International Patient Summary Implementation Guide
2.0.0 -

International Patient Summary Implementation Guide, published by HL7 International / Patient Care. 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-ips/ and changes regularly. See the Directory of published versions

## Resource Profile: Observation Social History - Tobacco Use (IPS)

Official URL: http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-tobaccouse-uv-ips | Version: 2.0.0
Standards status: Trial-use Active as of 2024-06-19 | Maturity Level: 3 | Computable Name: ObservationTobaccoUseUvIps

This profile constrains the Observation resource to represent Tobacco use assessment in a patient summary.

Usages:

- Use this Profile: Bundle (IPS)
- Refer to this Profile: Composition (IPS)
- Examples for this Profile: Observation/tobacco-use-example
- CapabilityStatements using this Profile: IPS Server Capability Statement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Obligations
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
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.
code | SO Σ | 1..1 | CodeableConceptIPS | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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: 72166-2
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 | SO Σ | 1..1 | Reference(Patient (IPS)) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
effective[x] | SO Σ | 1..1 | dateTime | Clinically relevant time/time-period for observation
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueCodeableConcept | Σ C | 0..1 | CodeableConcept | Actual result Binding: Current Smoking Status - IPS (preferred)
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueCodeableConcept | Base | preferred | Current Smoking Status - IPS | 📦2.0.0 | This IG
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  |  | Observation |
code | SO | 1..1 | CodeableConceptIPS | Type of observation (code / type) Required Pattern: At least the following
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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: 72166-2
subject | SO | 1..1 | Reference(Patient (IPS)) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
effective[x] | SO | 1..1 | dateTime | Clinically relevant time/time-period for observation
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Slices for value[x] |  | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Actual result Binding: Current Smoking Status - IPS (preferred)
component |  | 0..0 |  | Component results
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.value[x]:valueCodeableConcept | Base | preferred | Current Smoking Status - IPS | 📦2.0.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
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 | SO Σ | 1..1 | CodeableConceptIPS | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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: 72166-2
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 | SO Σ | 1..1 | Reference(Patient (IPS)) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | SO Σ | 1..1 | dateTime | Clinically relevant time/time-period for observation
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueCodeableConcept | Σ C | 0..1 | CodeableConcept | Actual result Binding: Current Smoking Status - IPS (preferred)
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 Constraints: obs-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | 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
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueCodeableConcept | Base | preferred | Current Smoking Status - IPS | 📦2.0.0 | This IG
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

Summary

Mandatory: 3 elements
Must-Support: 4 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.value[x]

Maturity: 3

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
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.
code | SO Σ | 1..1 | CodeableConceptIPS | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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: 72166-2
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 | SO Σ | 1..1 | Reference(Patient (IPS)) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
effective[x] | SO Σ | 1..1 | dateTime | Clinically relevant time/time-period for observation
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueCodeableConcept | Σ C | 0..1 | CodeableConcept | Actual result Binding: Current Smoking Status - IPS (preferred)
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueCodeableConcept | Base | preferred | Current Smoking Status - IPS | 📦2.0.0 | This IG
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  |  | Observation |
code | SO | 1..1 | CodeableConceptIPS | Type of observation (code / type) Required Pattern: At least the following
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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: 72166-2
subject | SO | 1..1 | Reference(Patient (IPS)) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
effective[x] | SO | 1..1 | dateTime | Clinically relevant time/time-period for observation
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Slices for value[x] |  | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Actual result Binding: Current Smoking Status - IPS (preferred)
component |  | 0..0 |  | Component results
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.value[x]:valueCodeableConcept | Base | preferred | Current Smoking Status - IPS | 📦2.0.0 | This IG

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
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 | SO Σ | 1..1 | CodeableConceptIPS | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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: 72166-2
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 | SO Σ | 1..1 | Reference(Patient (IPS)) | Who and/or what the observation is about
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | SO Σ | 1..1 | dateTime | Clinically relevant time/time-period for observation
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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
Slices for value[x] | Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueCodeableConcept | Σ C | 0..1 | CodeableConcept | Actual result Binding: Current Smoking Status - IPS (preferred)
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 Constraints: obs-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | 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
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.value[x]:valueCodeableConcept | Base | preferred | Current Smoking Status - IPS | 📦2.0.0 | This IG
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
Observation |  |
code | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
effective[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
Slices for value[x] |  |
Documentation for this format

Summary

Mandatory: 3 elements
Must-Support: 4 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.value[x]

Maturity: 3

Other representations of profile: CSV, Excel, Schematron