CH EMED EPR, published by CARA. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CARA-ch/ch-emed-epr/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON

Resource Profile: PADV Observation

Definition of the observation for the pharmaceutical advice document

Usage:

• Use this Resource Profile: PML Document and PADV Document
• Refer to this Resource Profile: PADV Composition, PML Changed Medication Request and PADV Changed MedicationRequest
• Examples for this Resource Profile: Observation/ObservationParacetamolAxapharmPrePadvCancel, Observation/ObservationParacetamolAxapharmPrePadvChange, Observation/ObservationRamiprilPadv and Observation/ObservationTriatecPadv

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 CHEMEDObservation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
meta
extension	D	0..*	Extension	✕ This element is not supported
versionId	D	0..1	id	✕ This element is not supported
lastUpdated	D	0..1	instant	✕ This element is not supported
source	D	0..1	uri	✕ This element is not supported
security	D	0..*	Coding	✕ This element is not supported
tag	D	0..*	Coding	✕ This element is not supported
implicitRules		0..0
Slices for extension				Content/Rules for all slices
extension:medicationStatementChanged		0..1	CHEMEDExtMedicationStatementChanged	CH EMED Extension
value[x]		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
extension:medicationRequestChanged		0..1	CHEMEDExtMedicationRequestChanged	CH EMED Extension
value[x]		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
modifierExtension		0..0
basedOn	D	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	D	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
category	D	0..*	CodeableConcept	✕ This element is not supported
subject		0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
focus	D	0..*	Reference(Resource)	✕ This element is not supported
encounter	D	0..1	Reference(Encounter)	✕ This element is not supported
effective[x]	D	0..1	dateTime, Period, Timing, instant	✕ This element is not supported
value[x]	D	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	✕ This element is not supported
dataAbsentReason	D	0..1	CodeableConcept	✕ This element is not supported
interpretation	D	0..*	CodeableConcept	✕ This element is not supported
note
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported
author[x]	D	0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	✕ The note author is ignored, as it cannot be different than the document and/or entry's author
time	D	0..1	dateTime	✕ This element is not supported
text		1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite	D	0..1	CodeableConcept	✕ This element is not supported
method	D	0..1	CodeableConcept	✕ This element is not supported
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	D	0..*	BackboneElement	✕ This element is not supported
hasMember	D	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	D	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	D	0..*	BackboneElement	✕ This element is not supported
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes. only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
Slices for extension				Content/Rules for all slices
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
medicationStatementChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
value[x]		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement ele-1: All FHIR elements must have a @value or children
medicationRequestChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
value[x]		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest ele-1: All FHIR elements must have a @value or children
identifier	Σ	1..1	Identifier	Observation Identifier ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID ele-1: All FHIR elements must have a @value or children Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
basedOn	ΣD	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
partOf	ΣD	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
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 Fixed Value: final
category	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required) ele-1: All FHIR elements must have a @value or children
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient 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
focus	ΣD	0..*	Reference(Resource)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
encounter	ΣD	0..1	Reference(Encounter)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
Slices for effective[x]	ΣD	0..1		✕ This element is not supported Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time ele-1: All FHIR elements must have a @value or children
issued	Σ	1..1	instant	Date/Time this version was made available ele-1: All FHIR elements must have a @value or children
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship' 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
value[x]	ΣCD	0..1		✕ This element is not supported 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	CD	0..1	CodeableConcept	✕ This element is not supported 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	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. ele-1: All FHIR elements must have a @value or children
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done. ele-1: All FHIR elements must have a @value or children
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
author[x]	ΣD	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author ele-1: All FHIR elements must have a @value or children
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	ΣD	0..1	dateTime	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed). ele-1: All FHIR elements must have a @value or children
bodySite	D	0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. ele-1: All FHIR elements must have a @value or children
method	D	0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations. ele-1: All FHIR elements must have a @value or children
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
referenceRange	CD	0..*	BackboneElement	✕ This element is not supported 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
hasMember	ΣD	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
derivedFrom	ΣD	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
component	ΣD	0..*	BackboneElement	✕ This element is not supported 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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	Fixed Value: final 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	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist
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.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes. only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
versionId	ΣD	0..1	id	✕ This element is not supported
lastUpdated	ΣD	0..1	instant	✕ This element is not supported
source	ΣD	0..1	uri	✕ This element is not supported
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	ΣD	0..*	Coding	✕ This element is not supported Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	ΣD	0..*	Coding	✕ This element is not supported Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
medicationStatementChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
value[x]		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
medicationRequestChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
value[x]		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
identifier	Σ	1..1	Identifier	Observation Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn	ΣD	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	ΣD	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
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
focus	ΣD	0..*	Reference(Resource)	✕ This element is not supported
encounter	ΣD	0..1	Reference(Encounter)	✕ This element is not supported
Slices for effective[x]	ΣD	0..1		✕ This element is not supported Slice: Unordered, Closed by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time
issued	Σ	1..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship'
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
value[x]	ΣCD	0..1		✕ This element is not supported
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	CD	0..1	CodeableConcept	✕ This element is not supported Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done.
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	ΣD	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	ΣD	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite	D	0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	D	0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations.
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	CD	0..*	BackboneElement	✕ This element is not supported 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	ΣD	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	ΣD	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	ΣD	0..*	BackboneElement	✕ This element is not supported
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Observation.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	Fixed Value: final 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	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
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

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

This structure is derived from CHEMEDObservation

Summary

Prohibited: 2 elements

Structures

This structure refers to these other structures:

• PADV Changed MedicationStatement (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationstatement-changed)
• PADV Changed MedicationRequest (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationrequest-changed)
• CH EMED EPR Patient (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-patient)

Differential View

This structure is derived from CHEMEDObservation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
meta
extension	D	0..*	Extension	✕ This element is not supported
versionId	D	0..1	id	✕ This element is not supported
lastUpdated	D	0..1	instant	✕ This element is not supported
source	D	0..1	uri	✕ This element is not supported
security	D	0..*	Coding	✕ This element is not supported
tag	D	0..*	Coding	✕ This element is not supported
implicitRules		0..0
Slices for extension				Content/Rules for all slices
extension:medicationStatementChanged		0..1	CHEMEDExtMedicationStatementChanged	CH EMED Extension
value[x]		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
extension:medicationRequestChanged		0..1	CHEMEDExtMedicationRequestChanged	CH EMED Extension
value[x]		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
modifierExtension		0..0
basedOn	D	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	D	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
category	D	0..*	CodeableConcept	✕ This element is not supported
subject		0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
focus	D	0..*	Reference(Resource)	✕ This element is not supported
encounter	D	0..1	Reference(Encounter)	✕ This element is not supported
effective[x]	D	0..1	dateTime, Period, Timing, instant	✕ This element is not supported
value[x]	D	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	✕ This element is not supported
dataAbsentReason	D	0..1	CodeableConcept	✕ This element is not supported
interpretation	D	0..*	CodeableConcept	✕ This element is not supported
note
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported
author[x]	D	0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	✕ The note author is ignored, as it cannot be different than the document and/or entry's author
time	D	0..1	dateTime	✕ This element is not supported
text		1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite	D	0..1	CodeableConcept	✕ This element is not supported
method	D	0..1	CodeableConcept	✕ This element is not supported
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	D	0..*	BackboneElement	✕ This element is not supported
hasMember	D	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	D	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	D	0..*	BackboneElement	✕ This element is not supported
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes. only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
Slices for extension				Content/Rules for all slices
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
medicationStatementChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
value[x]		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement ele-1: All FHIR elements must have a @value or children
medicationRequestChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
value[x]		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest ele-1: All FHIR elements must have a @value or children
identifier	Σ	1..1	Identifier	Observation Identifier ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID ele-1: All FHIR elements must have a @value or children Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
basedOn	ΣD	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
partOf	ΣD	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
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 Fixed Value: final
category	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required) ele-1: All FHIR elements must have a @value or children
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient 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
focus	ΣD	0..*	Reference(Resource)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
encounter	ΣD	0..1	Reference(Encounter)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
Slices for effective[x]	ΣD	0..1		✕ This element is not supported Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time ele-1: All FHIR elements must have a @value or children
issued	Σ	1..1	instant	Date/Time this version was made available ele-1: All FHIR elements must have a @value or children
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship' 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
value[x]	ΣCD	0..1		✕ This element is not supported 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	CD	0..1	CodeableConcept	✕ This element is not supported 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	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. ele-1: All FHIR elements must have a @value or children
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done. ele-1: All FHIR elements must have a @value or children
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
author[x]	ΣD	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author ele-1: All FHIR elements must have a @value or children
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	ΣD	0..1	dateTime	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed). ele-1: All FHIR elements must have a @value or children
bodySite	D	0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. ele-1: All FHIR elements must have a @value or children
method	D	0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations. ele-1: All FHIR elements must have a @value or children
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
referenceRange	CD	0..*	BackboneElement	✕ This element is not supported 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
hasMember	ΣD	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
derivedFrom	ΣD	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
component	ΣD	0..*	BackboneElement	✕ This element is not supported 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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	Fixed Value: final 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	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist
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.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CHEMEDObservation	CH EMED Observation (PADV) 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 ch-obs-1: In case of a 'CHANGE', reference shall be made to an entry containing the changes. only-one-obs-ref: A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present mtp-entry-only-with-ref: A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE pre-entry-only-with-ref: A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE treatment-plan-id-reference-matches-statement-changed-reference: If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
versionId	ΣD	0..1	id	✕ This element is not supported
lastUpdated	ΣD	0..1	instant	✕ This element is not supported
source	ΣD	0..1	uri	✕ This element is not supported
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	ΣD	0..*	Coding	✕ This element is not supported Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	ΣD	0..*	Coding	✕ This element is not supported Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
dispense		0..1	(Complex)	Reference to the medication dispense URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
medicationStatementChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed"
value[x]		1..1	Reference(PADV Changed MedicationStatement) {r, b}	The changed MedicationStatement
medicationRequestChanged		0..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed"
value[x]		1..1	Reference(PADV Changed MedicationRequest) {r, b}	The changed MedicationRequest
identifier	Σ	1..1	Identifier	Observation Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn	ΣD	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	✕ This element is not supported
partOf	ΣD	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	✕ This element is not supported
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Observation code Binding: IHE Pharmaceutical Advice Status List (required)
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
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
focus	ΣD	0..*	Reference(Resource)	✕ This element is not supported
encounter	ΣD	0..1	Reference(Encounter)	✕ This element is not supported
Slices for effective[x]	ΣD	0..1		✕ This element is not supported Slice: Unordered, Closed by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Effective Time
issued	Σ	1..1	instant	Date/Time this version was made available
performer	Σ	1..1	Reference(CH EMED PractitionerRole | CH Core Patient EPR | RelatedPerson)	The author of the medical decision, see also 'Guidance - Authorship'
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
value[x]	ΣCD	0..1		✕ This element is not supported
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	CD	0..1	CodeableConcept	✕ This element is not supported Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	D	0..*	CodeableConcept	✕ This element is not supported Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		1..1	Annotation	COMMENT: the actual comment. OK/CHANGE/REFUSE/CANCEL/SUSPEND: the reason why the action was done.
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	ΣD	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	ΣD	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
bodySite	D	0..1	CodeableConcept	✕ This element is not supported Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	D	0..1	CodeableConcept	✕ This element is not supported Binding: ObservationMethods (example): Methods for simple observations.
specimen	D	0..1	Reference(Specimen)	✕ This element is not supported
device	D	0..1	Reference(Device | DeviceMetric)	✕ This element is not supported
referenceRange	CD	0..*	BackboneElement	✕ This element is not supported 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	ΣD	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	✕ This element is not supported
derivedFrom	ΣD	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	✕ This element is not supported
component	ΣD	0..*	BackboneElement	✕ This element is not supported
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Observation.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	Fixed Value: final 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	required	IHEPharmaceuticalAdviceStatusList http://fhir.ch/ig/ch-term/ValueSet/ihe-pharmaceuticaladvicestatuslist
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
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

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-obs-1	error	Observation	In case of a 'CHANGE', reference shall be made to an entry containing the changes. : code.coding.exists(system='urn:oid:1.3.6.1.4.1.19376.1.9.2.1' and code='CHANGE') implies extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed' or url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mtp-entry-only-with-ref	error	Observation	A changed MedicationStatement SHALL only be present with a medication treatment plan reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists().not()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
only-one-obs-ref	error	Observation	A single reference (to either a medication treatment plan, prescription or dispense) SHALL be present : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() xor extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()) and (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense').exists()).not()
pre-entry-only-with-ref	error	Observation	A changed MedicationRequest SHALL only be present with a medication request reference, in a PADV CHANGE : (extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription').exists() and extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists() and code.coding.single().code = 'CHANGE') or extension.where(url='http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationrequest-changed').exists().not()
treatment-plan-id-reference-matches-statement-changed-reference	error	Observation	If the observation includes a medication statement changed reference, it SHALL match the treatment plan id reference : extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').exists() implies (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-medicationstatement-changed').single().value as Reference).reference = (extension('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan').extension('id').single().value as Identifier).value

This structure is derived from CHEMEDObservation

Summary

Prohibited: 2 elements

Structures

This structure refers to these other structures:

• PADV Changed MedicationStatement (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationstatement-changed)
• PADV Changed MedicationRequest (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medicationrequest-changed)
• CH EMED EPR Patient (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-patient)