HL7 Czech Lab Epidemiology Guide
0.0.1 - ci-build

HL7 Czech Lab Epidemiology Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/lab-epi/ and changes regularly. See the Directory of published versions

## Resource Profile: Observation – CZ Lab Result (qual/quant, AST)

Official URL: https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-labresult-obs | Version: 0.0.1
Active as of 2025-12-19 | Computable Name: CZ_LabResult_Obs

Jednotlivé výsledky včetně kvalitativních a kvantitativních hodnot; AST modelováno per antibiotikum

Usages:

- Use this Profile: Bundle (message) – CZ Lab Report
- Refer to this Profile: DiagnosticReport – CZ Lab Report (message payload)

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..* | CZ_ObservationResultLaboratory | 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, inv-obs-qty-ucum, inv-obs-cutoff
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
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) | Triggering observation(s) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy Constraints: ext-1
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:observation |  | 1..1 | Extension | Triggering observation. Constraints: ext-1
url |  | 1..1 | uri | "observation"
extension:type |  | 1..1 | Extension | The type of trigger Constraints: ext-1
url |  | 1..1 | uri | "type"
extension:reason |  | 0..1 | Extension | Reason that the observation was triggered Constraints: ext-1
url |  | 1..1 | uri | "reason"
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:accreditation |  | 0..1 | boolean | Accreditation Requirement URL: https://hl7.cz/fhir/core/StructureDefinition/accreditation-cz
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 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x] |  | 1..1 | Attachment | Value of extension
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 | S Σ | 1..1 | CodeableConceptIPS(2.0.0) | Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject | S Σ | 1..1 | Reference(Patient – CZ Lab (RID)) | Who and/or what the observation is about
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
effective[x] | S Σ 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 |
performer | S Σ | 1..* | Reference(Organization – CZ Lab (IČO/PCZ/ICP)) | 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] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed 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 C | 0..1 | string | Actual result
value[x]:valueRange | Σ C | 0..1 | RangeIPS | Actual result
value[x]:valueRatio | Σ C | 0..1 | RatioEuLab | Actual result
value[x]:valueTime | Σ C | 0..1 | time | Actual result
value[x]:valueDateTime | Σ C | 0..1 | dateTime | Actual result
value[x]:valuePeriod | Σ C | 0..1 | Period | Actual result
value[x]:valueQuantity | Σ C | 0..1 | QuantityEuLab | Actual result
value[x]:valueCodeableConcept | Σ C | 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
method | S | 0..1 | CodeableConceptIPS(2.0.0) | How it was done Binding: Laboratory Techniques (preferred)
specimen | S | 1..1 | Reference(Specimen – CZ Lab) | Specimen used for this observation
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
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 | HL7 CZ Laboratory IG vnull
Observation.category:specialty | Base | required | Laboratory Speciality Types (CZ) | 📦0.5.0 | HL7 CZ Laboratory IG vnull
Observation.code | Base | required | Národní číselník laboratorních položek | 📦0.5.0 | HL7 CZ Laboratory IG vnull
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 | HL7 CZ Laboratory IG vnull

#### 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()`
inv-obs-cutoff | warning | Observation | If quantitative result, provide referenceRange.low/high as cut-off when relevant | `valueQuantity.exists() implies referenceRange.exists()`
inv-obs-qty-ucum | error | Observation | If Observation.valueQuantity is present, unit must be UCUM with code | `valueQuantity.exists() implies (valueQuantity.system = 'http://unitsofmeasure.org' and valueQuantity.code.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 CZ_ObservationResultLaboratory

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | CZ_ObservationResultLaboratory | Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: inv-obs-qty-ucum, inv-obs-cutoff
code | S | 1..1 | CodeableConceptIPS(2.0.0) | Type of observation (code / type)
subject | S | 1..1 | Reference(Patient – CZ Lab (RID)) | Who and/or what the observation is about
effective[x] | S | 1..1 | dateTime, Period | Clinically relevant time/time-period for observation
performer | S | 1..* | Reference(Organization – CZ Lab (IČO/PCZ/ICP)) | Who is responsible for the observation
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result
method | S | 0..1 | CodeableConceptIPS(2.0.0) | How it was done
specimen | S | 1..1 | Reference(Specimen – CZ Lab) | Specimen used for this observation
referenceRange | S | 0..* | BackboneElement | Provides guide for interpretation
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
inv-obs-cutoff | warning | Observation | If quantitative result, provide referenceRange.low/high as cut-off when relevant | `valueQuantity.exists() implies referenceRange.exists()`
inv-obs-qty-ucum | error | Observation | If Observation.valueQuantity is present, unit must be UCUM with code | `valueQuantity.exists() implies (valueQuantity.system = 'http://unitsofmeasure.org' and valueQuantity.code.exists())`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | CZ_ObservationResultLaboratory | 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, inv-obs-qty-ucum, inv-obs-cutoff
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 | Information on the laboratory’s accreditation for the respective test 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) | Triggering observation(s) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:observation |  | 1..1 | Extension | Triggering observation. Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "observation"
value[x] |  | 0..1 | Reference() | Triggering observation
extension:type |  | 1..1 | Extension | The type of trigger Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "type"
value[x] |  | 0..1 | code | reflex | repeat | re-run Binding: R5_observation_triggeredbytype_for_R4 (0.0.1-snapshot-2) (required): The type of TriggeredBy Observation.
extension:reason |  | 0..1 | Extension | Reason that the observation was triggered Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reason"
value[x] |  | 0..1 | string | Reason that the observation was triggered
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
value[x] |  | 0..1 |  | Value of extension
valueBase64Binary |  |  | base64Binary |
valueBoolean |  |  | boolean |
valueCanonical |  |  | canonical(Any) |
valueCode |  |  | code |
valueDate |  |  | date |
valueDateTime |  |  | dateTime |
valueDecimal |  |  | decimal |
valueId |  |  | id |
valueInstant |  |  | instant |
valueInteger |  |  | integer |
valueMarkdown |  |  | markdown |
valueOid |  |  | oid |
valuePositiveInt |  |  | positiveInt |
valueString |  |  | string |
valueTime |  |  | time |
valueUnsignedInt |  |  | unsignedInt |
valueUri |  |  | uri |
valueUrl |  |  | url |
valueUuid |  |  | uuid |
valueAddress |  |  | Address |
valueAge |  |  | Age |
valueAnnotation |  |  | Annotation |
valueAttachment |  |  | Attachment |
valueCodeableConcept |  |  | CodeableConcept |
valueCoding |  |  | Coding |
valueContactPoint |  |  | ContactPoint |
valueCount |  |  | Count |
valueDistance |  |  | Distance |
valueDuration |  |  | Duration |
valueHumanName |  |  | HumanName |
valueIdentifier |  |  | Identifier |
valueMoney |  |  | Money |
valuePeriod |  |  | Period |
valueQuantity |  |  | Quantity |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueReference |  |  | Reference(Any) |
valueSampledData |  |  | SampledData |
valueSignature |  |  | Signature |
valueTiming |  |  | Timing |
valueContactDetail |  |  | ContactDetail |
valueContributor |  |  | Contributor |
valueDataRequirement |  |  | DataRequirement |
valueExpression |  |  | Expression |
valueParameterDefinition |  |  | ParameterDefinition |
valueRelatedArtifact |  |  | RelatedArtifact |
valueTriggerDefinition |  |  | TriggerDefinition |
valueUsageContext |  |  | UsageContext |
valueDosage |  |  | Dosage |
valueMeta |  |  | Meta |
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:accreditation |  | 0..1 | boolean | Accreditation Requirement URL: https://hl7.cz/fhir/core/StructureDefinition/accreditation-cz
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 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x] |  | 1..1 | Attachment | Value of extension
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 | S Σ | 1..1 | CodeableConceptIPS(2.0.0) | Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject | S Σ | 1..1 | Reference(Patient – CZ Lab (RID)) | 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 | Σ C | 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] | S Σ C | 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 | S Σ | 1..* | Reference(Organization – CZ Lab (IČO/PCZ/ICP)) | 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 | Σ C | 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] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed 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 C | 0..1 | string | Actual result
value[x]:valueRange | Σ C | 0..1 | RangeIPS | Actual result
value[x]:valueRatio | Σ C | 0..1 | RatioEuLab | Actual result
value[x]:valueTime | Σ C | 0..1 | time | Actual result
value[x]:valueDateTime | Σ C | 0..1 | dateTime | Actual result
value[x]:valuePeriod | Σ C | 0..1 | Period | Actual result
value[x]:valueQuantity | Σ C | 0..1 | QuantityEuLab | Actual result
value[x]:valueCodeableConcept | Σ C | 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 | S | 0..1 | CodeableConceptIPS(2.0.0) | How it was done Binding: Laboratory Techniques (preferred)
specimen | S | 1..1 | Reference(Specimen – CZ Lab) | Specimen used for this observation
device |  | 0..1 | Reference(Device: Performer/Observer (CZ) | DeviceMetric) | Measuring instrument
referenceRange | S 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 |  | Extension Slice: Unordered, Open by value:url
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.extension:triggeredBy-r5.​extension:type.value[x] | Base | required | Cross-version VS for R5.TriggeredBytype for use in FHIR R4 | 📍0.0.1-snapshot-2 | FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0
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 | HL7 CZ Laboratory IG vnull
Observation.category:specialty | Base | required | Laboratory Speciality Types (CZ) | 📦0.5.0 | HL7 CZ Laboratory IG vnull
Observation.code | Base | required | Národní číselník laboratorních položek | 📦0.5.0 | HL7 CZ Laboratory IG vnull
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 | HL7 CZ Laboratory IG vnull
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 | HL7 CZ Laboratory IG vnull
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()`
inv-obs-cutoff | warning | Observation | If quantitative result, provide referenceRange.low/high as cut-off when relevant | `valueQuantity.exists() implies referenceRange.exists()`
inv-obs-qty-ucum | error | Observation | If Observation.valueQuantity is present, unit must be UCUM with code | `valueQuantity.exists() implies (valueQuantity.system = 'http://unitsofmeasure.org' and valueQuantity.code.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 CZ_ObservationResultLaboratory

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- Patient – CZ Lab (RID) (https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-lab-patient)
- Organization – CZ Lab (IČO/PCZ/ICP) (https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-lab-organization)
- Specimen – CZ Lab (https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-lab-specimen)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | CZ_ObservationResultLaboratory | 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, inv-obs-qty-ucum, inv-obs-cutoff
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
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) | Triggering observation(s) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy Constraints: ext-1
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:observation |  | 1..1 | Extension | Triggering observation. Constraints: ext-1
url |  | 1..1 | uri | "observation"
extension:type |  | 1..1 | Extension | The type of trigger Constraints: ext-1
url |  | 1..1 | uri | "type"
extension:reason |  | 0..1 | Extension | Reason that the observation was triggered Constraints: ext-1
url |  | 1..1 | uri | "reason"
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:accreditation |  | 0..1 | boolean | Accreditation Requirement URL: https://hl7.cz/fhir/core/StructureDefinition/accreditation-cz
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 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x] |  | 1..1 | Attachment | Value of extension
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 | S Σ | 1..1 | CodeableConceptIPS(2.0.0) | Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject | S Σ | 1..1 | Reference(Patient – CZ Lab (RID)) | Who and/or what the observation is about
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
effective[x] | S Σ 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 |
performer | S Σ | 1..* | Reference(Organization – CZ Lab (IČO/PCZ/ICP)) | 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] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed 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 C | 0..1 | string | Actual result
value[x]:valueRange | Σ C | 0..1 | RangeIPS | Actual result
value[x]:valueRatio | Σ C | 0..1 | RatioEuLab | Actual result
value[x]:valueTime | Σ C | 0..1 | time | Actual result
value[x]:valueDateTime | Σ C | 0..1 | dateTime | Actual result
value[x]:valuePeriod | Σ C | 0..1 | Period | Actual result
value[x]:valueQuantity | Σ C | 0..1 | QuantityEuLab | Actual result
value[x]:valueCodeableConcept | Σ C | 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
method | S | 0..1 | CodeableConceptIPS(2.0.0) | How it was done Binding: Laboratory Techniques (preferred)
specimen | S | 1..1 | Reference(Specimen – CZ Lab) | Specimen used for this observation
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
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 | HL7 CZ Laboratory IG vnull
Observation.category:specialty | Base | required | Laboratory Speciality Types (CZ) | 📦0.5.0 | HL7 CZ Laboratory IG vnull
Observation.code | Base | required | Národní číselník laboratorních položek | 📦0.5.0 | HL7 CZ Laboratory IG vnull
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 | HL7 CZ Laboratory IG vnull

#### 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()`
inv-obs-cutoff | warning | Observation | If quantitative result, provide referenceRange.low/high as cut-off when relevant | `valueQuantity.exists() implies referenceRange.exists()`
inv-obs-qty-ucum | error | Observation | If Observation.valueQuantity is present, unit must be UCUM with code | `valueQuantity.exists() implies (valueQuantity.system = 'http://unitsofmeasure.org' and valueQuantity.code.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()`

Differential View

This structure is derived from CZ_ObservationResultLaboratory

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | CZ_ObservationResultLaboratory | Laboratory result for a simple test or for a panel/study This profile also imposes the profile Observation Results: laboratory Constraints: inv-obs-qty-ucum, inv-obs-cutoff
code | S | 1..1 | CodeableConceptIPS(2.0.0) | Type of observation (code / type)
subject | S | 1..1 | Reference(Patient – CZ Lab (RID)) | Who and/or what the observation is about
effective[x] | S | 1..1 | dateTime, Period | Clinically relevant time/time-period for observation
performer | S | 1..* | Reference(Organization – CZ Lab (IČO/PCZ/ICP)) | Who is responsible for the observation
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result
method | S | 0..1 | CodeableConceptIPS(2.0.0) | How it was done
specimen | S | 1..1 | Reference(Specimen – CZ Lab) | Specimen used for this observation
referenceRange | S | 0..* | BackboneElement | Provides guide for interpretation
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
inv-obs-cutoff | warning | Observation | If quantitative result, provide referenceRange.low/high as cut-off when relevant | `valueQuantity.exists() implies referenceRange.exists()`
inv-obs-qty-ucum | error | Observation | If Observation.valueQuantity is present, unit must be UCUM with code | `valueQuantity.exists() implies (valueQuantity.system = 'http://unitsofmeasure.org' and valueQuantity.code.exists())`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | CZ_ObservationResultLaboratory | 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, inv-obs-qty-ucum, inv-obs-cutoff
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 | Information on the laboratory’s accreditation for the respective test 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) | Triggering observation(s) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:observation |  | 1..1 | Extension | Triggering observation. Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "observation"
value[x] |  | 0..1 | Reference() | Triggering observation
extension:type |  | 1..1 | Extension | The type of trigger Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "type"
value[x] |  | 0..1 | code | reflex | repeat | re-run Binding: R5_observation_triggeredbytype_for_R4 (0.0.1-snapshot-2) (required): The type of TriggeredBy Observation.
extension:reason |  | 0..1 | Extension | Reason that the observation was triggered Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reason"
value[x] |  | 0..1 | string | Reason that the observation was triggered
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
value[x] |  | 0..1 |  | Value of extension
valueBase64Binary |  |  | base64Binary |
valueBoolean |  |  | boolean |
valueCanonical |  |  | canonical(Any) |
valueCode |  |  | code |
valueDate |  |  | date |
valueDateTime |  |  | dateTime |
valueDecimal |  |  | decimal |
valueId |  |  | id |
valueInstant |  |  | instant |
valueInteger |  |  | integer |
valueMarkdown |  |  | markdown |
valueOid |  |  | oid |
valuePositiveInt |  |  | positiveInt |
valueString |  |  | string |
valueTime |  |  | time |
valueUnsignedInt |  |  | unsignedInt |
valueUri |  |  | uri |
valueUrl |  |  | url |
valueUuid |  |  | uuid |
valueAddress |  |  | Address |
valueAge |  |  | Age |
valueAnnotation |  |  | Annotation |
valueAttachment |  |  | Attachment |
valueCodeableConcept |  |  | CodeableConcept |
valueCoding |  |  | Coding |
valueContactPoint |  |  | ContactPoint |
valueCount |  |  | Count |
valueDistance |  |  | Distance |
valueDuration |  |  | Duration |
valueHumanName |  |  | HumanName |
valueIdentifier |  |  | Identifier |
valueMoney |  |  | Money |
valuePeriod |  |  | Period |
valueQuantity |  |  | Quantity |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueReference |  |  | Reference(Any) |
valueSampledData |  |  | SampledData |
valueSignature |  |  | Signature |
valueTiming |  |  | Timing |
valueContactDetail |  |  | ContactDetail |
valueContributor |  |  | Contributor |
valueDataRequirement |  |  | DataRequirement |
valueExpression |  |  | Expression |
valueParameterDefinition |  |  | ParameterDefinition |
valueRelatedArtifact |  |  | RelatedArtifact |
valueTriggerDefinition |  |  | TriggerDefinition |
valueUsageContext |  |  | UsageContext |
valueDosage |  |  | Dosage |
valueMeta |  |  | Meta |
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:accreditation |  | 0..1 | boolean | Accreditation Requirement URL: https://hl7.cz/fhir/core/StructureDefinition/accreditation-cz
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 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x] |  | 1..1 | Attachment | Value of extension
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 | S Σ | 1..1 | CodeableConceptIPS(2.0.0) | Type of observation (code / type) Binding: Národní číselník laboratorních položek (required)
subject | S Σ | 1..1 | Reference(Patient – CZ Lab (RID)) | 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 | Σ C | 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] | S Σ C | 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 | S Σ | 1..* | Reference(Organization – CZ Lab (IČO/PCZ/ICP)) | 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 | Σ C | 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] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Closed 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 C | 0..1 | string | Actual result
value[x]:valueRange | Σ C | 0..1 | RangeIPS | Actual result
value[x]:valueRatio | Σ C | 0..1 | RatioEuLab | Actual result
value[x]:valueTime | Σ C | 0..1 | time | Actual result
value[x]:valueDateTime | Σ C | 0..1 | dateTime | Actual result
value[x]:valuePeriod | Σ C | 0..1 | Period | Actual result
value[x]:valueQuantity | Σ C | 0..1 | QuantityEuLab | Actual result
value[x]:valueCodeableConcept | Σ C | 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 | S | 0..1 | CodeableConceptIPS(2.0.0) | How it was done Binding: Laboratory Techniques (preferred)
specimen | S | 1..1 | Reference(Specimen – CZ Lab) | Specimen used for this observation
device |  | 0..1 | Reference(Device: Performer/Observer (CZ) | DeviceMetric) | Measuring instrument
referenceRange | S 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 |  | Extension Slice: Unordered, Open by value:url
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.extension:triggeredBy-r5.​extension:type.value[x] | Base | required | Cross-version VS for R5.TriggeredBytype for use in FHIR R4 | 📍0.0.1-snapshot-2 | FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0
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 | HL7 CZ Laboratory IG vnull
Observation.category:specialty | Base | required | Laboratory Speciality Types (CZ) | 📦0.5.0 | HL7 CZ Laboratory IG vnull
Observation.code | Base | required | Národní číselník laboratorních položek | 📦0.5.0 | HL7 CZ Laboratory IG vnull
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 | HL7 CZ Laboratory IG vnull
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 | HL7 CZ Laboratory IG vnull
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()`
inv-obs-cutoff | warning | Observation | If quantitative result, provide referenceRange.low/high as cut-off when relevant | `valueQuantity.exists() implies referenceRange.exists()`
inv-obs-qty-ucum | error | Observation | If Observation.valueQuantity is present, unit must be UCUM with code | `valueQuantity.exists() implies (valueQuantity.system = 'http://unitsofmeasure.org' and valueQuantity.code.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 CZ_ObservationResultLaboratory

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- Patient – CZ Lab (RID) (https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-lab-patient)
- Organization – CZ Lab (IČO/PCZ/ICP) (https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-lab-organization)
- Specimen – CZ Lab (https://hl7.cz/fhir/lab-epi/StructureDefinition/cz-lab-specimen)

Other representations of profile: CSV, Excel, Schematron