US Quality Core Implementation Guide
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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 Simple Observation

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

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

Usage

Note: US-Core and US Quality Core define precise profiles for specific observations, as well as a general profile for LOINC-code laboratory result observations. US Quality Core inherits these US Core specific profiles directly and individually profiles others. When creating expressions for eCQMs or CDS artifacts with US Quality Core for the following clinical data, use the applicable profile directly rather than the generic USQualityCore Observation profile:

​ As stated in the Home Page, US Quality Core derives from US Core and so the requirements on “MustSupport” defined in US Core must be respected. US Quality Core further describes and constrains the “MustSupport” functionality.

To create an expression specifically requesting information that an observation intentionally did not occur for a medical, patient or system reason, use the profile USQualityCore Observation Cancelled.

The following example illustrates the use of the observation profile.

define "Pap Test with Results":
  [Observation: "Pap Test"] PapTest
    where PapTest.value is not null
      and PapTest.status in { 'final', 'amended', 'corrected', 'preliminary' }

See the patterns page for implementation and usage patterns.

Examples

Example of a Frailty Observation
Example of a Gestation Age at Birth Observation
Example of a Date and time of obstetric delivery observation
Example of an estimated delivery date observation
Example of a number of preterm births observation
Example of a number of term births observation
Example of a number of parity observation
Example of a number of pregnancies observation

USCDI+ Quality Elements:

  • status: (USCDI+ Quality) (USCDI) registered \| prliminary \| final \| amended \| corrected \| entered-in-error \| unknown
  • category: (USCDI+ Quality) (USCDI) Classification of type of observation
  • category:us-core: (USCDI+ Quality) (USCDI) US Core classification of type of observation
  • code: (USCDI+ Quality) (USCDI) Type of observation (code / type)
  • effective[x]: (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
  • value[x]: (USCDI+ Quality) (USCDI) 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..* USCoreSimpleObservationProfile assessment observation
Constraints: obs-6, obs-7
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (USCDI+ Quality) (USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
Binding: Non-Negative Observation Status (required)
.... category:us-core S 0..* CodeableConcept (USCDI+ Quality) (USCDI) US Core classification of type of observation
Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred): This value set specifies the type of observation
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who and/or what the observation is about
... effective[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... performer SΣ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core PractitionerRole | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI) Who is responsible for the observation
... Slices for value[x] SΣC 0..1 (USCDI+ Quality) (USCDI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity S
.... valueCodeableConcept CodeableConcept S
.... valueString string S
.... valueBoolean boolean S
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S actual | potential
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 Quality Core ImagingStudy | US Core DocumentReference Profile | Media | MolecularSequence) (USCDI) US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required Non-Negative Observation Status 📦0.1.0 This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
Observation.code Base preferred 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()

This structure is derived from USCoreSimpleObservationProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* USCoreSimpleObservationProfile assessment observation
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status 1..1 code (USCDI+ Quality) (USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
Binding: Non-Negative Observation Status (required)
... Slices for category Content/Rules for all slices
.... category:us-core 0..* CodeableConcept (USCDI+ Quality) (USCDI) US Core classification of type of observation
... code 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred): This value set specifies the type of observation
... subject Σ 1..1 Reference(US Quality Core Patient) (USCDI) Who and/or what the observation is about
... effective[x] Σ 0..1 (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... performer 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core PractitionerRole | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI) Who is responsible for the observation
... Slices for value[x] Σ 0..1 (USCDI+ Quality) (USCDI) 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 | potential
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 Quality Core ImagingStudy | US Core DocumentReference Profile | Media | MolecularSequence) (USCDI) US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.status Base required Non-Negative Observation Status 📦0.1.0 This IG
Observation.code Base preferred 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.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSimpleObservationProfile assessment observation
Constraints: obs-6, obs-7
... 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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code (USCDI+ Quality) (USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
Binding: Non-Negative Observation Status (required)
... Slices for category S 1..* CodeableConcept (USCDI+ Quality) (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI+ Quality) (USCDI) US Core classification of type of observation
Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred): This value set specifies the type of observation
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 0..1 instant Date/Time this version was made available
... performer SΣ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core PractitionerRole | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI) Who is responsible for the observation
... Slices for value[x] SΣC 0..1 (USCDI+ Quality) (USCDI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity S
.... valueCodeableConcept CodeableConcept S
.... valueString string S
.... valueBoolean boolean S
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S actual | potential
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 Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Quality Core ImagingStudy | US Core DocumentReference Profile | Media | MolecularSequence) (USCDI) US Core Profiles or other resource 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 Non-Negative Observation Status 📦0.1.0 This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
Observation.code Base preferred 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()

This structure is derived from USCoreSimpleObservationProfile

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSimpleObservationProfile assessment observation
Constraints: obs-6, obs-7
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (USCDI+ Quality) (USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
Binding: Non-Negative Observation Status (required)
.... category:us-core S 0..* CodeableConcept (USCDI+ Quality) (USCDI) US Core classification of type of observation
Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred): This value set specifies the type of observation
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who and/or what the observation is about
... effective[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... performer SΣ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core PractitionerRole | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI) Who is responsible for the observation
... Slices for value[x] SΣC 0..1 (USCDI+ Quality) (USCDI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity S
.... valueCodeableConcept CodeableConcept S
.... valueString string S
.... valueBoolean boolean S
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S actual | potential
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 Quality Core ImagingStudy | US Core DocumentReference Profile | Media | MolecularSequence) (USCDI) US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required Non-Negative Observation Status 📦0.1.0 This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
Observation.code Base preferred 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()

Differential View

This structure is derived from USCoreSimpleObservationProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* USCoreSimpleObservationProfile assessment observation
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status 1..1 code (USCDI+ Quality) (USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
Binding: Non-Negative Observation Status (required)
... Slices for category Content/Rules for all slices
.... category:us-core 0..* CodeableConcept (USCDI+ Quality) (USCDI) US Core classification of type of observation
... code 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred): This value set specifies the type of observation
... subject Σ 1..1 Reference(US Quality Core Patient) (USCDI) Who and/or what the observation is about
... effective[x] Σ 0..1 (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... performer 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core PractitionerRole | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI) Who is responsible for the observation
... Slices for value[x] Σ 0..1 (USCDI+ Quality) (USCDI) 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 | potential
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 Quality Core ImagingStudy | US Core DocumentReference Profile | Media | MolecularSequence) (USCDI) US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.status Base required Non-Negative Observation Status 📦0.1.0 This IG
Observation.code Base preferred 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.

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* USCoreSimpleObservationProfile assessment observation
Constraints: obs-6, obs-7
... 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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code (USCDI+ Quality) (USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
Binding: Non-Negative Observation Status (required)
... Slices for category S 1..* CodeableConcept (USCDI+ Quality) (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI+ Quality) (USCDI) US Core classification of type of observation
Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Type of observation (code / type)
Binding: LOINCCodes (preferred): This value set specifies the type of observation
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who and/or what the observation is about
... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 0..1 instant Date/Time this version was made available
... performer SΣ 0..* Reference(US Quality Core Practitioner | US Quality Core Organization | US Quality Core Patient | US Quality Core PractitionerRole | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI) Who is responsible for the observation
... Slices for value[x] SΣC 0..1 (USCDI+ Quality) (USCDI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity S
.... valueCodeableConcept CodeableConcept S
.... valueString string S
.... valueBoolean boolean S
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S actual | potential
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 Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(US Quality Core Simple Observation | US Quality Core QuestionnaireResponse | US Quality Core ImagingStudy | US Core DocumentReference Profile | Media | MolecularSequence) (USCDI) US Core Profiles or other resource 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 Non-Negative Observation Status 📦0.1.0 This IG
Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
Observation.code Base preferred 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()

This structure is derived from USCoreSimpleObservationProfile

 

Other representations of profile: CSV, Excel, Schematron