Name	Flags	Card.	Type	Description & Constraints
Observation	S	0..*	Observation	Reportability Information Observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
determinationOfReportability	S	1..1	CodeableConcept	US Public Health Determination of Reportability Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension Binding: Determination of Reportability (eCR) (extensible): Determination of Reportability
determinationOfReportabilityReason	S	0..*	string, CodeableConcept	US Public Health Determination of Reportability Reason URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
determinationOfReportabilityRule	S	0..*	string	US Public Health Determination of Reportability Rule Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
externalResourceExtension	S	0..*	Reference(RR DocumentReference)	External resources pertaining to the condition URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension
status	S	1..1	code	registered | preliminary | final | amended + Fixed Value: final
code	S	1..1	CodeableConcept	Location Relevance Binding: Location Relevance (eCR) (required): Location Relevance
Slices for performer	S	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by profile:resolve()
performer:rulesAuthoringAgency	S	1..*	Reference(Rules Authoring Agency Organization)	Who is responsible for the observation
performer:routingEntity	S	1..*	Reference(Routing Entity Organization)	Who is responsible for the observation
performer:responsibleAgency	S	0..*	Reference(Responsible Agency Organization)	Who is responsible for the observation
Slices for component	S	1..*	BackboneElement	Reporting timeframe Slice: Unordered, Open by value:code
component:sliceReportingTimeframe	S	0..*	BackboneElement	Component results
code	S	1..1	CodeableConcept	Timeframe to report (urgency) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.114222.4.5.232
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RR4
value[x]	S	1..1	Quantity	Actual component result
value	S	1..1	decimal	Numerical value (with implicit precision)
unit	S	1..1	string	Unit representation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	RRVS_LocationRelevance_eCR

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	Observation	Reportability Information Observation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
determinationOfReportability	S	1..1	CodeableConcept	US Public Health Determination of Reportability Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension Binding: Determination of Reportability (eCR) (extensible): Determination of Reportability
determinationOfReportabilityReason	S	0..*	string, CodeableConcept	US Public Health Determination of Reportability Reason URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
determinationOfReportabilityRule	S	0..*	string	US Public Health Determination of Reportability Rule Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
externalResourceExtension	S	0..*	Reference(RR DocumentReference)	External resources pertaining to the condition URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
code	SΣ	1..1	CodeableConcept	Location Relevance Binding: Location Relevance (eCR) (required): Location Relevance
Slices for performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by profile:resolve()
performer:rulesAuthoringAgency	SΣ	1..*	Reference(Rules Authoring Agency Organization)	Who is responsible for the observation
performer:routingEntity	SΣ	1..*	Reference(Routing Entity Organization)	Who is responsible for the observation
performer:responsibleAgency	SΣ	0..*	Reference(Responsible Agency Organization)	Who is responsible for the observation
Slices for component	SΣ	1..*	BackboneElement	Reporting timeframe Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
component:sliceReportingTimeframe	SΣ	0..*	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Timeframe to report (urgency) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.114222.4.5.232
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RR4
value[x]	SΣ	1..1	Quantity	Actual component result
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	Fixed Value: final
Observation.code	required	RRVS_LocationRelevance_eCR
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component:sliceReportingTimeframe.code	example	Pattern: RR4
Observation.component:sliceReportingTimeframe.value[x].comparator	required	QuantityComparator

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	Observation	Reportability Information Observation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
determinationOfReportability	S	1..1	CodeableConcept	US Public Health Determination of Reportability Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension Binding: Determination of Reportability (eCR) (extensible): Determination of Reportability
determinationOfReportabilityReason	S	0..*	string, CodeableConcept	US Public Health Determination of Reportability Reason URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
determinationOfReportabilityRule	S	0..*	string	US Public Health Determination of Reportability Rule Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
externalResourceExtension	S	0..*	Reference(RR DocumentReference)	External resources pertaining to the condition URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Location Relevance Binding: Location Relevance (eCR) (required): Location Relevance
subject	Σ	0..1	Reference(Patient | Group | Device | Location)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
Slices for performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by profile:resolve()
performer:rulesAuthoringAgency	SΣ	1..*	Reference(Rules Authoring Agency Organization)	Who is responsible for the observation
performer:routingEntity	SΣ	1..*	Reference(Routing Entity Organization)	Who is responsible for the observation
performer:responsibleAgency	SΣ	0..*	Reference(Responsible Agency Organization)	Who is responsible for the observation
value[x]	ΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Slices for component	SΣ	1..*	BackboneElement	Reporting timeframe Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:sliceReportingTimeframe	SΣ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Timeframe to report (urgency) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.114222.4.5.232
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RR4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣ	1..1	Quantity	Actual component result
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	RRVS_LocationRelevance_eCR
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes
Observation.component:sliceReportingTimeframe.code	example	Pattern: RR4
Observation.component:sliceReportingTimeframe.value[x].comparator	required	QuantityComparator
Observation.component:sliceReportingTimeframe.dataAbsentReason	extensible	DataAbsentReason
Observation.component:sliceReportingTimeframe.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Summary

Mandatory: 5 elements (3 nested mandatory elements)
Must-Support: 16 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

• Rules Authoring Agency Organization (http://hl7.org/fhir/us/ecr/StructureDefinition/rr-rules-authoring-agency-organization)
• Routing Entity Organization (http://hl7.org/fhir/us/ecr/StructureDefinition/rr-routing-entity-organization)
• Responsible Agency Organization (http://hl7.org/fhir/us/ecr/StructureDefinition/rr-responsible-agency-organization)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension
• http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
• http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
• http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension

Slices

This structure defines the following Slices:

• The element Observation.performer is sliced based on the value of profile:resolve()
• The element Observation.component is sliced based on the value of value:code

Name	Flags	Card.	Type	Description & Constraints
Observation	S	0..*	Observation	Reportability Information Observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
determinationOfReportability	S	1..1	CodeableConcept	US Public Health Determination of Reportability Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension Binding: Determination of Reportability (eCR) (extensible): Determination of Reportability
determinationOfReportabilityReason	S	0..*	string, CodeableConcept	US Public Health Determination of Reportability Reason URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
determinationOfReportabilityRule	S	0..*	string	US Public Health Determination of Reportability Rule Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
externalResourceExtension	S	0..*	Reference(RR DocumentReference)	External resources pertaining to the condition URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension
status	S	1..1	code	registered | preliminary | final | amended + Fixed Value: final
code	S	1..1	CodeableConcept	Location Relevance Binding: Location Relevance (eCR) (required): Location Relevance
Slices for performer	S	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by profile:resolve()
performer:rulesAuthoringAgency	S	1..*	Reference(Rules Authoring Agency Organization)	Who is responsible for the observation
performer:routingEntity	S	1..*	Reference(Routing Entity Organization)	Who is responsible for the observation
performer:responsibleAgency	S	0..*	Reference(Responsible Agency Organization)	Who is responsible for the observation
Slices for component	S	1..*	BackboneElement	Reporting timeframe Slice: Unordered, Open by value:code
component:sliceReportingTimeframe	S	0..*	BackboneElement	Component results
code	S	1..1	CodeableConcept	Timeframe to report (urgency) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.114222.4.5.232
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RR4
value[x]	S	1..1	Quantity	Actual component result
value	S	1..1	decimal	Numerical value (with implicit precision)
unit	S	1..1	string	Unit representation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	RRVS_LocationRelevance_eCR

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	Observation	Reportability Information Observation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
determinationOfReportability	S	1..1	CodeableConcept	US Public Health Determination of Reportability Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension Binding: Determination of Reportability (eCR) (extensible): Determination of Reportability
determinationOfReportabilityReason	S	0..*	string, CodeableConcept	US Public Health Determination of Reportability Reason URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
determinationOfReportabilityRule	S	0..*	string	US Public Health Determination of Reportability Rule Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
externalResourceExtension	S	0..*	Reference(RR DocumentReference)	External resources pertaining to the condition URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
code	SΣ	1..1	CodeableConcept	Location Relevance Binding: Location Relevance (eCR) (required): Location Relevance
Slices for performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by profile:resolve()
performer:rulesAuthoringAgency	SΣ	1..*	Reference(Rules Authoring Agency Organization)	Who is responsible for the observation
performer:routingEntity	SΣ	1..*	Reference(Routing Entity Organization)	Who is responsible for the observation
performer:responsibleAgency	SΣ	0..*	Reference(Responsible Agency Organization)	Who is responsible for the observation
Slices for component	SΣ	1..*	BackboneElement	Reporting timeframe Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
component:sliceReportingTimeframe	SΣ	0..*	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Timeframe to report (urgency) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.114222.4.5.232
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RR4
value[x]	SΣ	1..1	Quantity	Actual component result
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	Fixed Value: final
Observation.code	required	RRVS_LocationRelevance_eCR
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component:sliceReportingTimeframe.code	example	Pattern: RR4
Observation.component:sliceReportingTimeframe.value[x].comparator	required	QuantityComparator

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	Observation	Reportability Information Observation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
determinationOfReportability	S	1..1	CodeableConcept	US Public Health Determination of Reportability Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension Binding: Determination of Reportability (eCR) (extensible): Determination of Reportability
determinationOfReportabilityReason	S	0..*	string, CodeableConcept	US Public Health Determination of Reportability Reason URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
determinationOfReportabilityRule	S	0..*	string	US Public Health Determination of Reportability Rule Extension URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
externalResourceExtension	S	0..*	Reference(RR DocumentReference)	External resources pertaining to the condition URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Location Relevance Binding: Location Relevance (eCR) (required): Location Relevance
subject	Σ	0..1	Reference(Patient | Group | Device | Location)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
Slices for performer	SΣ	1..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Open by profile:resolve()
performer:rulesAuthoringAgency	SΣ	1..*	Reference(Rules Authoring Agency Organization)	Who is responsible for the observation
performer:routingEntity	SΣ	1..*	Reference(Routing Entity Organization)	Who is responsible for the observation
performer:responsibleAgency	SΣ	0..*	Reference(Responsible Agency Organization)	Who is responsible for the observation
value[x]	ΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Slices for component	SΣ	1..*	BackboneElement	Reporting timeframe Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:sliceReportingTimeframe	SΣ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Timeframe to report (urgency) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.114222.4.5.232
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RR4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣ	1..1	Quantity	Actual component result
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	Fixed Value: final
Observation.category	preferred	ObservationCategoryCodes
Observation.code	required	RRVS_LocationRelevance_eCR
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes
Observation.component:sliceReportingTimeframe.code	example	Pattern: RR4
Observation.component:sliceReportingTimeframe.value[x].comparator	required	QuantityComparator
Observation.component:sliceReportingTimeframe.dataAbsentReason	extensible	DataAbsentReason
Observation.component:sliceReportingTimeframe.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Summary

Mandatory: 5 elements (3 nested mandatory elements)
Must-Support: 16 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

• Rules Authoring Agency Organization (http://hl7.org/fhir/us/ecr/StructureDefinition/rr-rules-authoring-agency-organization)
• Routing Entity Organization (http://hl7.org/fhir/us/ecr/StructureDefinition/rr-routing-entity-organization)
• Responsible Agency Organization (http://hl7.org/fhir/us/ecr/StructureDefinition/rr-responsible-agency-organization)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-extension
• http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-reason-extension
• http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-determination-of-reportability-rule-extension
• http://hl7.org/fhir/us/ecr/StructureDefinition/rr-external-resource-extension

Slices

This structure defines the following Slices:

• The element Observation.performer is sliced based on the value of profile:resolve()
• The element Observation.component is sliced based on the value of value:code