Australian Digital Health Agency FHIR Implementation Guide
1.2.0-ci-build - draft
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
| Official URL: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-observation-diagnosticresult-imag-1 | Version: 0.0.5 | |||
| Draft as of 2024-12-19 | Computable Name: ADHAObservationImagingResult | |||
Copyright/Legal: Copyright © 2022 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/. |
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The purpose of this profile is to represent a diagnostic imaging observation issued by the diagnostic service provider for the electronic exchange of imaging examination observations between healthcare providers, and between healthcare providers and the My Health Record system infrastructure in Australia. The observation may represent the result of a simple examination or study series.
This profile identifies the additional constraints, extensions, and value sets that build on and extend Observation that are supported.
This profile is designed to set an Observation standard for:
This profile may be referred to by APIs, which will be listed here when available.
Observation.category provides an efficient way of supporting system interactions, e.g. restricting searches to “imaging” observations. Implementers need to understand that data categorisation is somewhat subjective. The categorisation applied by the source may not align with a receiver’s expectations.Observation.value, or set of results using either Observation.component.value or Observation.hasMember.
Observation.identifier may contain the same identifier as in the order or report connecting the resources that are related to a single request fulfilment workflow.Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from AUBaseDiagnosticImagingResult
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Observation |
C | 0..* | AUBaseDiagnosticImagingResult | A imaging examination result in an Australian healthcare context inv-dh-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present |
  identifier |
S | 0..* | Identifier | Business Identifier for observation |
| status |
S | 1..1 | code | preliminary | final | amended + Binding: ObservationStatus Result Available  (required) |
| category |
S | 1..* | CodeableConcept | Relevant diagnostic imaging category: service, modality and anatomic region |
| code |
S | 1..1 | CodeableConcept | Diagnostic imaging examination or study |
 subject |
SC | 1..1 | Reference(ADHA Core Patient) | Who and/or what the observation is about inv-dh-obs-01: At least reference or a valid identifier shall be present |
| effective[x] |
SC | 1..1 | dateTime, Period | Date, and optionally time, the imaging study was performed inv-dh-obs-07: Date shall be at least to day |
| performer |
SC | 1..* | Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson) | Who is responsible for the observation inv-dh-obs-03: At least reference or display or a valid identifier shall be present |
| value[x] |
SC | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result |
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the result is missing |
| interpretation |
S | 0..* | CodeableConcept | High, low, normal, etc. |
| note |
S | 0..* | Annotation | Comments about the observation |
| bodySite |
SC | 1..1 | CodeableConcept | Observed body part Binding: Body Site (extensible)inv-dh-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT |
| method |
S | 0..1 | CodeableConcept | How it was done |
 referenceRange |
S | 0..* | BackboneElement | Provides guide for interpretation |
 low |
S | 0..1 | SimpleQuantity | Low Range, if relevant |
| high |
S | 0..1 | SimpleQuantity | High Range, if relevant |
| type |
S | 0..1 | CodeableConcept | Reference range qualifier |
 text |
S | 0..1 | string | Text based reference range in an observation |
| hasMember |
S | 0..* | Reference(ADHA Imaging Result Observation) | Individual observations in a group, study, or panel |
| reference |
1..1 | string | Literal reference, Relative, internal or absolute URL | |
 component |
SC | 0..* | BackboneElement | Individual examinations in a group or study series inv-dh-obs-06: The component shall at least have a value or a data absent reason |
 code |
S | 1..1 | CodeableConcept | Diagnostic imaging examination or study |
| value[x] |
SC | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result |
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the component result is missing |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Observation.status | required | ObservationStatusResultAvailable https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 | |
| Observation.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 |
| Id | Grade | Path(s) | Details | Requirements |
| inv-dh-obs-01 | error | Observation.subject | At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-03 | error | Observation.performer | At least reference or display or a valid identifier shall be present : reference.exists() or display.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-04 | error | Observation.bodySite | If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists() | |
| inv-dh-obs-05 | error | Observation | If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) | |
| inv-dh-obs-06 | error | Observation.component | The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists() | |
| inv-dh-obs-07 | error | Observation.effective[x] | Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10 |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation |
C | 0..* | AUBaseDiagnosticImagingResult | A imaging examination result in an Australian healthcare context 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-obs-0: An imaging result shall at least have value or data absent reason or a child observation with a value or data absent reason inv-dh-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present |
 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 |
 identifier |
SΣ | 0..* | Identifier | Business Identifier for observation ele-1: All FHIR elements must have a @value or children |
| status |
?!SΣ | 1..1 | code | preliminary | final | amended + Binding: ObservationStatus Result Available (required)ele-1: All FHIR elements must have a @value or children |
 Slices for category |
S | 1..* | CodeableConcept | Relevant diagnostic imaging category: service, modality and anatomic region Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children |
  category:diagImg |
1..1 | CodeableConcept | Observation generated by imaging Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children | |
  coding |
Σ | 1..* | Coding | Code defined by a terminology system 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://terminology.hl7.org/CodeSystem/observation-category |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children Fixed Value: imaging |
 category:anatomicRegionOfInterest |
0..* | CodeableConcept | Anatomic Region Of Interest Binding: Imaging Anatomic Region Of Interest (extensible)ele-1: All FHIR elements must have a @value or children | |
| code |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred)ele-1: All FHIR elements must have a @value or children |
| subject |
SΣC | 1..1 | Reference(ADHA Core Patient) | Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children inv-dh-obs-01: At least reference or a valid identifier shall be present |
 effective[x] |
SΣC | 1..1 | Date, and optionally time, the imaging study was performed ele-1: All FHIR elements must have a @value or children inv-dh-obs-07: Date shall be at least to day | |
| effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| performer |
SΣC | 1..* | Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson) | Who is responsible for the observation ele-1: All FHIR elements must have a @value or children inv-dh-obs-03: At least reference or display or a valid identifier shall be present |
| value[x] |
SΣC | 0..1 | Actual result ele-1: All FHIR elements must have a @value or children | |
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children |
| interpretation |
S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. ele-1: All FHIR elements must have a @value or children |
| note |
S | 0..* | Annotation | Comments about the observation ele-1: All FHIR elements must have a @value or children |
| bodySite |
SC | 1..1 | CodeableConcept | Observed body part Binding: Body Site (extensible)ele-1: All FHIR elements must have a @value or children inv-dh-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT |
| Slices for extension |
Content/Rules for all slices | |||
| bodySite |
0..1 | Reference(BodyStructure) | Target anatomic location or structure URL: http://hl7.org/fhir/StructureDefinition/bodySite ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
| method |
S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. ele-1: All FHIR elements must have a @value or children |
| referenceRange |
SC | 0..* | BackboneElement | Provides guide for interpretation ele-1: All FHIR elements must have a @value or children obs-3: Must have at least a low or a high or text |
| 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 |
| low |
SC | 0..1 | SimpleQuantity | Low Range, if relevant ele-1: All FHIR elements must have a @value or children |
| high |
SC | 0..1 | SimpleQuantity | High Range, if relevant ele-1: All FHIR elements must have a @value or children |
| type |
S | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. ele-1: All FHIR elements must have a @value or children |
| text |
S | 0..1 | string | Text based reference range in an observation ele-1: All FHIR elements must have a @value or children |
| hasMember |
SΣC | 0..* | Reference(ADHA Imaging Result Observation) | Individual observations in a group, study, or panel ele-1: All FHIR elements must have a @value or children |
| reference |
ΣC | 1..1 | string | Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children |
| component |
SΣC | 0..* | BackboneElement | Individual examinations in a group or study series ele-1: All FHIR elements must have a @value or children inv-dh-obs-06: The component shall at least have a value or a data absent reason |
| 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 |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred)ele-1: All FHIR elements must have a @value or children |
| value[x] |
SΣC | 0..1 | Actual component result ele-1: All FHIR elements must have a @value or children | |
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Observation.status | required | ObservationStatusResultAvailable https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 | |
| Observation.category | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | |
| Observation.category:diagImg | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | |
| Observation.category:anatomicRegionOfInterest | extensible | ImagingAnatomicRegionOfInterest https://healthterminologies.gov.au/fhir/ValueSet/imaging-anatomic-region-of-interest-1 | |
| Observation.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | |
| Observation.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | |
| Observation.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard | |
| Observation.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 | |
| Observation.method | example | ObservationMethodshttp://hl7.org/fhir/ValueSet/observation-methodsfrom the FHIR Standard | |
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodeshttp://hl7.org/fhir/ValueSet/referencerange-meaningfrom the FHIR Standard | |
| Observation.component.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | |
| Observation.component.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| inv-dh-obs-01 | error | Observation.subject | At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-03 | error | Observation.performer | At least reference or display or a valid identifier shall be present : reference.exists() or display.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-04 | error | Observation.bodySite | If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists() | |
| inv-dh-obs-05 | error | Observation | If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) | |
| inv-dh-obs-06 | error | Observation.component | The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists() | |
| inv-dh-obs-07 | error | Observation.effective[x] | Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10 |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | AUBaseDiagnosticImagingResult | A imaging examination result in an Australian healthcare context 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-obs-0: An imaging result shall at least have value or data absent reason or a child observation with a value or data absent reason inv-dh-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| 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 |
SΣ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn |
Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
| partOf |
Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
| status |
?!SΣ | 1..1 | code | preliminary | final | amended + Binding: ObservationStatus Result Available (required) | ||||
| Slices for category |
S | 1..* | CodeableConcept | Relevant diagnostic imaging category: service, modality and anatomic region Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | ||||
| category:diagImg |
1..1 | CodeableConcept | Observation generated by imaging Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
 id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
 coding |
Σ | 1..* | Coding | Code defined by a terminology system | ||||
 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://terminology.hl7.org/CodeSystem/observation-category | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: imaging | ||||
| 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 | ||||
 category:anatomicRegionOfInterest |
0..* | CodeableConcept | Anatomic Region Of Interest Binding: Imaging Anatomic Region Of Interest (extensible) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Code defined by a terminology system | ||||
| 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 | ||||
| code |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred) | ||||
| subject |
SΣC | 1..1 | Reference(ADHA Core Patient) | Who and/or what the observation is about inv-dh-obs-01: At least reference or a valid identifier shall be present | ||||
| focus |
Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | ||||
| encounter |
Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | ||||
| effective[x] |
SΣC | 1..1 | Date, and optionally time, the imaging study was performed inv-dh-obs-07: Date shall be at least to day | |||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| issued |
Σ | 0..1 | instant | Date/Time this version was made available | ||||
| performer |
SΣC | 1..* | Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson) | Who is responsible for the observation inv-dh-obs-03: At least reference or display or a valid identifier shall be present | ||||
| value[x] |
SΣC | 0..1 | Actual result | |||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | ||||
| note |
S | 0..* | Annotation | Comments about the observation | ||||
| bodySite |
SC | 1..1 | CodeableConcept | Observed body part Binding: Body Site (extensible)inv-dh-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| bodySite |
0..1 | Reference(BodyStructure) | Target anatomic location or structure URL: http://hl7.org/fhir/StructureDefinition/bodySite | |||||
| coding |
Σ | 0..* | Coding | Code defined by a terminology system | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| method |
S | 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 |
SC | 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 |
SC | 0..1 | SimpleQuantity | Low Range, if relevant | ||||
| high |
SC | 0..1 | SimpleQuantity | High Range, if relevant | ||||
| type |
S | 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 |
S | 0..1 | string | Text based reference range in an observation | ||||
| hasMember |
SΣC | 0..* | Reference(ADHA Imaging Result Observation) | Individual observations in a group, study, or panel | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
ΣC | 1..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| display |
Σ | 0..1 | string | Text alternative for the resource | ||||
| derivedFrom |
Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | ||||
| component |
SΣC | 0..* | BackboneElement | Individual examinations in a group or study series inv-dh-obs-06: The component shall at least have a value or a data absent reason | ||||
| 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 |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred) | ||||
| value[x] |
SΣC | 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 |
SC | 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 | ||||||||
| Path | Conformance | ValueSet | URI | |||
| Observation.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| Observation.status | required | ObservationStatusResultAvailable https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 | ||||
| Observation.category | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | ||||
| Observation.category:diagImg | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | ||||
| Observation.category:anatomicRegionOfInterest | extensible | ImagingAnatomicRegionOfInterest https://healthterminologies.gov.au/fhir/ValueSet/imaging-anatomic-region-of-interest-1 | ||||
| Observation.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | ||||
| Observation.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard | ||||
| Observation.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 | ||||
| Observation.method | example | ObservationMethodshttp://hl7.org/fhir/ValueSet/observation-methodsfrom the FHIR Standard | ||||
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodeshttp://hl7.org/fhir/ValueSet/referencerange-meaningfrom the FHIR Standard | ||||
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodeshttp://hl7.org/fhir/ValueSet/referencerange-appliestofrom the FHIR Standard | ||||
| Observation.hasMember.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.component.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | ||||
| Observation.component.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.component.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| inv-dh-obs-01 | error | Observation.subject | At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-03 | error | Observation.performer | At least reference or display or a valid identifier shall be present : reference.exists() or display.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-04 | error | Observation.bodySite | If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists() | |
| inv-dh-obs-05 | error | Observation | If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) | |
| inv-dh-obs-06 | error | Observation.component | The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists() | |
| inv-dh-obs-07 | error | Observation.effective[x] | Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10 |
This structure is derived from AUBaseDiagnosticImagingResult
Summary
Mandatory: 2 elements(1 nested mandatory element)
Must-Support: 23 elements
Structures
This structure refers to these other structures:
Differential View
This structure is derived from AUBaseDiagnosticImagingResult
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation |
C | 0..* | AUBaseDiagnosticImagingResult | A imaging examination result in an Australian healthcare context inv-dh-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present |
| identifier |
S | 0..* | Identifier | Business Identifier for observation |
| status |
S | 1..1 | code | preliminary | final | amended + Binding: ObservationStatus Result Available (required) |
| category |
S | 1..* | CodeableConcept | Relevant diagnostic imaging category: service, modality and anatomic region |
| code |
S | 1..1 | CodeableConcept | Diagnostic imaging examination or study |
| subject |
SC | 1..1 | Reference(ADHA Core Patient) | Who and/or what the observation is about inv-dh-obs-01: At least reference or a valid identifier shall be present |
| effective[x] |
SC | 1..1 | dateTime, Period | Date, and optionally time, the imaging study was performed inv-dh-obs-07: Date shall be at least to day |
| performer |
SC | 1..* | Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson) | Who is responsible for the observation inv-dh-obs-03: At least reference or display or a valid identifier shall be present |
| value[x] |
SC | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result |
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the result is missing |
| interpretation |
S | 0..* | CodeableConcept | High, low, normal, etc. |
| note |
S | 0..* | Annotation | Comments about the observation |
| bodySite |
SC | 1..1 | CodeableConcept | Observed body part Binding: Body Site (extensible)inv-dh-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT |
| method |
S | 0..1 | CodeableConcept | How it was done |
| referenceRange |
S | 0..* | BackboneElement | Provides guide for interpretation |
| low |
S | 0..1 | SimpleQuantity | Low Range, if relevant |
| high |
S | 0..1 | SimpleQuantity | High Range, if relevant |
| type |
S | 0..1 | CodeableConcept | Reference range qualifier |
| text |
S | 0..1 | string | Text based reference range in an observation |
| hasMember |
S | 0..* | Reference(ADHA Imaging Result Observation) | Individual observations in a group, study, or panel |
| reference |
1..1 | string | Literal reference, Relative, internal or absolute URL | |
| component |
SC | 0..* | BackboneElement | Individual examinations in a group or study series inv-dh-obs-06: The component shall at least have a value or a data absent reason |
| code |
S | 1..1 | CodeableConcept | Diagnostic imaging examination or study |
| value[x] |
SC | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result |
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the component result is missing |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Observation.status | required | ObservationStatusResultAvailable https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 | |
| Observation.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 |
| Id | Grade | Path(s) | Details | Requirements |
| inv-dh-obs-01 | error | Observation.subject | At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-03 | error | Observation.performer | At least reference or display or a valid identifier shall be present : reference.exists() or display.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-04 | error | Observation.bodySite | If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists() | |
| inv-dh-obs-05 | error | Observation | If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) | |
| inv-dh-obs-06 | error | Observation.component | The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists() | |
| inv-dh-obs-07 | error | Observation.effective[x] | Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10 |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation |
C | 0..* | AUBaseDiagnosticImagingResult | A imaging examination result in an Australian healthcare context 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-obs-0: An imaging result shall at least have value or data absent reason or a child observation with a value or data absent reason inv-dh-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present |
| 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 |
| identifier |
SΣ | 0..* | Identifier | Business Identifier for observation ele-1: All FHIR elements must have a @value or children |
| status |
?!SΣ | 1..1 | code | preliminary | final | amended + Binding: ObservationStatus Result Available (required)ele-1: All FHIR elements must have a @value or children |
| Slices for category |
S | 1..* | CodeableConcept | Relevant diagnostic imaging category: service, modality and anatomic region Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children |
| category:diagImg |
1..1 | CodeableConcept | Observation generated by imaging Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children | |
| coding |
Σ | 1..* | Coding | Code defined by a terminology system 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://terminology.hl7.org/CodeSystem/observation-category |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children Fixed Value: imaging |
| category:anatomicRegionOfInterest |
0..* | CodeableConcept | Anatomic Region Of Interest Binding: Imaging Anatomic Region Of Interest (extensible)ele-1: All FHIR elements must have a @value or children | |
| code |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred)ele-1: All FHIR elements must have a @value or children |
| subject |
SΣC | 1..1 | Reference(ADHA Core Patient) | Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children inv-dh-obs-01: At least reference or a valid identifier shall be present |
| effective[x] |
SΣC | 1..1 | Date, and optionally time, the imaging study was performed ele-1: All FHIR elements must have a @value or children inv-dh-obs-07: Date shall be at least to day | |
| effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| performer |
SΣC | 1..* | Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson) | Who is responsible for the observation ele-1: All FHIR elements must have a @value or children inv-dh-obs-03: At least reference or display or a valid identifier shall be present |
| value[x] |
SΣC | 0..1 | Actual result ele-1: All FHIR elements must have a @value or children | |
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children |
| interpretation |
S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. ele-1: All FHIR elements must have a @value or children |
| note |
S | 0..* | Annotation | Comments about the observation ele-1: All FHIR elements must have a @value or children |
| bodySite |
SC | 1..1 | CodeableConcept | Observed body part Binding: Body Site (extensible)ele-1: All FHIR elements must have a @value or children inv-dh-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT |
| Slices for extension |
Content/Rules for all slices | |||
| bodySite |
0..1 | Reference(BodyStructure) | Target anatomic location or structure URL: http://hl7.org/fhir/StructureDefinition/bodySite ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
| method |
S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. ele-1: All FHIR elements must have a @value or children |
| referenceRange |
SC | 0..* | BackboneElement | Provides guide for interpretation ele-1: All FHIR elements must have a @value or children obs-3: Must have at least a low or a high or text |
| 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 |
| low |
SC | 0..1 | SimpleQuantity | Low Range, if relevant ele-1: All FHIR elements must have a @value or children |
| high |
SC | 0..1 | SimpleQuantity | High Range, if relevant ele-1: All FHIR elements must have a @value or children |
| type |
S | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. ele-1: All FHIR elements must have a @value or children |
| text |
S | 0..1 | string | Text based reference range in an observation ele-1: All FHIR elements must have a @value or children |
| hasMember |
SΣC | 0..* | Reference(ADHA Imaging Result Observation) | Individual observations in a group, study, or panel ele-1: All FHIR elements must have a @value or children |
| reference |
ΣC | 1..1 | string | Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children |
| component |
SΣC | 0..* | BackboneElement | Individual examinations in a group or study series ele-1: All FHIR elements must have a @value or children inv-dh-obs-06: The component shall at least have a value or a data absent reason |
| 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 |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred)ele-1: All FHIR elements must have a @value or children |
| value[x] |
SΣC | 0..1 | Actual component result ele-1: All FHIR elements must have a @value or children | |
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Observation.status | required | ObservationStatusResultAvailable https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 | |
| Observation.category | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | |
| Observation.category:diagImg | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | |
| Observation.category:anatomicRegionOfInterest | extensible | ImagingAnatomicRegionOfInterest https://healthterminologies.gov.au/fhir/ValueSet/imaging-anatomic-region-of-interest-1 | |
| Observation.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | |
| Observation.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | |
| Observation.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard | |
| Observation.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 | |
| Observation.method | example | ObservationMethodshttp://hl7.org/fhir/ValueSet/observation-methodsfrom the FHIR Standard | |
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodeshttp://hl7.org/fhir/ValueSet/referencerange-meaningfrom the FHIR Standard | |
| Observation.component.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | |
| Observation.component.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| inv-dh-obs-01 | error | Observation.subject | At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-03 | error | Observation.performer | At least reference or display or a valid identifier shall be present : reference.exists() or display.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-04 | error | Observation.bodySite | If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists() | |
| inv-dh-obs-05 | error | Observation | If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) | |
| inv-dh-obs-06 | error | Observation.component | The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists() | |
| inv-dh-obs-07 | error | Observation.effective[x] | Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10 |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | AUBaseDiagnosticImagingResult | A imaging examination result in an Australian healthcare context 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-obs-0: An imaging result shall at least have value or data absent reason or a child observation with a value or data absent reason inv-dh-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| 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 |
SΣ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn |
Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
| partOf |
Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
| status |
?!SΣ | 1..1 | code | preliminary | final | amended + Binding: ObservationStatus Result Available (required) | ||||
| Slices for category |
S | 1..* | CodeableConcept | Relevant diagnostic imaging category: service, modality and anatomic region Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | ||||
| category:diagImg |
1..1 | CodeableConcept | Observation generated by imaging Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system | ||||
| 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://terminology.hl7.org/CodeSystem/observation-category | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: imaging | ||||
| 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 | ||||
| category:anatomicRegionOfInterest |
0..* | CodeableConcept | Anatomic Region Of Interest Binding: Imaging Anatomic Region Of Interest (extensible) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Code defined by a terminology system | ||||
| 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 | ||||
| code |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred) | ||||
| subject |
SΣC | 1..1 | Reference(ADHA Core Patient) | Who and/or what the observation is about inv-dh-obs-01: At least reference or a valid identifier shall be present | ||||
| focus |
Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | ||||
| encounter |
Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | ||||
| effective[x] |
SΣC | 1..1 | Date, and optionally time, the imaging study was performed inv-dh-obs-07: Date shall be at least to day | |||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| issued |
Σ | 0..1 | instant | Date/Time this version was made available | ||||
| performer |
SΣC | 1..* | Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson) | Who is responsible for the observation inv-dh-obs-03: At least reference or display or a valid identifier shall be present | ||||
| value[x] |
SΣC | 0..1 | Actual result | |||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| dataAbsentReason |
SC | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | ||||
| note |
S | 0..* | Annotation | Comments about the observation | ||||
| bodySite |
SC | 1..1 | CodeableConcept | Observed body part Binding: Body Site (extensible)inv-dh-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| bodySite |
0..1 | Reference(BodyStructure) | Target anatomic location or structure URL: http://hl7.org/fhir/StructureDefinition/bodySite | |||||
| coding |
Σ | 0..* | Coding | Code defined by a terminology system | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| method |
S | 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 |
SC | 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 |
SC | 0..1 | SimpleQuantity | Low Range, if relevant | ||||
| high |
SC | 0..1 | SimpleQuantity | High Range, if relevant | ||||
| type |
S | 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 |
S | 0..1 | string | Text based reference range in an observation | ||||
| hasMember |
SΣC | 0..* | Reference(ADHA Imaging Result Observation) | Individual observations in a group, study, or panel | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
ΣC | 1..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
| identifier |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||
| display |
Σ | 0..1 | string | Text alternative for the resource | ||||
| derivedFrom |
Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | ||||
| component |
SΣC | 0..* | BackboneElement | Individual examinations in a group or study series inv-dh-obs-06: The component shall at least have a value or a data absent reason | ||||
| 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 |
SΣ | 1..1 | CodeableConcept | Diagnostic imaging examination or study Binding: Imaging Procedure (preferred) | ||||
| value[x] |
SΣC | 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 |
SC | 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 | ||||||||
| Path | Conformance | ValueSet | URI | |||
| Observation.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| Observation.status | required | ObservationStatusResultAvailable https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 | ||||
| Observation.category | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | ||||
| Observation.category:diagImg | preferred | ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-categoryfrom the FHIR Standard | ||||
| Observation.category:anatomicRegionOfInterest | extensible | ImagingAnatomicRegionOfInterest https://healthterminologies.gov.au/fhir/ValueSet/imaging-anatomic-region-of-interest-1 | ||||
| Observation.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | ||||
| Observation.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard | ||||
| Observation.bodySite | extensible | BodySite https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 | ||||
| Observation.method | example | ObservationMethodshttp://hl7.org/fhir/ValueSet/observation-methodsfrom the FHIR Standard | ||||
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodeshttp://hl7.org/fhir/ValueSet/referencerange-meaningfrom the FHIR Standard | ||||
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodeshttp://hl7.org/fhir/ValueSet/referencerange-appliestofrom the FHIR Standard | ||||
| Observation.hasMember.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| Observation.component.code | preferred | ImagingProcedure https://healthterminologies.gov.au/fhir/ValueSet/imaging-procedure-1 | ||||
| Observation.component.dataAbsentReason | extensible | DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reasonfrom the FHIR Standard | ||||
| Observation.component.interpretation | extensible | ObservationInterpretationCodeshttp://hl7.org/fhir/ValueSet/observation-interpretationfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| inv-dh-obs-01 | error | Observation.subject | At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-03 | error | Observation.performer | At least reference or display or a valid identifier shall be present : reference.exists() or display.exists() or identifier.where(system.count() + value.count() >1).exists() | |
| inv-dh-obs-04 | error | Observation.bodySite | If a coded body site is provided, at least one code shall be from SNOMED CT : coding.exists() implies coding.where(system='http://snomed.info/sct').exists() | |
| inv-dh-obs-05 | error | Observation | If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) | |
| inv-dh-obs-06 | error | Observation.component | The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists() | |
| inv-dh-obs-07 | error | Observation.effective[x] | Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10 |
This structure is derived from AUBaseDiagnosticImagingResult
Summary
Mandatory: 2 elements(1 nested mandatory element)
Must-Support: 23 elements
Structures
This structure refers to these other structures:
Other representations of profile: CSV, Excel, Schematron
Below is an overview of the mandatory and optional search parameters. FHIR search operations and the syntax used to describe the interactions is described here.
| Name | Type | Conformance | Description | Path | |
|---|---|---|---|---|---|
| category | token | SHALL | SHALL | The classification of the type of observation | Observation.category |
| subject:identifier | token | SHALL | The subject that the observation is about | Observation.subject.identifier | |
| code | token | SHALL | The code of the observation type | Observation.code | |
| date | date | SHALL | Obtained date/time. If the obtained element is a period, a date that falls in the period | Observation.effective | |
| status | date | SHOULD | The status of the observation | Observation.status |
The following search parameters and search parameter combinations SHALL be supported:
SHALL support searching for all observations for a patient using the subject:identifier search parameter:
GET [base]/Observation?subject:identifier={system|}[code]
Example:
GET [base]/Observation?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient (how to search by :identifier)
SHALL support searching using the combination subject:identifier and category search parameter:
GET [base]/Observation?subject:identifier={system|}[code]&category[code]
Example:
GET [base]/Observation?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437&category=http://terminology.hl7.org/CodeSystem/observation-category|imaging
Implementation Notes: Fetches a bundle of all Observation resources with the category of "imaging" for the specified patient (how to search by :identifier and how to search by token)
SHALL support searching using the combination subject:identifier and code search parameter:
GET [base]/Observation?subject:identifier={system|}[code]&code={system|}[code]
Example:
GET [base]/Observation?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437&code=http://snomed.info/sct|427407003
Implementation Notes: Fetches a bundle of all Observation resources with the code of an 427407003 (X-ray of right knee) for the specified patient (how to search by :identifier and how to search by token)
SHALL support searching using the combination of the subject:identifier and date search parameters:
GET [base]/Observation?subject:identifier={system|}[code]&date=[date]
Example:
GET [base]/Observation?subject:identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608000228437&date=ge2013-03-14
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient that have a date greater than or equal to 21st Jan 2013. (how to search by :identifier and how to search by date)
IG © 2023+ Australian Digital Health Agency. Package au.digitalhealth.r4#1.2.0-ci-build based on FHIR 4.0.1. Generated 2024-12-19
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