US Quality Core Implementation Guide
0.1.0 - cibuild United States of America flag

US Quality Core Implementation Guide, published by ASTP. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

Resource Profile: US Quality Core Observation Cancelled

Official URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observationcancelled Version: 0.1.0
Active as of 2026-03-31 Computable Name: USQualityCoreObservationCancelled

Profile of ObservationCancelled for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

The Simple Observation and ObservationCancelled profiles represent the positive and negative statements for an observation. To ensure instances retrieved meet negative intent, applications should check the status element as illustrated in this example:

define "Pap Test Refused":
  ["ObservationCancelled": "Pap Test"] PapTest
    where PapTest.notDoneReason in "Patient Refusal"

Note that when a more specific observation, such as a Blood Pressure, is negated, the resource instance should conform to both the specific observation profile AND the general negation profile.

Examples

Negation Example with valuesetObservation not indicated; indicates that none of the observations in the given not done value set were performed.
Negation Example with codeObservation not indicate; indicates that a specific observation, by code, was not done.

​For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.

USCDI+ Quality Elements:

  • extension:notDoneReason: (USCDI+ Quality) Extension
  • status: (USCDI+ Quality) registered \| preliminary \| final \| amended +
  • category: (USCDI+ Quality) Classification of type of observation
  • code: (USCDI+ Quality) Type of observation (code / type)
  • code.extension:notDoneValueSet: (USCDI+ Quality) What was not done
  • effective[x]: (USCDI+ Quality) Clinically relevant time/time-period for observation
  • value[x]: (USCDI+ Quality) Actual result

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, ond-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:notDoneReason 1..1 CodeableConcept (USCDI+ Quality) Extension
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category 1..* CodeableConcept (USCDI+ Quality) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code Σ 1..1 CodeableConcept (USCDI+ Quality) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet 0..1 canonical(ValueSet) (USCDI+ Quality) What was not done
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject Σ 1..1 Reference(US Quality Core Patient) Who and/or what the observation is about
... effective[x] Σ 0..1 (USCDI+ Quality) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 0..1 (USCDI+ Quality) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... derivedFrom Σ 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📦6.1.0 US Core v6.1
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
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()
ond-1 error Observation to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: ond-1
... Slices for extension Content/Rules for all slices
.... extension:notDoneReason 1..1 CodeableConcept (USCDI+ Quality) Extension
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... status 1..1 code (USCDI+ Quality) registered | preliminary | final | amended +
Fixed Value: cancelled
... category 1..* CodeableConcept (USCDI+ Quality) Classification of type of observation
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet 0..1 canonical(ValueSet) (USCDI+ Quality) What was not done
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject 1..1 Reference(US Quality Core Patient) Who and/or what the observation is about
... effective[x] 0..1 dateTime, Period, Timing, instant (USCDI+ Quality) Clinically relevant time/time-period for observation
... issued 1..1 instant Date/Time this version was made available
... performer 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson) Who is responsible for the observation
... Slices for value[x] Σ 0..1 (USCDI+ Quality) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept 0..1 CodeableConcept Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... derivedFrom 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📦6.1.0 US Core v6.1
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ond-1 error Observation to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, ond-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:notDoneReason 1..1 CodeableConcept (USCDI+ Quality) Extension
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code (USCDI+ Quality) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Fixed Value: cancelled
... category 1..* CodeableConcept (USCDI+ Quality) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code Σ 1..1 CodeableConcept (USCDI+ Quality) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:notDoneValueSet 0..1 canonical(ValueSet) (USCDI+ Quality) What was not done
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(US Quality Core Patient) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] Σ 0..1 (USCDI+ Quality) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 0..1 (USCDI+ Quality) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📦6.1.0 US Core v6.1
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
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()
ond-1 error Observation to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, ond-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:notDoneReason 1..1 CodeableConcept (USCDI+ Quality) Extension
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category 1..* CodeableConcept (USCDI+ Quality) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code Σ 1..1 CodeableConcept (USCDI+ Quality) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet 0..1 canonical(ValueSet) (USCDI+ Quality) What was not done
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject Σ 1..1 Reference(US Quality Core Patient) Who and/or what the observation is about
... effective[x] Σ 0..1 (USCDI+ Quality) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 0..1 (USCDI+ Quality) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... derivedFrom Σ 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📦6.1.0 US Core v6.1
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
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()
ond-1 error Observation to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: ond-1
... Slices for extension Content/Rules for all slices
.... extension:notDoneReason 1..1 CodeableConcept (USCDI+ Quality) Extension
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... status 1..1 code (USCDI+ Quality) registered | preliminary | final | amended +
Fixed Value: cancelled
... category 1..* CodeableConcept (USCDI+ Quality) Classification of type of observation
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet 0..1 canonical(ValueSet) (USCDI+ Quality) What was not done
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject 1..1 Reference(US Quality Core Patient) Who and/or what the observation is about
... effective[x] 0..1 dateTime, Period, Timing, instant (USCDI+ Quality) Clinically relevant time/time-period for observation
... issued 1..1 instant Date/Time this version was made available
... performer 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson) Who is responsible for the observation
... Slices for value[x] Σ 0..1 (USCDI+ Quality) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept 0..1 CodeableConcept Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... derivedFrom 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📦6.1.0 US Core v6.1
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ond-1 error Observation to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, ond-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:notDoneReason 1..1 CodeableConcept (USCDI+ Quality) Extension
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code (USCDI+ Quality) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Fixed Value: cancelled
... category 1..* CodeableConcept (USCDI+ Quality) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code Σ 1..1 CodeableConcept (USCDI+ Quality) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:notDoneValueSet 0..1 canonical(ValueSet) (USCDI+ Quality) What was not done
URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(US Quality Core Patient) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] Σ 0..1 (USCDI+ Quality) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 0..1 (USCDI+ Quality) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📦6.1.0 US Core v6.1
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
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()
ond-1 error Observation to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

 

Other representations of profile: CSV, Excel, Schematron