Birth And Fetal Death (BFDR) FHIR Implementation Guide
2.0.0 - STU2 United States of America flag

Birth And Fetal Death (BFDR) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-bfdr/ and changes regularly. See the Directory of published versions

Resource Profile: Observation - Gestational Age at Delivery

Official URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-gestational-age-at-delivery Version: 2.0.0
Active as of 2024-09-16 Computable Name: ObservationGestationalAgeAtDelivery
Other Identifiers: OID:2.16.840.1.113883.4.642.40.13.42.48

The obstetric estimate of the infant’s gestation in completed weeks based on the birth/delivery attendant’s final estimate of gestation which should be determined by all perinatal factors and assessments such as ultrasound, but not the neonatal exam. For submission to NCHS, values in days will be divided by 7 without remainder, and values in weeks will be rounded down to an integer.

The edit flag extension supports validation as part of the Jurisdiction to NCHS use case and can be ingnored for the provider to jurisdiction use case. The validation checks are done at the jurisdiction prior to sending to the National Statistical Agency and are based on the item specific edit criteria specified in the Birth Edit Specifications for the 2003 Proposed Revision of the U.S. Standard Certificate of Birth and the Fetal Death Edit Specifications for the 2003 Revision of the U.S. Standard Report of Fetal Death.

IJE Mapping

Natality
Use Case # Description IJE Name Field Type Value Set/Comments
Natality 203 Obstetric Estimation of Gestation OWGEST value quantity value is a decimal; unit is from UnitsOfGestationalAgeVS
Natality 204 Obstetric Estimation of Gestation--Edit Flag OWGEST_BYPASS value.extension[bypassEditFlag].value codeable EstimateOfGestationEditFlagsVS,
See Handling of edit flags 

Fetal Death
Use Case # Description IJE Name Field Type Value Set/Comments
Fetal Death 145 Obstetric Estimation of Gestation OWGEST value quantity value is a decimal; unit is from UnitsOfGestationalAgeVS
Fetal Death 146 Obstetric Estimation of Gestation--Edit Flag OWGEST_BYPASS value.extension[bypassEditFlag].value codeable EstimateOfGestationEditFlagsVS,
See Handling of edit flags 

Form Mapping

Form Mapping
Item # Form Field FHIR Profile Field Reference
50 Obstetric Estimate of Gestation value Certificate of Live Birth
30 Obstetric estimate of gestation at delivery value Facility Worksheet for the Live Birth Certificate
30 Obstetric estimate of gestation at delivery value Attachment to the Facility Worksheet for the Live Birth Certificate for Multiple Births
18d Obstetric Estimate of Gestation at Delivery value Report of Fetal Death
20 Obstetric estimate of gestation at delivery value Facility Worksheet for the Report of Fetal Death

Usage:

Formal Views of Profile Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation Observation
... code 1..1 CodeableConcept Gestational age Estimated
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
... subject 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
... value[x] 1..1 Quantity Age in weeks or days
.... Slices for extension Content/Rules for all slices
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)

.... value 1..1 decimal Numerical value (with implicit precision)
.... code 0..1 code Coded form of the unit
Binding: Units of Gestational Age (required)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
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
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
... subject Σ 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
... value[x] ΣC 1..1 Quantity Age in weeks or days
.... Slices for extension Content/Rules for all slices
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)

.... value Σ 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.

.... code Σ 0..1 code Coded form of the unit
Binding: Units of Gestational Age (required)

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.codeexamplePattern: LOINC Code 11884-4
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
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
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept Gestational age Estimated
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: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
..... 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
... subject Σ 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) 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
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] ΣC 1..1 Quantity Age in weeks or days
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)

.... value Σ 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 Σ 0..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
Binding: Units of Gestational Age (required)
... 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
obs-3: Must have at least a low or a high or text
.... 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
... component Σ 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 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

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.codeexamplePattern: LOINC Code 11884-4
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG
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.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
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

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation Observation
... code 1..1 CodeableConcept Gestational age Estimated
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
... subject 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
... value[x] 1..1 Quantity Age in weeks or days
.... Slices for extension Content/Rules for all slices
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)

.... value 1..1 decimal Numerical value (with implicit precision)
.... code 0..1 code Coded form of the unit
Binding: Units of Gestational Age (required)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
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
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
... subject Σ 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
... value[x] ΣC 1..1 Quantity Age in weeks or days
.... Slices for extension Content/Rules for all slices
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)

.... value Σ 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.

.... code Σ 0..1 code Coded form of the unit
Binding: Units of Gestational Age (required)

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.codeexamplePattern: LOINC Code 11884-4
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
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
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept Gestational age Estimated
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: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
..... 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
... subject Σ 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) 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
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] ΣC 1..1 Quantity Age in weeks or days
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)

.... value Σ 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 Σ 0..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
Binding: Units of Gestational Age (required)
... 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
obs-3: Must have at least a low or a high or text
.... 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
... component Σ 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 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

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.codeexamplePattern: LOINC Code 11884-4
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG
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.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
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

 

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