HL7 CZ Laboratory IG, published by HL7 Czech Republic. 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/HL7-cz/cz-lab/ and changes regularly. See the Directory of published versions

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Resource Profile: Observation Laboratory (CZ)

This profile constrains the Observation resource to represent results produced by laboratory tests or panels/studies.

This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and or a global interpretation by the producer of the study in the comment element; and references the atomic results of the study as "has-member" child observations.

This profile constrains the Observation resource to represent a laboratory in vitro diagnostic test or panel/study. In case of a panel/study, the results of the panel appear as sub-observations. In this case this top-level Observation acts as a grouper of all the observations belonging to the panel or study. The top-level observation may carry a conclusion in the value element and or a global interpretation by the producer of the study, in the comment element.

Usages:

• Use this Profile: Bundle - Laboratory Result Report
• Refer to this Profile: Composition: Laboratory Report, DiagnosticReport: Laboratory Report and Observation Laboratory (CZ)
• Examples for this Profile: Observation/2fb0c9d4-7e12-47a6-9a3b-1c5e8d2f4a76, Observation/5c3e9a12-4f7b-41d0-86a2-9b7e4d2f1c08, Observation/8d6e1f2b-3a84-4c9d-bc2e-5f71a9d4e6c3, Observation/b4e2d7a9-63c1-44f8-b0a5-2e9d1c7a3f56 and Observation/d1a7f3c8-0e5b-4b2a-8c91-6f4e2d7a9b35

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.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, cz-lab-0, cz-lab-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		0..*	Extension	Triggering observation.
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
extension:accreditation		0..1	boolean	Information on the laboratory’s accreditation for the respective test URL: https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConceptIPS(2.0.0)	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (CZ) (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Speciality Types (CZ) (required)
code	Σ	1..1	CodeableConceptIPS(2.0.0)	Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject	Σ	1..1	Reference(Patient: Animal (CZ) | Patient (CZ core) | Group | Device | Location (CZ core))	Who and/or what the observation is about
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	ΣC	1..1		Clinically relevant time/time-period for observation Constraints: cz-lab-1
effective[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
extension:ClinicallyRelevantTime	S	0..1	Coding	Extension - Clinically Relevant Time URL: https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time Binding: ValueSet - Clinically Relevant Time (required)
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this result was made available
performer	Σ	1..*	Reference(CareTeam | Related Person (CZ core) | Patient (CZ core) | Organization (CZ core) | Practitioner Role (CZ core) | Practitioner (CZ core))	Who is responsible for the observation
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
Slices for value[x]	ΣC	0..1		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]:valueString	ΣC	0..1	string	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Actual result
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConceptIPS(2.0.0)	Actual result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
dataAbsentReason	C	0..1	CodeableConcept	Provides a reason why the expected value is missing. Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConceptIPS(2.0.0)	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
method		0..1	CodeableConceptIPS(2.0.0)	How it was done Binding: Laboratory Techniques (preferred)
specimen		0..1	Reference(Specimen Laboratory (CZ))	Specimen used for this observation
device		0..1	Reference(Device: Performer/Observer (CZ) | DeviceMetric)	Measuring instrument
hasMember	Σ	0..*	Reference(Observation Laboratory (CZ))	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Observation Laboratory (CZ))	In the initial iteration of the Czech interoperability project: this can be ObservationLaboratory (CZ) or Media
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.category:laboratory	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types (CZ)	📦0.5.0	This IG
Observation.category:specialty	Base	required	Laboratory Speciality Types (CZ)	📦0.5.0	This IG
Observation.code	Base	required	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.method	Base	preferred	Laboratory Techniques	📦0.5.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
cz-lab-0	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
cz-lab-1	error	Observation.effective[x]	Datetime musí být uveden s přesností alespoň na den	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
cz-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.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()
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 Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: cz-lab-0, cz-lab-2
Slices for extension		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		0..*	Extension	Triggering observation.
extension:type		0..*	Extension	The type of trigger
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
value[x]		1..1	Attachment	Value of extension
extension:accreditation		0..1	boolean	Information on the laboratory’s accreditation for the respective test URL: https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
status		1..1	code	Status of this observation (e.g. preliminary, final,...)
Slices for category		1..*	CodeableConceptIPS(2.0.0)	Classification of type of observation Slice: Unordered, Open by pattern:$this
category:laboratory		1..1	CodeableConcept	Classification of type of observation Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (CZ) (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Speciality Types (CZ) (required)
code		1..1	CodeableConceptIPS(2.0.0)	Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject		1..1	Reference(Patient: Animal (CZ) | Patient (CZ core) | Group | Device | Location (CZ core))	Who and/or what the observation is about
reference		1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	C	1..1		Clinically relevant time/time-period for observation Constraints: cz-lab-1
effective[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
extension:ClinicallyRelevantTime	S	0..1	Coding	Extension - Clinically Relevant Time URL: https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time Binding: ValueSet - Clinically Relevant Time (required)
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
issued		0..1	instant	Date/Time this result was made available
performer		1..*	Reference(CareTeam | Related Person (CZ core) | Patient (CZ core) | Organization (CZ core) | Practitioner Role (CZ core) | Practitioner (CZ core))	Who is responsible for the observation
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..*	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueString		0..1	string	Actual result
value[x]:valueRange		0..1	RangeIPS	Actual result
value[x]:valueRatio		0..1	RatioEuLab	Actual result
value[x]:valueTime		0..1	time	Actual result
value[x]:valueDateTime		0..1	dateTime	Actual result
value[x]:valuePeriod		0..1	Period	Actual result
value[x]:valueQuantity		0..1	QuantityEuLab	Actual result
value[x]:valueCodeableConcept		0..1	CodeableConceptIPS(2.0.0)	Actual result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
dataAbsentReason		0..1	CodeableConcept	Provides a reason why the expected value is missing.
interpretation		0..*	CodeableConceptIPS(2.0.0)	High, low, normal, etc.
method		0..1	CodeableConceptIPS(2.0.0)	How it was done Binding: Laboratory Techniques (preferred)
specimen		0..1	Reference(Specimen Laboratory (CZ))	Specimen used for this observation
device		0..1	Reference(Device: Performer/Observer (CZ) | DeviceMetric)	Measuring instrument
hasMember		0..*	Reference(Observation Laboratory (CZ))	Related resource that belongs to the Observation group
derivedFrom		0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Observation Laboratory (CZ))	In the initial iteration of the Czech interoperability project: this can be ObservationLaboratory (CZ) or Media
component
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
value[x]		1..1	Attachment	Value of extension
code		1..1	CodeableConceptIPS(2.0.0)	Type of component observation (code / type) Binding: Národní číselník laboratorních položek (preferred)
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result Slice: Unordered, Closed by type:$this
value[x]:valueString		0..1	string	Actual component result
value[x]:valueRange		0..1	RangeIPS	Actual component result
value[x]:valueRatio		0..1	RatioEuLab	Actual component result
value[x]:valueTime		0..1	time	Actual component result
value[x]:valueDateTime		0..1	dateTime	Actual component result
value[x]:valuePeriod		0..1	Period	Actual component result
value[x]:valueQuantity		0..1	QuantityEuLab	Actual component result
value[x]:valueCodeableConcept		0..1	CodeableConceptIPS(2.0.0)	Actual component result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.category:studyType	Base	required	Laboratory Study Types (CZ)	📦0.5.0	This IG
Observation.category:specialty	Base	required	Laboratory Speciality Types (CZ)	📦0.5.0	This IG
Observation.code	Base	required	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
Observation.method	Base	preferred	Laboratory Techniques	📦0.5.0	This IG
Observation.component.​code	Base	preferred	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.component.​value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1

Constraints

Id	Grade	Path(s)	Description	Expression
cz-lab-0	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
cz-lab-1	error	Observation.effective[x]	Datetime musí být uveden s přesností alespoň na den	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
cz-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, cz-lab-0, cz-lab-2
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 Bindings Purpose 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		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
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:observation		0..*	Extension	Triggering observation.
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
extension:accreditation		0..1	boolean	Information on the laboratory’s accreditation for the respective test URL: https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
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	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConceptIPS(2.0.0)	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (CZ) (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Speciality Types (CZ) (required)
code	Σ	1..1	CodeableConceptIPS(2.0.0)	Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject	Σ	1..1	Reference(Patient: Animal (CZ) | Patient (CZ core) | Group | Device | Location (CZ core))	Who and/or what the observation is about
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	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]	ΣC	1..1		Clinically relevant time/time-period for observation Constraints: cz-lab-1
effective[x]All Types				Content/Rules for all Types
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:ClinicallyRelevantTime	S	0..1	Coding	Extension - Clinically Relevant Time URL: https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time Binding: ValueSet - Clinically Relevant Time (required)
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this result was made available
performer	Σ	1..*	Reference(CareTeam | Related Person (CZ core) | Patient (CZ core) | Organization (CZ core) | Practitioner Role (CZ core) | Practitioner (CZ core))	Who is responsible for the observation
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:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..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
Slices for value[x]	ΣC	0..1		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]:valueString	ΣC	0..1	string	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Actual result
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConceptIPS(2.0.0)	Actual result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
dataAbsentReason	C	0..1	CodeableConcept	Provides a reason why the expected value is missing. Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConceptIPS(2.0.0)	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	CodeableConceptIPS(2.0.0)	How it was done Binding: Laboratory Techniques (preferred)
specimen		0..1	Reference(Specimen Laboratory (CZ))	Specimen used for this observation
device		0..1	Reference(Device: Performer/Observer (CZ) | DeviceMetric)	Measuring instrument
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 Laboratory (CZ))	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Observation Laboratory (CZ))	In the initial iteration of the Czech interoperability project: this can be ObservationLaboratory (CZ) or Media
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConceptIPS(2.0.0)	Type of component observation (code / type) Binding: Národní číselník laboratorních položek (preferred)
Slices for value[x]	Σ	0..1		Actual component 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]:valueString	Σ	0..1	string	Actual component result
value[x]:valueRange	Σ	0..1	RangeIPS	Actual component result
value[x]:valueRatio	Σ	0..1	RatioEuLab	Actual component result
value[x]:valueTime	Σ	0..1	time	Actual component result
value[x]:valueDateTime	Σ	0..1	dateTime	Actual component result
value[x]:valuePeriod	Σ	0..1	Period	Actual component result
value[x]:valueQuantity	Σ	0..1	QuantityEuLab	Actual component result
value[x]:valueCodeableConcept	Σ	0..1	CodeableConceptIPS(2.0.0)	Actual component result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
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	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.category:laboratory	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types (CZ)	📦0.5.0	This IG
Observation.category:specialty	Base	required	Laboratory Speciality Types (CZ)	📦0.5.0	This IG
Observation.code	Base	required	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.subject.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Observation.performer.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
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	preferred	Laboratory Techniques	📦0.5.0	This IG
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	preferred	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.component.​value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
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
cz-lab-0	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
cz-lab-1	error	Observation.effective[x]	Datetime musí být uveden s přesností alespoň na den	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
cz-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.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()
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 Observation

Summary

Mandatory: 6 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips|2.0.0)
• Patient: Animal (CZ) (https://hl7.cz/fhir/core/StructureDefinition/cz-patient-animal)
• Patient (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-patient-core)
• Location (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-location-core)
• Related Person (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-relatedPerson-core)
• Organization (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-organization-core)
• Practitioner Role (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-practitionerrole-core)
• Practitioner (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-practitioner-core)
• Range (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Range-uv-ips)
• Ratio (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Ratio-eu-lab)
• Quantity (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Quantity-eu-lab)
• Specimen Laboratory (CZ) (https://hl7.cz/fhir/lab/StructureDefinition/cz-specimen-lab)
• Device: Performer/Observer (CZ) (https://hl7.cz/fhir/core/StructureDefinition/cz-device-observer)
• Observation Laboratory (CZ) (https://hl7.cz/fhir/lab/StructureDefinition/cz-observation-result-laboratory)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo|5.2.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
• http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable
• http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
• http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
• Unable to summarise extension http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D (no extension found)
• https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
• https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time
• http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0
• http://hl7.org/fhir/StructureDefinition/event-performerFunction|5.2.0

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.category
• The element 1 is sliced based on the value of Observation.value[x] (Closed)
• The element 1 is sliced based on the value of Observation.component.value[x] (Closed)

Maturity: 1

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, cz-lab-0, cz-lab-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		0..*	Extension	Triggering observation.
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
extension:accreditation		0..1	boolean	Information on the laboratory’s accreditation for the respective test URL: https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConceptIPS(2.0.0)	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (CZ) (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Speciality Types (CZ) (required)
code	Σ	1..1	CodeableConceptIPS(2.0.0)	Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject	Σ	1..1	Reference(Patient: Animal (CZ) | Patient (CZ core) | Group | Device | Location (CZ core))	Who and/or what the observation is about
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	ΣC	1..1		Clinically relevant time/time-period for observation Constraints: cz-lab-1
effective[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
extension:ClinicallyRelevantTime	S	0..1	Coding	Extension - Clinically Relevant Time URL: https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time Binding: ValueSet - Clinically Relevant Time (required)
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this result was made available
performer	Σ	1..*	Reference(CareTeam | Related Person (CZ core) | Patient (CZ core) | Organization (CZ core) | Practitioner Role (CZ core) | Practitioner (CZ core))	Who is responsible for the observation
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
Slices for value[x]	ΣC	0..1		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]:valueString	ΣC	0..1	string	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Actual result
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConceptIPS(2.0.0)	Actual result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
dataAbsentReason	C	0..1	CodeableConcept	Provides a reason why the expected value is missing. Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConceptIPS(2.0.0)	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
method		0..1	CodeableConceptIPS(2.0.0)	How it was done Binding: Laboratory Techniques (preferred)
specimen		0..1	Reference(Specimen Laboratory (CZ))	Specimen used for this observation
device		0..1	Reference(Device: Performer/Observer (CZ) | DeviceMetric)	Measuring instrument
hasMember	Σ	0..*	Reference(Observation Laboratory (CZ))	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Observation Laboratory (CZ))	In the initial iteration of the Czech interoperability project: this can be ObservationLaboratory (CZ) or Media
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.category:laboratory	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types (CZ)	📦0.5.0	This IG
Observation.category:specialty	Base	required	Laboratory Speciality Types (CZ)	📦0.5.0	This IG
Observation.code	Base	required	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.method	Base	preferred	Laboratory Techniques	📦0.5.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
cz-lab-0	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
cz-lab-1	error	Observation.effective[x]	Datetime musí být uveden s přesností alespoň na den	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
cz-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.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()
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 Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: cz-lab-0, cz-lab-2
Slices for extension		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		0..*	Extension	Triggering observation.
extension:type		0..*	Extension	The type of trigger
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
value[x]		1..1	Attachment	Value of extension
extension:accreditation		0..1	boolean	Information on the laboratory’s accreditation for the respective test URL: https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
status		1..1	code	Status of this observation (e.g. preliminary, final,...)
Slices for category		1..*	CodeableConceptIPS(2.0.0)	Classification of type of observation Slice: Unordered, Open by pattern:$this
category:laboratory		1..1	CodeableConcept	Classification of type of observation Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (CZ) (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Speciality Types (CZ) (required)
code		1..1	CodeableConceptIPS(2.0.0)	Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject		1..1	Reference(Patient: Animal (CZ) | Patient (CZ core) | Group | Device | Location (CZ core))	Who and/or what the observation is about
reference		1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	C	1..1		Clinically relevant time/time-period for observation Constraints: cz-lab-1
effective[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
extension:ClinicallyRelevantTime	S	0..1	Coding	Extension - Clinically Relevant Time URL: https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time Binding: ValueSet - Clinically Relevant Time (required)
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
issued		0..1	instant	Date/Time this result was made available
performer		1..*	Reference(CareTeam | Related Person (CZ core) | Patient (CZ core) | Organization (CZ core) | Practitioner Role (CZ core) | Practitioner (CZ core))	Who is responsible for the observation
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..*	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueString		0..1	string	Actual result
value[x]:valueRange		0..1	RangeIPS	Actual result
value[x]:valueRatio		0..1	RatioEuLab	Actual result
value[x]:valueTime		0..1	time	Actual result
value[x]:valueDateTime		0..1	dateTime	Actual result
value[x]:valuePeriod		0..1	Period	Actual result
value[x]:valueQuantity		0..1	QuantityEuLab	Actual result
value[x]:valueCodeableConcept		0..1	CodeableConceptIPS(2.0.0)	Actual result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
dataAbsentReason		0..1	CodeableConcept	Provides a reason why the expected value is missing.
interpretation		0..*	CodeableConceptIPS(2.0.0)	High, low, normal, etc.
method		0..1	CodeableConceptIPS(2.0.0)	How it was done Binding: Laboratory Techniques (preferred)
specimen		0..1	Reference(Specimen Laboratory (CZ))	Specimen used for this observation
device		0..1	Reference(Device: Performer/Observer (CZ) | DeviceMetric)	Measuring instrument
hasMember		0..*	Reference(Observation Laboratory (CZ))	Related resource that belongs to the Observation group
derivedFrom		0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Observation Laboratory (CZ))	In the initial iteration of the Czech interoperability project: this can be ObservationLaboratory (CZ) or Media
component
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
value[x]		1..1	Attachment	Value of extension
code		1..1	CodeableConceptIPS(2.0.0)	Type of component observation (code / type) Binding: Národní číselník laboratorních položek (preferred)
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result Slice: Unordered, Closed by type:$this
value[x]:valueString		0..1	string	Actual component result
value[x]:valueRange		0..1	RangeIPS	Actual component result
value[x]:valueRatio		0..1	RatioEuLab	Actual component result
value[x]:valueTime		0..1	time	Actual component result
value[x]:valueDateTime		0..1	dateTime	Actual component result
value[x]:valuePeriod		0..1	Period	Actual component result
value[x]:valueQuantity		0..1	QuantityEuLab	Actual component result
value[x]:valueCodeableConcept		0..1	CodeableConceptIPS(2.0.0)	Actual component result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.category:studyType	Base	required	Laboratory Study Types (CZ)	📦0.5.0	This IG
Observation.category:specialty	Base	required	Laboratory Speciality Types (CZ)	📦0.5.0	This IG
Observation.code	Base	required	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
Observation.method	Base	preferred	Laboratory Techniques	📦0.5.0	This IG
Observation.component.​code	Base	preferred	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.component.​value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1

Constraints

Id	Grade	Path(s)	Description	Expression
cz-lab-0	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
cz-lab-1	error	Observation.effective[x]	Datetime musí být uveden s přesností alespoň na den	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
cz-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, cz-lab-0, cz-lab-2
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 Bindings Purpose 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		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
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:observation		0..*	Extension	Triggering observation.
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
extension:accreditation		0..1	boolean	Information on the laboratory’s accreditation for the respective test URL: https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
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	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConceptIPS(2.0.0)	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (CZ) (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Speciality Types (CZ) (required)
code	Σ	1..1	CodeableConceptIPS(2.0.0)	Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject	Σ	1..1	Reference(Patient: Animal (CZ) | Patient (CZ core) | Group | Device | Location (CZ core))	Who and/or what the observation is about
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	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]	ΣC	1..1		Clinically relevant time/time-period for observation Constraints: cz-lab-1
effective[x]All Types				Content/Rules for all Types
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:ClinicallyRelevantTime	S	0..1	Coding	Extension - Clinically Relevant Time URL: https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time Binding: ValueSet - Clinically Relevant Time (required)
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this result was made available
performer	Σ	1..*	Reference(CareTeam | Related Person (CZ core) | Patient (CZ core) | Organization (CZ core) | Practitioner Role (CZ core) | Practitioner (CZ core))	Who is responsible for the observation
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:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..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
Slices for value[x]	ΣC	0..1		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]:valueString	ΣC	0..1	string	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Actual result
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConceptIPS(2.0.0)	Actual result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
dataAbsentReason	C	0..1	CodeableConcept	Provides a reason why the expected value is missing. Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConceptIPS(2.0.0)	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	CodeableConceptIPS(2.0.0)	How it was done Binding: Laboratory Techniques (preferred)
specimen		0..1	Reference(Specimen Laboratory (CZ))	Specimen used for this observation
device		0..1	Reference(Device: Performer/Observer (CZ) | DeviceMetric)	Measuring instrument
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 Laboratory (CZ))	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Observation Laboratory (CZ))	In the initial iteration of the Czech interoperability project: this can be ObservationLaboratory (CZ) or Media
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConceptIPS(2.0.0)	Type of component observation (code / type) Binding: Národní číselník laboratorních položek (preferred)
Slices for value[x]	Σ	0..1		Actual component 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]:valueString	Σ	0..1	string	Actual component result
value[x]:valueRange	Σ	0..1	RangeIPS	Actual component result
value[x]:valueRatio	Σ	0..1	RatioEuLab	Actual component result
value[x]:valueTime	Σ	0..1	time	Actual component result
value[x]:valueDateTime	Σ	0..1	dateTime	Actual component result
value[x]:valuePeriod	Σ	0..1	Period	Actual component result
value[x]:valueQuantity	Σ	0..1	QuantityEuLab	Actual component result
value[x]:valueCodeableConcept	Σ	0..1	CodeableConceptIPS(2.0.0)	Actual component result Binding: Results Coded Values Laboratory - IPS (preferred) Additional Bindings Purpose Results Blood Group - SNOMED CT IPS Free Set candidate Results Presence Absence - SNOMED CT IPS Free Set candidate Results Microorganism - SNOMED CT IPS Free Set candidate
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	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.category:laboratory	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types (CZ)	📦0.5.0	This IG
Observation.category:specialty	Base	required	Laboratory Speciality Types (CZ)	📦0.5.0	This IG
Observation.code	Base	required	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.subject.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Observation.performer.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
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	preferred	Laboratory Techniques	📦0.5.0	This IG
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	preferred	Národní číselník laboratorních položek	📦0.5.0	This IG
Observation.component.​value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
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
cz-lab-0	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
cz-lab-1	error	Observation.effective[x]	Datetime musí být uveden s přesností alespoň na den	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
cz-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.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()
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 Observation

Summary

Mandatory: 6 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips|2.0.0)
• Patient: Animal (CZ) (https://hl7.cz/fhir/core/StructureDefinition/cz-patient-animal)
• Patient (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-patient-core)
• Location (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-location-core)
• Related Person (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-relatedPerson-core)
• Organization (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-organization-core)
• Practitioner Role (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-practitionerrole-core)
• Practitioner (CZ core) (https://hl7.cz/fhir/core/StructureDefinition/cz-practitioner-core)
• Range (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Range-uv-ips)
• Ratio (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Ratio-eu-lab)
• Quantity (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Quantity-eu-lab)
• Specimen Laboratory (CZ) (https://hl7.cz/fhir/lab/StructureDefinition/cz-specimen-lab)
• Device: Performer/Observer (CZ) (https://hl7.cz/fhir/core/StructureDefinition/cz-device-observer)
• Observation Laboratory (CZ) (https://hl7.cz/fhir/lab/StructureDefinition/cz-observation-result-laboratory)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo|5.2.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
• http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable
• http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
• http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
• Unable to summarise extension http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D (no extension found)
• https://hl7.cz/fhir/lab/StructureDefinition/accreditation-cz
• https://hl7.cz/fhir/lab/StructureDefinition/cz-lab-clinically-relevant-time
• http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0
• http://hl7.org/fhir/StructureDefinition/event-performerFunction|5.2.0

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.category
• The element 1 is sliced based on the value of Observation.value[x] (Closed)
• The element 1 is sliced based on the value of Observation.component.value[x] (Closed)

Maturity: 1