).exists() or component.where(code.coding.where(code='32403-8').exists()).exists() or component.where(code.coding.where(code='32405-3').exists()).exists() or component.where(code.coding.where(code='32404-6').exists()).exists()) implies code.coding.where(code='9271-8').exists()
inv-dh-apg-04	error	Observation.value[x]:valueInteger	The value shall be an integer from 0 to 10 : $this >= 0 and $this <= 10
inv-dh-apg-05	error	Observation.value[x]:valueQuantity	The value shall be an integer from 0 to 10 : value.value.toString().matches('^[0-9]$|^10$')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	APGAR score observation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present inv-dh-apg-01: APGAR 1 minute component codes must match observation type inv-dh-apg-02: APGAR 5 minute component codes must match observation type inv-dh-apg-03: APGAR 10 minute component codes must match observation type
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	APGAR score observation type Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:scoreTypeLoinc	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type LOINC (required): APGAR score type (LOINC)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:scoreTypeSnomedCt	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type SNOMED CT (required): APGAR score type (SNOMED CT)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	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]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Closed by type:$this
valueInteger			integer
valueQuantity			Quantity
value[x]:valueInteger	ΣC	0..1	integer	Actual result inv-dh-apg-04: The value shall be an integer from 0 to 10
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result inv-dh-apg-05: The value shall be an integer from 0 to 10
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Slices for component	Σ	0..5	BackboneElement	Component results Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:colourScore	Σ	0..1	BackboneElement	APGAR colour
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249227004
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Colour Finding (required): Colour finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:heartRateScore	Σ	0..1	BackboneElement	APGAR heart rate
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249223000
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Heart Rate Finding (required): Heart rate finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:muscleToneScore	Σ	0..1	BackboneElement	APGAR muscle tone
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249225007
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Muscle Tone Finding (required): Muscle tone finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:respiratoryEffortScore	Σ	0..1	BackboneElement	APGAR respiratory effort
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249224006
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Respiratory Effort Finding (required): Respiratory effort finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:reflexIrritabilityScore	Σ	0..1	BackboneElement	APGAR reflex irritability
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249226008
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Reflex Irritability Finding (required): Reflex irritability finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.code.coding:scoreTypeLoinc	required	ApgarScoreTypeLoinc http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypeloinc-1 from this IG
Observation.code.coding:scoreTypeSnomedCt	required	ApgarScoreTypeSnomedCt http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypesnomedct-1 from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:colourScore.code	example	Pattern: SNOMED-CT Code 249227004 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:colourScore.value[x]:valueCodeableConcept	required	ApgarColourFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarcolourfinding-1 from this IG
Observation.component:colourScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:colourScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:heartRateScore.code	example	Pattern: SNOMED-CT Code 249223000 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:heartRateScore.value[x]:valueCodeableConcept	required	ApgarHeartRateFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarheartratefinding-1 from this IG
Observation.component:heartRateScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:heartRateScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:muscleToneScore.code	example	Pattern: SNOMED-CT Code 249225007 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:muscleToneScore.value[x]:valueCodeableConcept	required	ApgarMuscleToneFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarmuscletonefinding-1 from this IG
Observation.component:muscleToneScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:muscleToneScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:respiratoryEffortScore.code	example	Pattern: SNOMED-CT Code 249224006 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:respiratoryEffortScore.value[x]:valueCodeableConcept	required	ApgarRespiratoryEffortFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarrespiratoryeffortfinding-1 from this IG
Observation.component:respiratoryEffortScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:respiratoryEffortScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:reflexIrritabilityScore.code	example	Pattern: SNOMED-CT Code 249226008 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:reflexIrritabilityScore.value[x]:valueCodeableConcept	required	ApgarReflexIrritabilityFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarreflexirritabilityfinding-1 from this IG
Observation.component:reflexIrritabilityScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:reflexIrritabilityScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-apg-01	error	Observation	APGAR 1 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-02	error	Observation	APGAR 5 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-03	error	Observation	APGAR 10 minute component codes must match observation type : (component.where(code.coding.where(code='32401-2').exists()).exists() or component.where(code.coding.where(code='32402-0').exists()).exists() or component.where(code.coding.where(code='32403-8').exists()).exists() or component.where(code.coding.where(code='32405-3').exists()).exists() or component.where(code.coding.where(code='32404-6').exists()).exists()) implies code.coding.where(code='9271-8').exists()
inv-dh-apg-04	error	Observation.value[x]:valueInteger	The value shall be an integer from 0 to 10 : $this >= 0 and $this <= 10
inv-dh-apg-05	error	Observation.value[x]:valueQuantity	The value shall be an integer from 0 to 10 : value.value.toString().matches('^[0-9]$|^10$')

This structure is derived from Observation

Summary

Mandatory: 4 elements(7 nested mandatory elements)
Fixed: 2 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.component

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	APGAR score observation inv-dh-apg-01: APGAR 1 minute component codes must match observation type inv-dh-apg-02: APGAR 5 minute component codes must match observation type inv-dh-apg-03: APGAR 10 minute component codes must match observation type
code		1..1	CodeableConcept	APGAR score observation type
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:scoreTypeLoinc		0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type LOINC (required): APGAR score type (LOINC)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
coding:scoreTypeSnomedCt		0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type SNOMED CT (required): APGAR score type (SNOMED CT)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
subject		1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation
value[x]		1..1		Actual result
valueInteger			integer
valueQuantity			Quantity
Slices for valueInteger				Content/Rules for all slices
valueInteger:valueInteger	C	0..1	integer	Actual result inv-dh-apg-04: The value shall be an integer from 0 to 10
Slices for valueQuantity				Content/Rules for all slices
valueQuantity:valueQuantity	C	0..1	Quantity	Actual result inv-dh-apg-05: The value shall be an integer from 0 to 10
Slices for component		0..5	BackboneElement	Component results Slice: Unordered, Open by value:code
component:colourScore		0..1	BackboneElement	APGAR colour
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249227004
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Colour Finding (required): Colour finding values
component:heartRateScore		0..1	BackboneElement	APGAR heart rate
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249223000
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Heart Rate Finding (required): Heart rate finding values
component:muscleToneScore		0..1	BackboneElement	APGAR muscle tone
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249225007
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Muscle Tone Finding (required): Muscle tone finding values
component:respiratoryEffortScore		0..1	BackboneElement	APGAR respiratory effort
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249224006
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Respiratory Effort Finding (required): Respiratory effort finding values
component:reflexIrritabilityScore		0..1	BackboneElement	APGAR reflex irritability
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249226008
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept		1..1	CodeableConcept	Actual component result Binding: Apgar Reflex Irritability Finding (required): Reflex irritability finding values
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code.coding:scoreTypeLoinc	required	ApgarScoreTypeLoinc http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypeloinc-1 from this IG
Observation.code.coding:scoreTypeSnomedCt	required	ApgarScoreTypeSnomedCt http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypesnomedct-1 from this IG
Observation.component:colourScore.valueCodeableConcept:valueCodeableConcept	required	ApgarColourFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarcolourfinding-1 from this IG
Observation.component:heartRateScore.valueCodeableConcept:valueCodeableConcept	required	ApgarHeartRateFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarheartratefinding-1 from this IG
Observation.component:muscleToneScore.valueCodeableConcept:valueCodeableConcept	required	ApgarMuscleToneFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarmuscletonefinding-1 from this IG
Observation.component:respiratoryEffortScore.valueCodeableConcept:valueCodeableConcept	required	ApgarRespiratoryEffortFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarrespiratoryeffortfinding-1 from this IG
Observation.component:reflexIrritabilityScore.valueCodeableConcept:valueCodeableConcept	required	ApgarReflexIrritabilityFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarreflexirritabilityfinding-1 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-apg-01	error	Observation	APGAR 1 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-02	error	Observation	APGAR 5 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-03	error	Observation	APGAR 10 minute component codes must match observation type : (component.where(code.coding.where(code='32401-2').exists()).exists() or component.where(code.coding.where(code='32402-0').exists()).exists() or component.where(code.coding.where(code='32403-8').exists()).exists() or component.where(code.coding.where(code='32405-3').exists()).exists() or component.where(code.coding.where(code='32404-6').exists()).exists()) implies code.coding.where(code='9271-8').exists()
inv-dh-apg-04	error	Observation.valueInteger:valueInteger	The value shall be an integer from 0 to 10 : $this >= 0 and $this <= 10
inv-dh-apg-05	error	Observation.valueQuantity:valueQuantity	The value shall be an integer from 0 to 10 : value.value.toString().matches('^[0-9]$|^10$')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	APGAR score observation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present inv-dh-apg-01: APGAR 1 minute component codes must match observation type inv-dh-apg-02: APGAR 5 minute component codes must match observation type inv-dh-apg-03: APGAR 10 minute component codes must match observation type
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	CodeableConcept	APGAR score observation type Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children
coding:scoreTypeLoinc	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type LOINC (required): APGAR score type (LOINC) ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://loinc.org
coding:scoreTypeSnomedCt	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type SNOMED CT (required): APGAR score type (SNOMED CT) ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children Fixed Value: http://snomed.info/sct
subject	Σ	1..1	Reference(Patient)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
valueInteger			integer
valueQuantity			Quantity
value[x]:valueInteger	ΣC	0..1	integer	Actual result ele-1: All FHIR elements must have a @value or children inv-dh-apg-04: The value shall be an integer from 0 to 10
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result ele-1: All FHIR elements must have a @value or children inv-dh-apg-05: The value shall be an integer from 0 to 10
Slices for component	Σ	0..5	BackboneElement	Component results Slice: Unordered, Open by value:code ele-1: All FHIR elements must have a @value or children
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children
component:colourScore	Σ	0..1	BackboneElement	APGAR colour ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249227004
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Colour Finding (required): Colour finding values ele-1: All FHIR elements must have a @value or children
component:heartRateScore	Σ	0..1	BackboneElement	APGAR heart rate ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249223000
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Heart Rate Finding (required): Heart rate finding values ele-1: All FHIR elements must have a @value or children
component:muscleToneScore	Σ	0..1	BackboneElement	APGAR muscle tone ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249225007
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Muscle Tone Finding (required): Muscle tone finding values ele-1: All FHIR elements must have a @value or children
component:respiratoryEffortScore	Σ	0..1	BackboneElement	APGAR respiratory effort ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249224006
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Respiratory Effort Finding (required): Respiratory effort finding values ele-1: All FHIR elements must have a @value or children
component:reflexIrritabilityScore	Σ	0..1	BackboneElement	APGAR reflex irritability ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249226008
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Reflex Irritability Finding (required): Reflex irritability finding values ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.code.coding:scoreTypeLoinc	required	ApgarScoreTypeLoinc http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypeloinc-1 from this IG
Observation.code.coding:scoreTypeSnomedCt	required	ApgarScoreTypeSnomedCt http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypesnomedct-1 from this IG
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:colourScore.code	example	Pattern: SNOMED-CT Code 249227004 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:colourScore.value[x]:valueCodeableConcept	required	ApgarColourFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarcolourfinding-1 from this IG
Observation.component:heartRateScore.code	example	Pattern: SNOMED-CT Code 249223000 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:heartRateScore.value[x]:valueCodeableConcept	required	ApgarHeartRateFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarheartratefinding-1 from this IG
Observation.component:muscleToneScore.code	example	Pattern: SNOMED-CT Code 249225007 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:muscleToneScore.value[x]:valueCodeableConcept	required	ApgarMuscleToneFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarmuscletonefinding-1 from this IG
Observation.component:respiratoryEffortScore.code	example	Pattern: SNOMED-CT Code 249224006 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:respiratoryEffortScore.value[x]:valueCodeableConcept	required	ApgarRespiratoryEffortFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarrespiratoryeffortfinding-1 from this IG
Observation.component:reflexIrritabilityScore.code	example	Pattern: SNOMED-CT Code 249226008 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:reflexIrritabilityScore.value[x]:valueCodeableConcept	required	ApgarReflexIrritabilityFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarreflexirritabilityfinding-1 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-apg-01	error	Observation	APGAR 1 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-02	error	Observation	APGAR 5 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-03	error	Observation	APGAR 10 minute component codes must match observation type : (component.where(code.coding.where(code='32401-2').exists()).exists() or component.where(code.coding.where(code='32402-0').exists()).exists() or component.where(code.coding.where(code='32403-8').exists()).exists() or component.where(code.coding.where(code='32405-3').exists()).exists() or component.where(code.coding.where(code='32404-6').exists()).exists()) implies code.coding.where(code='9271-8').exists()
inv-dh-apg-04	error	Observation.value[x]:valueInteger	The value shall be an integer from 0 to 10 : $this >= 0 and $this <= 10
inv-dh-apg-05	error	Observation.value[x]:valueQuantity	The value shall be an integer from 0 to 10 : value.value.toString().matches('^[0-9]$|^10$')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	APGAR score observation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present inv-dh-apg-01: APGAR 1 minute component codes must match observation type inv-dh-apg-02: APGAR 5 minute component codes must match observation type inv-dh-apg-03: APGAR 10 minute component codes must match observation type
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	APGAR score observation type Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:scoreTypeLoinc	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type LOINC (required): APGAR score type (LOINC)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:scoreTypeSnomedCt	Σ	0..1	Coding	Code defined by a terminology system Binding: Apgar Score Type SNOMED CT (required): APGAR score type (SNOMED CT)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	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]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Closed by type:$this
valueInteger			integer
valueQuantity			Quantity
value[x]:valueInteger	ΣC	0..1	integer	Actual result inv-dh-apg-04: The value shall be an integer from 0 to 10
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result inv-dh-apg-05: The value shall be an integer from 0 to 10
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Slices for component	Σ	0..5	BackboneElement	Component results Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:colourScore	Σ	0..1	BackboneElement	APGAR colour
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249227004
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Colour Finding (required): Colour finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:heartRateScore	Σ	0..1	BackboneElement	APGAR heart rate
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249223000
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Heart Rate Finding (required): Heart rate finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:muscleToneScore	Σ	0..1	BackboneElement	APGAR muscle tone
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249225007
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Muscle Tone Finding (required): Muscle tone finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:respiratoryEffortScore	Σ	0..1	BackboneElement	APGAR respiratory effort
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249224006
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Respiratory Effort Finding (required): Respiratory effort finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:reflexIrritabilityScore	Σ	0..1	BackboneElement	APGAR reflex irritability
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 249226008
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
Slices for value[x]				Content/Rules for all slices
value[x]:valueCodeableConcept	Σ	1..1	CodeableConcept	Actual component result Binding: Apgar Reflex Irritability Finding (required): Reflex irritability finding values
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.code.coding:scoreTypeLoinc	required	ApgarScoreTypeLoinc http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypeloinc-1 from this IG
Observation.code.coding:scoreTypeSnomedCt	required	ApgarScoreTypeSnomedCt http://ns.electronichealth.net.au/fhir/ValueSet/apgarscoretypesnomedct-1 from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:colourScore.code	example	Pattern: SNOMED-CT Code 249227004 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:colourScore.value[x]:valueCodeableConcept	required	ApgarColourFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarcolourfinding-1 from this IG
Observation.component:colourScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:colourScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:heartRateScore.code	example	Pattern: SNOMED-CT Code 249223000 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:heartRateScore.value[x]:valueCodeableConcept	required	ApgarHeartRateFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarheartratefinding-1 from this IG
Observation.component:heartRateScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:heartRateScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:muscleToneScore.code	example	Pattern: SNOMED-CT Code 249225007 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:muscleToneScore.value[x]:valueCodeableConcept	required	ApgarMuscleToneFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarmuscletonefinding-1 from this IG
Observation.component:muscleToneScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:muscleToneScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:respiratoryEffortScore.code	example	Pattern: SNOMED-CT Code 249224006 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:respiratoryEffortScore.value[x]:valueCodeableConcept	required	ApgarRespiratoryEffortFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarrespiratoryeffortfinding-1 from this IG
Observation.component:respiratoryEffortScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:respiratoryEffortScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:reflexIrritabilityScore.code	example	Pattern: SNOMED-CT Code 249226008 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:reflexIrritabilityScore.value[x]:valueCodeableConcept	required	ApgarReflexIrritabilityFinding http://ns.electronichealth.net.au/fhir/ValueSet/apgarreflexirritabilityfinding-1 from this IG
Observation.component:reflexIrritabilityScore.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component:reflexIrritabilityScore.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-apg-01	error	Observation	APGAR 1 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-02	error	Observation	APGAR 5 minute component codes must match observation type : (component.where(code.coding.where(code='32406-1').exists()).exists() or component.where(code.coding.where(code='32407-9').exists()).exists() or component.where(code.coding.where(code='32408-7').exists()).exists() or component.where(code.coding.where(code='32410-3').exists()).exists() or component.where(code.coding.where(code='32409-5').exists()).exists()) implies code.coding.where(code='9272-6').exists()
inv-dh-apg-03	error	Observation	APGAR 10 minute component codes must match observation type : (component.where(code.coding.where(code='32401-2').exists()).exists() or component.where(code.coding.where(code='32402-0').exists()).exists() or component.where(code.coding.where(code='32403-8').exists()).exists() or component.where(code.coding.where(code='32405-3').exists()).exists() or component.where(code.coding.where(code='32404-6').exists()).exists()) implies code.coding.where(code='9271-8').exists()
inv-dh-apg-04	error	Observation.value[x]:valueInteger	The value shall be an integer from 0 to 10 : $this >= 0 and $this <= 10
inv-dh-apg-05	error	Observation.value[x]:valueQuantity	The value shall be an integer from 0 to 10 : value.value.toString().matches('^[0-9]$|^10$')

This structure is derived from Observation

Summary

Mandatory: 4 elements(7 nested mandatory elements)
Fixed: 2 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.component