US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Pediatric Head Occipital Frontal Circumference Percentile Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/head-occipital-frontal-circumference-percentile Version: 7.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: USCorePediatricHeadOccipitalFrontalCircumferencePercentileProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.42.61

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

To promote interoperability and adoption through common implementation, this profile sets minimum expectations for the Observation resource to record, search, and fetch pediatric head occipital frontal circumference (OFC) percentile observations associated with a patients from birth to 37 Months of age using a standard LOINC code and UCUM units of measure. It is based on the US Core Vital Signs Profile and identifies which additional core elements, extensions, vocabularies, and value sets SHALL be present and constrains the way the elements are used when using the profile. It provides the floor for standards development for specific use cases.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for OFC percentile observation belonging to a pediatric patient
  • Record or update OFC percentile observations belonging to a pediatric patient

Mandatory and Must Support Data Elements

In addition to the Mandatory and Must Support data elements in the US Core Vital Signs Profile, the following data-elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.
Note that the “Differential Table” displays elements unique to this profile and the “Key Elements Table” displays a combined view of elements for this profile and the US Core Vital Signs Profile.

Each Observation Must Have:

  1. a patient
  2. a fixed code for head occipital frontal circumference percentile measurement

Each Observation Must Support:

  1. a result value

Profile Specific Implementation Guidance:

  • The observations MAY have additional codes that translate or map to the Observation code or category codes. For example:
    • providing a local system specific code
    • providing more specific codes such as 8306-3 - Body height - lying in addition to 8302-2 - Body height. Several additional observation codes are provided in the FHIR core specification vital signs table.

    a code system value SHOULD be supplied for each additional code.

  • The observations MAY have component observations. For example, to qualify the vital sign observation 8310-5 - Body temperature, 8327-9 - Body temperature measurement site (oral, forehead, rectal, etc.) may be used as a component observation. Several of these are provided in the FHIR core specification vital signs table.
  • *An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
    • For further guidance see the Observation Grouping section in FHIR Specification.
    • Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.
  • *An Observation.component without a value, SHALL include a reason why the data is absent.
    • Systems that never provide a component observation without a component value are not required to support Observation.component.dataAbsentReason.
  • Implementers may use this profile as a base for other vital signs in addition to those in this guide.

  • Information about the growth chart tables used to determine percentiles SHOULD be supplied in Observation.note.text (for example, ‘WHO Males, 0-2 years Chart’).
  • For representing the raw OFC measurements use the US Core Head Circumference Profile.

Usage:

Changes since version 7.0.0-ballot:

  • The data elements list has changed
  • One or more text definitions, invariants or bindings have changed
  • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    This structure is derived from USCoreVitalSignsProfile

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..*USCoreVitalSignsProfileUS Core Pediatric Head Occipital Frontal Circumference Percentile Profile
    ... code S1..1CodeableConceptHead Occipital Frontal circumference Percentile
    Required Pattern: At least the following
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 8289-1
    ... valueQuantity S0..1Quantity SVital Signs Value
    .... value S1..1decimalNumerical value (with implicit precision)
    .... unit S1..1stringUnit representation
    .... system S1..1uriSystem that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    .... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
    Fixed Value: %

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*USCoreVitalSignsProfileUS Core Pediatric Head Occipital Frontal Circumference Percentile Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S1..*CodeableConceptClassification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:VSCat S1..1CodeableConceptClassification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ..... coding SΣ1..*CodingCode defined by a terminology system
    ...... system SΣ1..1uriIdentity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code SΣ1..1codeSymbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code SΣ1..1CodeableConceptHead Occipital Frontal circumference Percentile
    Binding: Vital Sign Result Type . (extensible): Vital sign result types


    Required Pattern: At least the following
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 8289-1
    ... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
    ... effective[x] SΣC1..1Often just a dateTime for Vital Signs
    vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    .... effectiveDateTimedateTime
    ... Slices for value[x] SΣC0..1Vital Signs Value
    Slice: Unordered, Open by type:$this
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    .... valueQuantityQuantity
    .... value[x]:valueQuantity SΣC0..1QuantityVital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... value SΣ1..1decimalNumerical value (with implicit precision)
    ..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ..... unit SΣ1..1stringUnit representation
    ..... system SΣC1..1uriSystem that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ..... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
    Fixed Value: %
    ... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... component SΣC0..*BackboneElementComponent observations
    vs-3: If there is no a value a data absent reason must be present
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code SΣ1..1CodeableConceptCoded vital sign result type
    Binding: Vital Sign Result Type . (extensible): Vital sign result types

    .... value[x] SΣC0..1Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... valueQuantityQuantity
    .... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeextensiblePattern: LOINC code 8289-1
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantityextensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.codeextensibleVitalSignResultType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.component.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceObservationA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()
    obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
    : dataAbsentReason.empty() or value.empty()
    obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    vs-1errorObservation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    : $this is dateTime implies $this.toString().length() >= 10
    vs-2errorObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3errorObservation.componentIf there is no a value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*USCoreVitalSignsProfileUS Core Pediatric Head Occipital Frontal Circumference Percentile Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    ... id Σ0..1idLogical id of this artifact
    ... meta Σ0..1MetaMetadata about the resource
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... language 0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    ... text 0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... extension 0..*ExtensionAdditional content defined by implementations
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier Σ0..*IdentifierBusiness Identifier for observation
    ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
    ... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S1..*CodeableConceptClassification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:VSCat S1..1CodeableConceptClassification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ..... id 0..1stringUnique id for inter-element referencing
    ..... extension 0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... coding SΣ1..*CodingCode defined by a terminology system
    ...... id 0..1stringUnique id for inter-element referencing
    ...... extension 0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... system SΣ1..1uriIdentity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... version Σ0..1stringVersion of the system - if relevant
    ...... code SΣ1..1codeSymbol in syntax defined by the system
    Fixed Value: vital-signs
    ...... display Σ0..1stringRepresentation defined by the system
    ...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
    ..... text Σ0..1stringPlain text representation of the concept
    ... code SΣ1..1CodeableConceptHead Occipital Frontal circumference Percentile
    Binding: Vital Sign Result Type . (extensible): Vital sign result types


    Required Pattern: At least the following
    .... id0..1stringUnique id for inter-element referencing
    .... extension0..*ExtensionAdditional content defined by implementations
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... version0..1stringVersion of the system - if relevant
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 8289-1
    ..... display0..1stringRepresentation defined by the system
    ..... userSelected0..1booleanIf this coding was chosen directly by the user
    .... text0..1stringPlain text representation of the concept
    ... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
    ... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
    ... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
    ... effective[x] SΣC1..1Often just a dateTime for Vital Signs
    vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    .... effectiveDateTimedateTime S
    .... effectivePeriodPeriod
    ... issued Σ0..1instantDate/Time this version was made available
    ... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
    ... Slices for value[x] SΣC0..1Vital Signs Value
    Slice: Unordered, Open by type:$this
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    .... valueQuantityQuantity S
    .... valueCodeableConceptCodeableConcept
    .... valueStringstring
    .... valueBooleanboolean
    .... valueIntegerinteger
    .... valueRangeRange
    .... valueRatioRatio
    .... valueSampledDataSampledData
    .... valueTimetime
    .... valueDateTimedateTime
    .... valuePeriodPeriod
    .... value[x]:valueQuantity SΣC0..1Quantity SVital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... id 0..1stringUnique id for inter-element referencing
    ..... extension 0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... value SΣ1..1decimalNumerical value (with implicit precision)
    ..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ..... unit SΣ1..1stringUnit representation
    ..... system SΣC1..1uriSystem that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ..... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
    Fixed Value: %
    ... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation 0..*CodeableConceptHigh, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ... note 0..*AnnotationComments about the observation
    ... bodySite 0..1CodeableConceptObserved body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

    ... method 0..1CodeableConceptHow it was done
    Binding: ObservationMethods (example): Methods for simple observations.

    ... specimen 0..1Reference(Specimen)Specimen used for this observation
    ... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
    ... referenceRange C0..*BackboneElementProvides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... low C0..1SimpleQuantityLow Range, if relevant
    .... high C0..1SimpleQuantityHigh Range, if relevant
    .... type 0..1CodeableConceptReference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..*CodeableConceptReference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1RangeApplicable age range, if relevant
    .... text 0..1stringText based reference range in an observation
    ... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
    ... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
    ... component SΣC0..*BackboneElementComponent observations
    vs-3: If there is no a value a data absent reason must be present
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code SΣ1..1CodeableConceptCoded vital sign result type
    Binding: Vital Sign Result Type . (extensible): Vital sign result types

    .... value[x] SΣC0..1Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... valueQuantityQuantity S
    ..... valueCodeableConceptCodeableConcept
    ..... valueStringstring
    ..... valueBooleanboolean
    ..... valueIntegerinteger
    ..... valueRangeRange
    ..... valueRatioRatio
    ..... valueSampledDataSampledData
    ..... valueTimetime
    ..... valueDateTimedateTime
    ..... valuePeriodPeriod
    .... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... interpretation 0..*CodeableConceptHigh, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    .... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeextensiblePattern: LOINC code 8289-1
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantityextensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeextensibleVitalSignResultType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.component.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceObservationA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()
    obs-3errorObservation.referenceRangeMust have at least a low or a high or text
    : low.exists() or high.exists() or text.exists()
    obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
    : dataAbsentReason.empty() or value.empty()
    obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    vs-1errorObservation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    : $this is dateTime implies $this.toString().length() >= 10
    vs-2errorObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3errorObservation.componentIf there is no a value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    This structure is derived from USCoreVitalSignsProfile

    Summary

    Mandatory: 0 element (4 nested mandatory elements)
    Must-Support: 6 elements
    Fixed Value: 2 elements

    Maturity: 3

    Differential View

    This structure is derived from USCoreVitalSignsProfile

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..*USCoreVitalSignsProfileUS Core Pediatric Head Occipital Frontal Circumference Percentile Profile
    ... code S1..1CodeableConceptHead Occipital Frontal circumference Percentile
    Required Pattern: At least the following
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 8289-1
    ... valueQuantity S0..1Quantity SVital Signs Value
    .... value S1..1decimalNumerical value (with implicit precision)
    .... unit S1..1stringUnit representation
    .... system S1..1uriSystem that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    .... code S1..1codeCoded responses from the common UCUM units for vital signs value set.
    Fixed Value: %

    doco Documentation for this format

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*USCoreVitalSignsProfileUS Core Pediatric Head Occipital Frontal Circumference Percentile Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S1..*CodeableConceptClassification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:VSCat S1..1CodeableConceptClassification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ..... coding SΣ1..*CodingCode defined by a terminology system
    ...... system SΣ1..1uriIdentity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code SΣ1..1codeSymbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code SΣ1..1CodeableConceptHead Occipital Frontal circumference Percentile
    Binding: Vital Sign Result Type . (extensible): Vital sign result types


    Required Pattern: At least the following
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 8289-1
    ... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
    ... effective[x] SΣC1..1Often just a dateTime for Vital Signs
    vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    .... effectiveDateTimedateTime
    ... Slices for value[x] SΣC0..1Vital Signs Value
    Slice: Unordered, Open by type:$this
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    .... valueQuantityQuantity
    .... value[x]:valueQuantity SΣC0..1QuantityVital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... value SΣ1..1decimalNumerical value (with implicit precision)
    ..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ..... unit SΣ1..1stringUnit representation
    ..... system SΣC1..1uriSystem that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ..... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
    Fixed Value: %
    ... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... component SΣC0..*BackboneElementComponent observations
    vs-3: If there is no a value a data absent reason must be present
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code SΣ1..1CodeableConceptCoded vital sign result type
    Binding: Vital Sign Result Type . (extensible): Vital sign result types

    .... value[x] SΣC0..1Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... valueQuantityQuantity
    .... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeextensiblePattern: LOINC code 8289-1
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantityextensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.codeextensibleVitalSignResultType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.component.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceObservationA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()
    obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
    : dataAbsentReason.empty() or value.empty()
    obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    vs-1errorObservation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    : $this is dateTime implies $this.toString().length() >= 10
    vs-2errorObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3errorObservation.componentIf there is no a value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*USCoreVitalSignsProfileUS Core Pediatric Head Occipital Frontal Circumference Percentile Profile
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    ... id Σ0..1idLogical id of this artifact
    ... meta Σ0..1MetaMetadata about the resource
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... language 0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    ... text 0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... extension 0..*ExtensionAdditional content defined by implementations
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier Σ0..*IdentifierBusiness Identifier for observation
    ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
    ... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S1..*CodeableConceptClassification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:VSCat S1..1CodeableConceptClassification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ..... id 0..1stringUnique id for inter-element referencing
    ..... extension 0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... coding SΣ1..*CodingCode defined by a terminology system
    ...... id 0..1stringUnique id for inter-element referencing
    ...... extension 0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... system SΣ1..1uriIdentity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... version Σ0..1stringVersion of the system - if relevant
    ...... code SΣ1..1codeSymbol in syntax defined by the system
    Fixed Value: vital-signs
    ...... display Σ0..1stringRepresentation defined by the system
    ...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
    ..... text Σ0..1stringPlain text representation of the concept
    ... code SΣ1..1CodeableConceptHead Occipital Frontal circumference Percentile
    Binding: Vital Sign Result Type . (extensible): Vital sign result types


    Required Pattern: At least the following
    .... id0..1stringUnique id for inter-element referencing
    .... extension0..*ExtensionAdditional content defined by implementations
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... version0..1stringVersion of the system - if relevant
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 8289-1
    ..... display0..1stringRepresentation defined by the system
    ..... userSelected0..1booleanIf this coding was chosen directly by the user
    .... text0..1stringPlain text representation of the concept
    ... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
    ... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
    ... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
    ... effective[x] SΣC1..1Often just a dateTime for Vital Signs
    vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    .... effectiveDateTimedateTime S
    .... effectivePeriodPeriod
    ... issued Σ0..1instantDate/Time this version was made available
    ... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
    ... Slices for value[x] SΣC0..1Vital Signs Value
    Slice: Unordered, Open by type:$this
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    .... valueQuantityQuantity S
    .... valueCodeableConceptCodeableConcept
    .... valueStringstring
    .... valueBooleanboolean
    .... valueIntegerinteger
    .... valueRangeRange
    .... valueRatioRatio
    .... valueSampledDataSampledData
    .... valueTimetime
    .... valueDateTimedateTime
    .... valuePeriodPeriod
    .... value[x]:valueQuantity SΣC0..1Quantity SVital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... id 0..1stringUnique id for inter-element referencing
    ..... extension 0..*ExtensionAdditional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... value SΣ1..1decimalNumerical value (with implicit precision)
    ..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
    Binding: QuantityComparator (required): How the Quantity should be understood and represented.

    ..... unit SΣ1..1stringUnit representation
    ..... system SΣC1..1uriSystem that defines coded unit form
    Fixed Value: http://unitsofmeasure.org
    ..... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
    Fixed Value: %
    ... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation 0..*CodeableConceptHigh, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ... note 0..*AnnotationComments about the observation
    ... bodySite 0..1CodeableConceptObserved body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

    ... method 0..1CodeableConceptHow it was done
    Binding: ObservationMethods (example): Methods for simple observations.

    ... specimen 0..1Reference(Specimen)Specimen used for this observation
    ... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
    ... referenceRange C0..*BackboneElementProvides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... low C0..1SimpleQuantityLow Range, if relevant
    .... high C0..1SimpleQuantityHigh Range, if relevant
    .... type 0..1CodeableConceptReference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..*CodeableConceptReference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1RangeApplicable age range, if relevant
    .... text 0..1stringText based reference range in an observation
    ... hasMember Σ0..*Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Used when reporting vital signs panel components
    ... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)Related measurements the observation is made from
    ... component SΣC0..*BackboneElementComponent observations
    vs-3: If there is no a value a data absent reason must be present
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code SΣ1..1CodeableConceptCoded vital sign result type
    Binding: Vital Sign Result Type . (extensible): Vital sign result types

    .... value[x] SΣC0..1Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.

    ..... valueQuantityQuantity S
    ..... valueCodeableConceptCodeableConcept
    ..... valueStringstring
    ..... valueBooleanboolean
    ..... valueIntegerinteger
    ..... valueRangeRange
    ..... valueRatioRatio
    ..... valueSampledDataSampledData
    ..... valueTimetime
    ..... valueDateTimedateTime
    ..... valuePeriodPeriod
    .... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... interpretation 0..*CodeableConceptHigh, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    .... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:VSCatpreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeextensiblePattern: LOINC code 8289-1
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantityextensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
    http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeextensibleVitalSignResultType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.62
    Observation.component.value[x]extensibleVitalSignsUnits
    http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceObservationA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()
    obs-3errorObservation.referenceRangeMust have at least a low or a high or text
    : low.exists() or high.exists() or text.exists()
    obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
    : dataAbsentReason.empty() or value.empty()
    obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    vs-1errorObservation.effective[x]if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    : $this is dateTime implies $this.toString().length() >= 10
    vs-2errorObservationIf there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3errorObservation.componentIf there is no a value a data absent reason must be present
    : value.exists() or dataAbsentReason.exists()

    This structure is derived from USCoreVitalSignsProfile

    Summary

    Mandatory: 0 element (4 nested mandatory elements)
    Must-Support: 6 elements
    Fixed Value: 2 elements

    Maturity: 3

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:


    Quick Start


    Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • See the General Requirements section for additional rules and expectations when a server requires status parameters.
    • See the General Guidance section for additional guidance on searching for multiple <patient user system>s.

    US Core Scopes

    Servers providing access to vital signs data SHALL support these US Core SMART Scopes:

    • resource level scopes: <patient|user|system>/Observation.rs

    • [granular scope]: <patient|user|system>.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

    Mandatory Search Parameters:

    The following search parameters and search parameter combinations SHALL be supported:

    1. SHALL support searching using the combination of the patient and category search parameters:

      GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = vital-signs (how to search by reference and how to search by token)

    2. SHALL support searching using the combination of the patient and code search parameters:
      • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)

      GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/Observation?patient=1186747&code=http://loinc.org|29463-7,http://loinc.org|9843-4,http://loinc.org|8289-1

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). SHOULD support search by multiple codes. The Observation code parameter searches `Observation.code only. (how to search by reference and how to search by token)

    3. SHALL support searching using the combination of the patient and category and date search parameters:
      • including support for these date comparators: gt,lt,ge,le
      • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

      GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&date=ge2020-01-01T00:00:00Z

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = vital-signs (how to search by reference and how to search by token and how to search by date)

    Optional Search Parameters:

    The following search parameter combinations SHOULD be supported:

    1. SHOULD support searching using the combination of the patient and category and status search parameters:
      • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

      GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs&status=final

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and status (how to search by reference and how to search by token)

    2. SHOULD support searching using the combination of the patient and code and date search parameters:
      • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
      • including support for these date comparators: gt,lt,ge,le
      • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

      GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

      Example:

      1. GET [base]/Observation?patient=1186747&code=http://loinc.org|29463-7,http://loinc.org|9843-4,http://loinc.org|8289-1&date=ge2020-01-01T00:00:00Z

      Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and report code(s). SHOULD support search by multiple codes. (how to search by reference and how to search by token and how to search by date)