2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 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

## : Observation example - JSON Representation

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    {
      "resourceType" : "Observation",
      "id" : "example",
      "meta" : {
        "profile" : [
          🔗 "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-simple-observation"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Observation example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-us-quality-core-simple-observation.html\">US Quality Core Simple Observation</a></p></div><p><b>Observation Body Position</b>: <span title=\"Codes:{http://snomed.info/sct 33586001}\">Sitting position (finding)</span></p><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category vital-signs}\">Vital Signs</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 30350-3}\">Hemoglobin [Mass/volume] in Venous blood</span></p><p><b>subject</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>encounter</b>: <a href=\"Encounter-example.html\">Encounter: identifier = http://example.org/encounters#ENC-20130404-appendicitis; status = finished; class = inpatient encounter (v3 Code System ActCode#IMP); type = Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.; period = 2013-04-04 18:00:00-0400 --&gt; 2013-04-06 11:00:00-0400</a></p><p><b>effective</b>: 2013-04-02 10:30:10+0100 --&gt; 2013-04-05 10:30:10+0100</p><p><b>issued</b>: 2013-04-03 15:30:10+0100</p><p><b>performer</b>: <a href=\"Practitioner-example.html\">Practitioner</a></p><p><b>value</b>: 7.2 g/dl<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  codeg/dL = 'g/dL')</span></p><p><b>interpretation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation L}\">Below low normal</span></p><p><b>bodySite</b>: <span title=\"Codes:{http://snomed.info/sct 308046002}\">Superficial forearm vein</span></p><p><b>method</b>: <span title=\"Codes:{http://snomed.info/sct 120220003}\">Injection to forearm</span></p><p><b>derivedFrom</b>: <a href=\"Observation-example.html\">Observation Hemoglobin [Mass/volume] in Venous blood</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 8480-6}, {http://snomed.info/sct 271649006}\">Systolic blood pressure</span></p><p><b>value</b>: 107 mmHg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  codemm[Hg] = 'mm[Hg]')</span></p><p><b>interpretation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation N}\">Normal</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 8462-4}\">Diastolic blood pressure</span></p><p><b>value</b>: 60 mmHg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  codemm[Hg] = 'mm[Hg]')</span></p><p><b>interpretation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation L}\">Below low normal</span></p></blockquote></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "33586001",
                "display" : "Sitting position (finding)"
              }
            ]
          }
        }
      ],
      "status" : "final",
      "category" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
              "code" : "vital-signs",
              "display" : "Vital Signs"
            }
          ]
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "30350-3",
            "display" : "Hemoglobin [Mass/volume] in Venous blood"
          }
        ]
      },
      "subject" : {
        🔗 "reference" : "Patient/example"
      },
      "encounter" : {
        🔗 "reference" : "Encounter/example"
      },
      "effectivePeriod" : {
        "start" : "2013-04-02T10:30:10+01:00",
        "end" : "2013-04-05T10:30:10+01:00"
      },
      "issued" : "2013-04-03T15:30:10+01:00",
      "performer" : [
        {
          🔗 "reference" : "Practitioner/example",
          "display" : "Practitioner"
        }
      ],
      "valueQuantity" : {
        "value" : 7.2,
        "unit" : "g/dl",
        "system" : "http://unitsofmeasure.org",
        "code" : "g/dL"
      },
      "interpretation" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
              "code" : "L",
              "display" : "Low"
            }
          ],
          "text" : "Below low normal"
        }
      ],
      "bodySite" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "308046002",
            "display" : "Superficial forearm vein"
          }
        ]
      },
      "method" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "120220003",
            "display" : "Injection to forearm"
          }
        ]
      },
      "derivedFrom" : [
        {
          🔗 "reference" : "Observation/example"
        }
      ],
      "component" : [
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://loinc.org",
                "code" : "8480-6",
                "display" : "Systolic blood pressure"
              },
              {
                "system" : "http://snomed.info/sct",
                "code" : "271649006",
                "display" : "Systolic blood pressure"
              }
            ]
          },
          "valueQuantity" : {
            "value" : 107,
            "unit" : "mmHg",
            "system" : "http://unitsofmeasure.org",
            "code" : "mm[Hg]"
          },
          "interpretation" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                  "code" : "N",
                  "display" : "Normal"
                }
              ],
              "text" : "Normal"
            }
          ]
        },
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://loinc.org",
                "code" : "8462-4",
                "display" : "Diastolic blood pressure"
              }
            ]
          },
          "valueQuantity" : {
            "value" : 60,
            "unit" : "mmHg",
            "system" : "http://unitsofmeasure.org",
            "code" : "mm[Hg]"
          },
          "interpretation" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                  "code" : "L",
                  "display" : "Low"
                }
              ],
              "text" : "Below low normal"
            }
          ]
        }
      ]
    }