Consolidated CDA (C-CDA)
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Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

Logical Model: SocialHistoryObservation - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the SocialHistoryObservation logical model.

Guidance on how to interpret the contents of this table can be found here

0. Observation
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-value: SHOULD contain value (value.exists())
4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. ()
should-sh-author: SHOULD contain author (author.exists())
2. Observation.templateId
Control1..?
SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Observation.templateId:social-history-obs
    Slice Namesocial-history-obs
    Control1..1
    6. Observation.templateId:social-history-obs.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.38
    8. Observation.templateId:social-history-obs.extension
    Control1..?
    Pattern Value2022-06-01
    10. Observation.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4515-8548).

    Fixed ValueOBS
    12. Observation.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4515-8549).

    Fixed ValueEVN
    14. Observation.id
    Comments

    SHALL contain at least one [1..*] id (CONF:4515-8551).

    Control1..?
    16. Observation.code
    Comments

    SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Social History Type urn:oid:2.16.840.1.113883.3.88.12.80.60 DYNAMIC (CONF:4515-8558).

    BindingThe codes SHOULD be taken from Social History Type .
    (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60)
    Invariants4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). (codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists())
    18. Observation.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    20. Observation.text.reference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    22. Observation.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:4515-8553).

    Control1..?
    24. Observation.statusCode.code
    Comments

    This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4515-19117).

    Control1..?
    Fixed Valuecompleted
    26. Observation.effectiveTime
    Comments

    SHALL contain exactly one [1..1] effectiveTime (CONF:4515-31868).

    Control1..?
    28. Observation.value
    Short𝗨𝗦𝗖𝗗𝗜: Alcohol Use, Substance Use, SDOH Problems/Health Concerns
    Comments

    SHOULD contain zero or one [0..1] value (CONF:4515-8559).

    Control0..1
    SlicingThis element introduces a set of slices on Observation.value. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 30. Observation.value:physical-quantity
      Slice Namephysical-quantity
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
      32. Observation.value:physical-quantity.unit
      Control1..?
      BindingThe codes SHOULD be taken from UnitsOfMeasureCaseSensitive
      (preferred to http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive)
      34. Observation.value:coded
      Slice Namecoded
      Control0..1
      Binding

      See additional binding

      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
      36. Observation.author
      Comments

      SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31869).

      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
      38. Observation.entryRelationship
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:4515-32969) such that it

      SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ act
      • profile @ observation
      • 40. Observation.entryRelationship:supportingObs
        Slice NamesupportingObs
        ShortWhen an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments.
        Comments

        MAY contain zero or more [0..*] entryRelationship (CONF:4515-32958) such that it

        Control0..*
        42. Observation.entryRelationship:supportingObs.typeCode
        Comments

        SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32960).

        Fixed ValueSPRT
        44. Observation.entryRelationship:supportingObs.observation
        Comments

        SHALL contain exactly one [1..1] Assessment Scale Observation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.69) (CONF:4515-32959).

        Control1..?
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Assessment Scale Observation)
        46. Observation.entryRelationship:entryReference
        Slice NameentryReference
        ShortWhen an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments.
        Control0..*
        48. Observation.entryRelationship:entryReference.typeCode
        Comments

        SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32971).

        Fixed ValueSPRT
        50. Observation.entryRelationship:entryReference.act
        Comments

        SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32970).

        Control1..?
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)

        Guidance on how to interpret the contents of this table can be found here

        0. Observation
        Definition

        Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


        Base definition for all types defined in FHIR type system.

        ShortBase for all types and resources
        Control10..1*
        Is Modifierfalse
        Logical ContainerClinicalDocument (CDA Class)
        ValidationInstance of this type are validated by templateId
        XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
        Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
        should-value: SHOULD contain value (value.exists())
        4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. ()
        should-sh-author: SHOULD contain author (author.exists())
        2. Observation.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        4. Observation.realmCode
        Definition

        When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

        Control0..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
        6. Observation.typeId
        Definition

        When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

        Control0..1
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
        8. Observation.typeId.nullFlavor
        Definition

        If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

        Control0..1
        BindingThe codes SHALL be taken from CDANullFlavor
        (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
        Typecode(cs: Coded Simple Value)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExceptional Value Detail
        10. Observation.typeId.assigningAuthorityName
        Definition

        A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

        Control0..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelAssigning Authority Name
        12. Observation.typeId.displayable
        Definition

        Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

        Control0..1
        Typeboolean(bl: Boolean)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelDisplayable
        14. Observation.typeId.root
        Definition

        Identifies the type as an HL7 Registered model

        Control1..1
        Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelRoot
        Fixed Value2.16.840.1.113883.1.3
        16. Observation.typeId.extension
        Definition

        A character string as a unique identifier within the scope of the identifier root.

        Control1..1
        Typestring(st: Character String)
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        LabelExtension
        18. Observation.templateId
        Definition

        When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

        Control1..*
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
        SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ root
        • value @ extension
        • 20. Observation.templateId:social-history-obs
          Slice Namesocial-history-obs
          Definition

          When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

          Control1..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          22. Observation.templateId:social-history-obs.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          24. Observation.templateId:social-history-obs.assigningAuthorityName
          Definition

          A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelAssigning Authority Name
          26. Observation.templateId:social-history-obs.displayable
          Definition

          Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplayable
          28. Observation.templateId:social-history-obs.root
          Definition

          A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

          Control1..1
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelRoot
          Pattern Value2.16.840.1.113883.10.20.22.4.38
          30. Observation.templateId:social-history-obs.extension
          Definition

          A character string as a unique identifier within the scope of the identifier root.

          Control1..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExtension
          Pattern Value2022-06-01
          32. Observation.classCode
          Comments

          SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4515-8548).

          Control1..1
          BindingThe codes SHALL be taken from CDAActClassObservation
          (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed ValueOBS
          34. Observation.moodCode
          Comments

          SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4515-8549).

          Control1..1
          BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
          (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed ValueEVN
          36. Observation.negationInd
          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          38. Observation.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          SHALL contain at least one [1..*] id (CONF:4515-8551).


          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

          Control10..*1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
          Is Modifierfalse
          40. Observation.sdtcCategory
          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namecategory.
          42. Observation.code
          Definition

          Describes what was observed. Sometimes this is called the observation "name".

          ShortType of observation (code / type)
          Comments

          SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Social History Type urn:oid:2.16.840.1.113883.3.88.12.80.60 DYNAMIC (CONF:4515-8558).


          All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

          Control1..1
          This element is affected by the following invariants: obs-7
          BindingThe codes SHOULD be taken from For example codes, see Social History Type .http://hl7.org/fhir/ValueSet/observation-codes
          (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60)
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CDCodeableConcept
          Is Modifierfalse
          XML FormatThe type of this property is determined using the xsi:typeattribute.
          Requirements

          Knowing what kind of observation is being made is essential to understanding the observation.

          Alternate NamesName
          Invariants4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). (codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Observation.derivationExpr
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
          46. Observation.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortSHOULD reference the portion of section narrative text corresponding to this entryText summary of the resource, for human interpretation
          Comments

          Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          This element is affected by the following invariants: dom-6
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
          Is Modifierfalse
          XML FormatThe type of this property is determined using the xsi:typeattribute.
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Observation.text.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          50. Observation.text.compression
          Definition

          Indicates whether the raw byte data is compressed, and what compression algorithm was used.

          Control0..1
          BindingThe codes SHALL be taken from CDACompressionAlgorithm
          (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelCompression
          52. Observation.text.integrityCheck
          Definition

          The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

          Control0..1
          Typebase64Binary(bin: Binary Data)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelIntegrity Check
          54. Observation.text.integrityCheckAlgorithm
          Definition

          Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

          Control0..1
          BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
          (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelIntegrity Check Algorithm
          56. Observation.text.language
          Definition

          For character based information the language property specifies the human language of the text.

          Control0..1
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelLanguage
          58. Observation.text.mediaType
          Definition

          Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

          Control0..1
          BindingFor example codes, see MediaType
          (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelMedia Type
          60. Observation.text.representation
          Control0..1
          BindingThe codes SHALL be taken from CDABinaryDataEncoding
          (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          62. Observation.text.xmlText
          Definition

          Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

          ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
          Comments

          This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as unadorned text.
          64. Observation.text.reference
          Definition

          A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
          LabelReference
          Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
          66. Observation.text.thumbnail
          Definition

          An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
          LabelThumbnail
          68. Observation.statusCode
          Comments

          SHALL contain exactly one [1..1] statusCode (CONF:4515-8553).

          Control1..1
          BindingThe codes SHALL be taken from ActStatus
          (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          70. Observation.statusCode.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          72. Observation.statusCode.code
          Definition

          The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

          Comments

          This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4515-19117).

          Control1..1
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelCode
          Fixed Valuecompleted
          74. Observation.statusCode.codeSystem
          Definition

          Specifies the code system that defines the code.

          Control0..0
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelCode System
          76. Observation.statusCode.codeSystemName
          Definition

          The common name of the coding system.

          Control0..0
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelCode System Name
          78. Observation.statusCode.codeSystemVersion
          Definition

          If applicable, a version descriptor defined specifically for the given code system.

          Control0..0
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelCode System Version
          80. Observation.statusCode.displayName
          Definition

          A name or title for the code, under which the sending system shows the code value to its users.

          Control0..0
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplay Name
          82. Observation.statusCode.sdtcValueSet
          Definition

          The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

          Control0..1
          Typestring(oid: ISO Object Identifier)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
          84. Observation.statusCode.sdtcValueSetVersion
          Definition

          The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
          86. Observation.statusCode.originalText
          Definition

          The text or phrase used as the basis for the coding.

          Control0..0
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
          LabelOriginal Text
          88. Observation.statusCode.qualifier
          Definition

          Specifies additional codes that increase the specificity of the the primary code.

          Control0..0
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
          LabelQualifier
          90. Observation.statusCode.translation
          Definition

          A set of other concept descriptors that translate this concept descriptor into other code systems.

          Control0..0
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
          XML FormatThe type of this property is determined using the xsi:typeattribute.
          LabelTranslation
          92. Observation.effectiveTime
          Comments

          SHALL contain exactly one [1..1] effectiveTime (CONF:4515-31868).

          Control1..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
          94. Observation.priorityCode
          Control0..1
          BindingFor example codes, see ActPriority
          (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
          96. Observation.repeatNumber
          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
          98. Observation.languageCode
          Control0..1
          BindingThe codes SHALL be taken from AllLanguages
          (required to http://hl7.org/fhir/ValueSet/all-languages)
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          100. Observation.value
          Short𝗨𝗦𝗖𝗗𝗜: Alcohol Use, Substance Use, SDOH Problems/Health Concerns
          Comments

          SHOULD contain zero or one [0..1] value (CONF:4515-8559).

          Control0..1
          TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/SC, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ
          XML FormatThe type of this property is determined using the xsi:typeattribute.
          SlicingThis element introduces a set of slices on Observation.value. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 102. Observation.value:physical-quantity
            Slice Namephysical-quantity
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            104. Observation.value:physical-quantity.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            106. Observation.value:physical-quantity.unit
            Definition

            The unit of measure specified in the Unified Code for Units of Measure (UCUM) [].

            Control1..1
            BindingThe codes SHOULD be taken from UnitsOfMeasureCaseSensitive
            (preferred to http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelUnit of Measure
            Default Value1
            108. Observation.value:physical-quantity.value
            Definition

            The magnitude of the quantity measured in terms of the unit.

            Control0..1
            Typedecimal(real: Real Number)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelMaginitude Value
            110. Observation.value:physical-quantity.translation
            Definition

            An alternative representation of the same physical quantity expressed in a different unit, of a different unit code system and possibly with a different value.

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQR
            LabelTranslation
            112. Observation.value:coded
            Slice Namecoded
            Control0..1
            Binding

            See additional binding

            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            114. Observation.interpretationCode
            Control0..*
            BindingThe codes SHALL be taken from CDAObservationInterpretation
            (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            116. Observation.methodCode
            Control0..*
            BindingFor example codes, see ObservationMethod
            (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            118. Observation.targetSiteCode
            Definition

            Drawn from concept domain ActSite

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            120. Observation.subject
            Definition

            The patient, or group of patients, location, device, organization, procedure or practitioner this observation is about and into whose or what record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

            ShortWho and/or what the observation is about
            Comments

            One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. The subject of an Observation may in some cases be a procedure. This supports the regulatory inspection use case where observations are captured during inspections of a procedure that is being performed (independent of any particular patient or whether patient related at all).

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubjectReference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance, BiologicallyDerivedProduct, NutritionProduct)
            Is Modifierfalse
            Requirements

            Observations have no value if you don't know who or what they're about.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            122. Observation.specimen
            Definition

            The specimen that was used when this observation was made.

            ShortSpecimen used for this observation
            Comments

            Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

            Control0..*1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/SpecimenReference(Specimen, Group)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            obs-9: If Observation.specimen is a reference to Group, the group can only have specimens ((reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen))
            124. Observation.performer
            Definition

            Who was responsible for asserting the observed value as "true".

            ShortWho is responsible for the observation
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
            Is Modifierfalse
            Requirements

            May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            126. Observation.author
            Definition

            Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

            ShortBase for all types and resources
            Comments

            SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31869).

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
            Is Modifierfalse
            128. Observation.informant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
            130. Observation.participant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
            132. Observation.entryRelationship
            Comments

            MAY contain zero or more [0..*] entryRelationship (CONF:4515-32969) such that it

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
            SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ act
            • profile @ observation
            • 134. Observation.entryRelationship:supportingObs
              Slice NamesupportingObs
              ShortWhen an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments.
              Comments

              MAY contain zero or more [0..*] entryRelationship (CONF:4515-32958) such that it

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              136. Observation.entryRelationship:supportingObs.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              138. Observation.entryRelationship:supportingObs.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              140. Observation.entryRelationship:supportingObs.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              142. Observation.entryRelationship:supportingObs.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              144. Observation.entryRelationship:supportingObs.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              146. Observation.entryRelationship:supportingObs.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              148. Observation.entryRelationship:supportingObs.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              150. Observation.entryRelationship:supportingObs.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              152. Observation.entryRelationship:supportingObs.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              154. Observation.entryRelationship:supportingObs.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32960).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueSPRT
              156. Observation.entryRelationship:supportingObs.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              158. Observation.entryRelationship:supportingObs.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              160. Observation.entryRelationship:supportingObs.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              162. Observation.entryRelationship:supportingObs.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              164. Observation.entryRelationship:supportingObs.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              166. Observation.entryRelationship:supportingObs.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              168. Observation.entryRelationship:supportingObs.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              170. Observation.entryRelationship:supportingObs.observation
              Definition

              Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

              ShortBase for all types and resources
              Comments

              SHALL contain exactly one [1..1] Assessment Scale Observation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.69) (CONF:4515-32959).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Assessment Scale Observation)
              Is Modifierfalse
              Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
              172. Observation.entryRelationship:supportingObs.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              174. Observation.entryRelationship:supportingObs.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              176. Observation.entryRelationship:supportingObs.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              178. Observation.entryRelationship:supportingObs.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              180. Observation.entryRelationship:supportingObs.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              182. Observation.entryRelationship:supportingObs.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              184. Observation.entryRelationship:entryReference
              Slice NameentryReference
              ShortWhen an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments.
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              186. Observation.entryRelationship:entryReference.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              188. Observation.entryRelationship:entryReference.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              190. Observation.entryRelationship:entryReference.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              192. Observation.entryRelationship:entryReference.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              194. Observation.entryRelationship:entryReference.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              196. Observation.entryRelationship:entryReference.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              198. Observation.entryRelationship:entryReference.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              200. Observation.entryRelationship:entryReference.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              202. Observation.entryRelationship:entryReference.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              204. Observation.entryRelationship:entryReference.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32971).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueSPRT
              206. Observation.entryRelationship:entryReference.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              208. Observation.entryRelationship:entryReference.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              210. Observation.entryRelationship:entryReference.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              212. Observation.entryRelationship:entryReference.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              214. Observation.entryRelationship:entryReference.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              216. Observation.entryRelationship:entryReference.act
              Definition

              Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

              ShortBase for all types and resources
              Comments

              SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32970).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
              Is Modifierfalse
              Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
              218. Observation.entryRelationship:entryReference.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              220. Observation.entryRelationship:entryReference.observation
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
              222. Observation.entryRelationship:entryReference.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              224. Observation.entryRelationship:entryReference.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              226. Observation.entryRelationship:entryReference.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              228. Observation.entryRelationship:entryReference.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              230. Observation.entryRelationship:entryReference.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              232. Observation.entryRelationship:entryReference.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              234. Observation.reference
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              236. Observation.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              238. Observation.sdtcPrecondition2
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
              240. Observation.referenceRange
              Definition

              Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.


              Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

              ShortProvides guide for interpretation
              Comments

              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRootBackboneElement
              Is Modifierfalse
              Requirements

              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
              242. Observation.referenceRange.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              244. Observation.referenceRange.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              246. Observation.referenceRange.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              248. Observation.referenceRange.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              250. Observation.referenceRange.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              252. Observation.referenceRange.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              254. Observation.referenceRange.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              256. Observation.referenceRange.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              258. Observation.referenceRange.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              260. Observation.referenceRange.typeCode
              Control0..1
              BindingThe codes SHALL be taken from CDAActRelationshipType
              (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFV
              262. Observation.referenceRange.observationRange
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
              264. Observation.sdtcInFulfillmentOf1
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.

              Guidance on how to interpret the contents of this table can be found here

              0. Observation
              Definition

              Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

              ShortBase for all types and resources
              Control1..1
              Is Modifierfalse
              Logical ContainerClinicalDocument (CDA Class)
              ValidationInstance of this type are validated by templateId
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
              Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
              should-value: SHOULD contain value (value.exists())
              4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. ()
              should-sh-author: SHOULD contain author (author.exists())
              2. Observation.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              4. Observation.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              6. Observation.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              8. Observation.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              10. Observation.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              12. Observation.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              14. Observation.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              16. Observation.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              18. Observation.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control1..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ root
              • value @ extension
              • 20. Observation.templateId:social-history-obs
                Slice Namesocial-history-obs
                Definition

                When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

                Control1..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                22. Observation.templateId:social-history-obs.nullFlavor
                Definition

                If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                Control0..1
                BindingThe codes SHALL be taken from CDANullFlavor
                (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelExceptional Value Detail
                24. Observation.templateId:social-history-obs.assigningAuthorityName
                Definition

                A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

                Control0..1
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelAssigning Authority Name
                26. Observation.templateId:social-history-obs.displayable
                Definition

                Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

                Control0..1
                Typeboolean(bl: Boolean)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelDisplayable
                28. Observation.templateId:social-history-obs.root
                Definition

                A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

                Control1..1
                Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelRoot
                Pattern Value2.16.840.1.113883.10.20.22.4.38
                30. Observation.templateId:social-history-obs.extension
                Definition

                A character string as a unique identifier within the scope of the identifier root.

                Control1..1
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelExtension
                Pattern Value2022-06-01
                32. Observation.classCode
                Comments

                SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:4515-8548).

                Control1..1
                BindingThe codes SHALL be taken from CDAActClassObservation
                (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed ValueOBS
                34. Observation.moodCode
                Comments

                SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:4515-8549).

                Control1..1
                BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
                (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed ValueEVN
                36. Observation.negationInd
                Control0..1
                Typeboolean(bl: Boolean)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                38. Observation.id
                Comments

                SHALL contain at least one [1..*] id (CONF:4515-8551).

                Control1..*
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                40. Observation.sdtcCategory
                Control0..*
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namecategory.
                42. Observation.code
                Comments

                SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Social History Type urn:oid:2.16.840.1.113883.3.88.12.80.60 DYNAMIC (CONF:4515-8558).

                Control1..1
                BindingThe codes SHOULD be taken from Social History Type .
                (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60)
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                XML FormatThe type of this property is determined using the xsi:typeattribute.
                Invariants4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). (codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists())
                44. Observation.derivationExpr
                Control0..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
                46. Observation.text
                ShortSHOULD reference the portion of section narrative text corresponding to this entry
                Control0..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                XML FormatThe type of this property is determined using the xsi:typeattribute.
                48. Observation.text.nullFlavor
                Definition

                If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                Control0..1
                BindingThe codes SHALL be taken from CDANullFlavor
                (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelExceptional Value Detail
                50. Observation.text.compression
                Definition

                Indicates whether the raw byte data is compressed, and what compression algorithm was used.

                Control0..1
                BindingThe codes SHALL be taken from CDACompressionAlgorithm
                (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelCompression
                52. Observation.text.integrityCheck
                Definition

                The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

                Control0..1
                Typebase64Binary(bin: Binary Data)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelIntegrity Check
                54. Observation.text.integrityCheckAlgorithm
                Definition

                Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

                Control0..1
                BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
                (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelIntegrity Check Algorithm
                56. Observation.text.language
                Definition

                For character based information the language property specifies the human language of the text.

                Control0..1
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelLanguage
                58. Observation.text.mediaType
                Definition

                Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

                Control0..1
                BindingFor example codes, see MediaType
                (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelMedia Type
                60. Observation.text.representation
                Control0..1
                BindingThe codes SHALL be taken from CDABinaryDataEncoding
                (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                62. Observation.text.xmlText
                Definition

                Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

                ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
                Comments

                This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

                Control0..1
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as unadorned text.
                64. Observation.text.reference
                Definition

                A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

                Control0..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
                LabelReference
                Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
                66. Observation.text.thumbnail
                Definition

                An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

                Control0..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                LabelThumbnail
                68. Observation.statusCode
                Comments

                SHALL contain exactly one [1..1] statusCode (CONF:4515-8553).

                Control1..1
                BindingThe codes SHALL be taken from ActStatus
                (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                70. Observation.statusCode.nullFlavor
                Definition

                If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                Control0..1
                BindingThe codes SHALL be taken from CDANullFlavor
                (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelExceptional Value Detail
                72. Observation.statusCode.code
                Definition

                The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

                Comments

                This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:4515-19117).

                Control1..1
                Typecode(cs: Coded Simple Value)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelCode
                Fixed Valuecompleted
                74. Observation.statusCode.codeSystem
                Definition

                Specifies the code system that defines the code.

                Control0..0
                Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelCode System
                76. Observation.statusCode.codeSystemName
                Definition

                The common name of the coding system.

                Control0..0
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelCode System Name
                78. Observation.statusCode.codeSystemVersion
                Definition

                If applicable, a version descriptor defined specifically for the given code system.

                Control0..0
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelCode System Version
                80. Observation.statusCode.displayName
                Definition

                A name or title for the code, under which the sending system shows the code value to its users.

                Control0..0
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                LabelDisplay Name
                82. Observation.statusCode.sdtcValueSet
                Definition

                The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

                Control0..1
                Typestring(oid: ISO Object Identifier)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
                84. Observation.statusCode.sdtcValueSetVersion
                Definition

                The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

                Control0..1
                Typestring(st: Character String)
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
                86. Observation.statusCode.originalText
                Definition

                The text or phrase used as the basis for the coding.

                Control0..0
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
                LabelOriginal Text
                88. Observation.statusCode.qualifier
                Definition

                Specifies additional codes that increase the specificity of the the primary code.

                Control0..0
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
                LabelQualifier
                90. Observation.statusCode.translation
                Definition

                A set of other concept descriptors that translate this concept descriptor into other code systems.

                Control0..0
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                XML FormatThe type of this property is determined using the xsi:typeattribute.
                LabelTranslation
                92. Observation.effectiveTime
                Comments

                SHALL contain exactly one [1..1] effectiveTime (CONF:4515-31868).

                Control1..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
                94. Observation.priorityCode
                Control0..1
                BindingFor example codes, see ActPriority
                (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                96. Observation.repeatNumber
                Control0..1
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
                98. Observation.languageCode
                Control0..1
                BindingThe codes SHALL be taken from AllLanguages
                (required to http://hl7.org/fhir/ValueSet/all-languages)
                Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                100. Observation.value
                Short𝗨𝗦𝗖𝗗𝗜: Alcohol Use, Substance Use, SDOH Problems/Health Concerns
                Comments

                SHOULD contain zero or one [0..1] value (CONF:4515-8559).

                Control0..1
                TypeChoice of: http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/SC, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ
                XML FormatThe type of this property is determined using the xsi:typeattribute.
                SlicingThis element introduces a set of slices on Observation.value. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 102. Observation.value:physical-quantity
                  Slice Namephysical-quantity
                  Control0..1
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
                  XML FormatThe type of this property is determined using the xsi:typeattribute.
                  104. Observation.value:physical-quantity.nullFlavor
                  Definition

                  If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                  Control0..1
                  BindingThe codes SHALL be taken from CDANullFlavor
                  (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                  Typecode(cs: Coded Simple Value)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelExceptional Value Detail
                  106. Observation.value:physical-quantity.unit
                  Definition

                  The unit of measure specified in the Unified Code for Units of Measure (UCUM) [].

                  Control1..1
                  BindingThe codes SHOULD be taken from UnitsOfMeasureCaseSensitive
                  (preferred to http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive)
                  Typecode(cs: Coded Simple Value)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelUnit of Measure
                  Default Value1
                  108. Observation.value:physical-quantity.value
                  Definition

                  The magnitude of the quantity measured in terms of the unit.

                  Control0..1
                  Typedecimal(real: Real Number)
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  LabelMaginitude Value
                  110. Observation.value:physical-quantity.translation
                  Definition

                  An alternative representation of the same physical quantity expressed in a different unit, of a different unit code system and possibly with a different value.

                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQR
                  LabelTranslation
                  112. Observation.value:coded
                  Slice Namecoded
                  Control0..1
                  Binding

                  See additional binding

                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                  XML FormatThe type of this property is determined using the xsi:typeattribute.
                  114. Observation.interpretationCode
                  Control0..*
                  BindingThe codes SHALL be taken from CDAObservationInterpretation
                  (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                  116. Observation.methodCode
                  Control0..*
                  BindingFor example codes, see ObservationMethod
                  (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
                  118. Observation.targetSiteCode
                  Definition

                  Drawn from concept domain ActSite

                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
                  120. Observation.subject
                  Control0..1
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
                  122. Observation.specimen
                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
                  124. Observation.performer
                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
                  126. Observation.author
                  Definition

                  Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

                  ShortBase for all types and resources
                  Comments

                  SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31869).

                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
                  Is Modifierfalse
                  128. Observation.informant
                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
                  130. Observation.participant
                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
                  132. Observation.entryRelationship
                  Comments

                  MAY contain zero or more [0..*] entryRelationship (CONF:4515-32969) such that it

                  Control0..*
                  Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
                  SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • profile @ act
                  • profile @ observation
                  • 134. Observation.entryRelationship:supportingObs
                    Slice NamesupportingObs
                    ShortWhen an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments.
                    Comments

                    MAY contain zero or more [0..*] entryRelationship (CONF:4515-32958) such that it

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
                    136. Observation.entryRelationship:supportingObs.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    138. Observation.entryRelationship:supportingObs.realmCode
                    Definition

                    When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                    140. Observation.entryRelationship:supportingObs.typeId
                    Definition

                    When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                    142. Observation.entryRelationship:supportingObs.typeId.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    144. Observation.entryRelationship:supportingObs.typeId.assigningAuthorityName
                    Definition

                    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

                    Control0..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelAssigning Authority Name
                    146. Observation.entryRelationship:supportingObs.typeId.displayable
                    Definition

                    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelDisplayable
                    148. Observation.entryRelationship:supportingObs.typeId.root
                    Definition

                    Identifies the type as an HL7 Registered model

                    Control1..1
                    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelRoot
                    Fixed Value2.16.840.1.113883.1.3
                    150. Observation.entryRelationship:supportingObs.typeId.extension
                    Definition

                    A character string as a unique identifier within the scope of the identifier root.

                    Control1..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExtension
                    152. Observation.entryRelationship:supportingObs.templateId
                    Definition

                    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    154. Observation.entryRelationship:supportingObs.typeCode
                    Comments

                    SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32960).

                    Control1..1
                    BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
                    (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValueSPRT
                    156. Observation.entryRelationship:supportingObs.inversionInd
                    Definition

                    The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    158. Observation.entryRelationship:supportingObs.contextConductionInd
                    Definition

                    The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Default Valuetrue
                    160. Observation.entryRelationship:supportingObs.negationInd
                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    162. Observation.entryRelationship:supportingObs.sequenceNumber
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
                    164. Observation.entryRelationship:supportingObs.seperatableInd
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
                    166. Observation.entryRelationship:supportingObs.act
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
                    168. Observation.entryRelationship:supportingObs.encounter
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
                    170. Observation.entryRelationship:supportingObs.observation
                    Definition

                    Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

                    ShortBase for all types and resources
                    Comments

                    SHALL contain exactly one [1..1] Assessment Scale Observation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.69) (CONF:4515-32959).

                    Control1..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Assessment Scale Observation)
                    Is Modifierfalse
                    Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
                    172. Observation.entryRelationship:supportingObs.observationMedia
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
                    174. Observation.entryRelationship:supportingObs.organizer
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
                    176. Observation.entryRelationship:supportingObs.procedure
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
                    178. Observation.entryRelationship:supportingObs.regionOfInterest
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
                    180. Observation.entryRelationship:supportingObs.substanceAdministration
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
                    182. Observation.entryRelationship:supportingObs.supply
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
                    184. Observation.entryRelationship:entryReference
                    Slice NameentryReference
                    ShortWhen an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments.
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
                    186. Observation.entryRelationship:entryReference.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    188. Observation.entryRelationship:entryReference.realmCode
                    Definition

                    When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                    190. Observation.entryRelationship:entryReference.typeId
                    Definition

                    When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                    192. Observation.entryRelationship:entryReference.typeId.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    194. Observation.entryRelationship:entryReference.typeId.assigningAuthorityName
                    Definition

                    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

                    Control0..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelAssigning Authority Name
                    196. Observation.entryRelationship:entryReference.typeId.displayable
                    Definition

                    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelDisplayable
                    198. Observation.entryRelationship:entryReference.typeId.root
                    Definition

                    Identifies the type as an HL7 Registered model

                    Control1..1
                    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelRoot
                    Fixed Value2.16.840.1.113883.1.3
                    200. Observation.entryRelationship:entryReference.typeId.extension
                    Definition

                    A character string as a unique identifier within the scope of the identifier root.

                    Control1..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExtension
                    202. Observation.entryRelationship:entryReference.templateId
                    Definition

                    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    204. Observation.entryRelationship:entryReference.typeCode
                    Comments

                    SHALL contain exactly one [1..1] @typeCode="SPRT" Has support (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32971).

                    Control1..1
                    BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
                    (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValueSPRT
                    206. Observation.entryRelationship:entryReference.inversionInd
                    Definition

                    The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    208. Observation.entryRelationship:entryReference.contextConductionInd
                    Definition

                    The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Default Valuetrue
                    210. Observation.entryRelationship:entryReference.negationInd
                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    212. Observation.entryRelationship:entryReference.sequenceNumber
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
                    214. Observation.entryRelationship:entryReference.seperatableInd
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
                    216. Observation.entryRelationship:entryReference.act
                    Definition

                    Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

                    ShortBase for all types and resources
                    Comments

                    SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32970).

                    Control1..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
                    Is Modifierfalse
                    Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
                    218. Observation.entryRelationship:entryReference.encounter
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
                    220. Observation.entryRelationship:entryReference.observation
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
                    222. Observation.entryRelationship:entryReference.observationMedia
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
                    224. Observation.entryRelationship:entryReference.organizer
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
                    226. Observation.entryRelationship:entryReference.procedure
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
                    228. Observation.entryRelationship:entryReference.regionOfInterest
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
                    230. Observation.entryRelationship:entryReference.substanceAdministration
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
                    232. Observation.entryRelationship:entryReference.supply
                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
                    234. Observation.reference
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
                    236. Observation.precondition
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
                    238. Observation.sdtcPrecondition2
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
                    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
                    240. Observation.referenceRange
                    Definition

                    Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
                    242. Observation.referenceRange.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    244. Observation.referenceRange.realmCode
                    Definition

                    When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
                    246. Observation.referenceRange.typeId
                    Definition

                    When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

                    Control0..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
                    248. Observation.referenceRange.typeId.nullFlavor
                    Definition

                    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

                    Control0..1
                    BindingThe codes SHALL be taken from CDANullFlavor
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExceptional Value Detail
                    250. Observation.referenceRange.typeId.assigningAuthorityName
                    Definition

                    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

                    Control0..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelAssigning Authority Name
                    252. Observation.referenceRange.typeId.displayable
                    Definition

                    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

                    Control0..1
                    Typeboolean(bl: Boolean)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelDisplayable
                    254. Observation.referenceRange.typeId.root
                    Definition

                    Identifies the type as an HL7 Registered model

                    Control1..1
                    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelRoot
                    Fixed Value2.16.840.1.113883.1.3
                    256. Observation.referenceRange.typeId.extension
                    Definition

                    A character string as a unique identifier within the scope of the identifier root.

                    Control1..1
                    Typestring(st: Character String)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    LabelExtension
                    258. Observation.referenceRange.templateId
                    Definition

                    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
                    260. Observation.referenceRange.typeCode
                    Control0..1
                    BindingThe codes SHALL be taken from CDAActRelationshipType
                    (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
                    Typecode(cs: Coded Simple Value)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValueREFV
                    262. Observation.referenceRange.observationRange
                    Control1..1
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
                    264. Observation.sdtcInFulfillmentOf1
                    Control0..*
                    Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
                    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.