Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-adi-documentation vs http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-UponDeathPreferences

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/Observation
copyright	Used by permission of HL7 International, all rights reserved Creative Commons License		Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date	2024-09-13	2026-10-15T19:33:19+00:00	Values Differ
description	The US Core Observation Advance Directive Information (ADI) Documentation Profile inherits from the FHIR [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile and the [US Core Observation ADI DocumentationReference Profile](StructureDefinition-us-core-adi-documentreference.html) meet the [U.S. Core Data for Interoperability (USCDI)](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi) *Advance Directive Observation* Data Element requirements. It is used to communicate whether a person has advance directive information (ADI) and, if one or more documents exist, their location. Examples of advance healthcare directive documents include physician order for life sustaining treatment (POLST), do not resuscitate order (DNR), and medical power of attorney. To communicate the type of advance directive document, the author, the verifier, and other properties, see the US Core ADI DocumentReference Profile. This profile sets minimum expectations for the Observation resource to record, search, and fetch findings about the presence of a patient's advance directives. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.	This profile is used to represent the author's thoughts about preferences upon death.	Values Differ
experimental	false		Removed the item 'false'
fhirVersion	4.0.1
jurisdiction
jurisdiction / jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreObservationADIDocumentationProfile	ADIUponDeathPreference	Values Differ
publisher	HL7 International / Cross-Group Projects	HL7 International / Patient Empowerment	Values Differ
purpose
status	active
title	US Core Observation ADI Documentation Profile	ADI Upon Death Preferences	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-adi-documentation	http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-UponDeathPreferences	Values Differ
version	9.0.0	2.0.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
Observation	C	0..*	Observation	US Core Observation ADI Presence Profile	C	0..*	Observation	Measurements and simple assertions
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
Observation.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	S This element must be supported.	1..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	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
Observation.contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
Observation.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Additional content defined by implementations
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.identifier	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for observation	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for observation
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
Observation.partOf	Σ This element is included in summaries.	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event	Σ This element is included in summaries.	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation.	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation. Required Pattern: final (extensions allowed)	Elements differ in definition for mustSupport: 'true' vs 'false'
Observation.Slices for category	S This element must be supported.	0..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ?? (preferred): FHIR and US Core codes for high level observation categories. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them		0..*	CodeableConcept	Classification of type of observation Binding: ?? (preferred): Codes for high level observation categories. Required Pattern: { "coding" : [ { "system" : "http://hl7.org/fhir/us/pacio-adi/CodeSystem/ADIPreferenceCategoryCS", "code" : "care-experience-preference" } ] }	Elements differ in definition for mustSupport: 'true' vs 'false' Example/preferred bindings differ at Observation.category using binding from USCoreObservationADIDocumentationProfile
Observation.code	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Observation ADI Documentation code Binding: ?? (example): Codes identifying names of simple observations. Required Pattern: { "coding" : [ { "system" : "http://loinc.org", "code" : "45473-6" } ] }	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	Type of observation (code / type) Binding: ?? (extensible)
Observation.code.id						0..1	string	Unique id for inter-element referencing	Added this element
Observation.code.Slices for extension						0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url	Added this element
Observation.code.coding					Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system	Added this element
Observation.code.text					S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept	Added this element
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
Observation.focus	Σ This element is included in summaries.	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record	Σ This element is included in summaries.	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
Observation.encounter	Σ This element is included in summaries.	0..1	Reference(Encounter)	Healthcare event during which this observation is made	Σ This element is included in summaries.	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Observation.effective[x]	Σ This element is included in summaries.	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation	Σ This element is included in summaries.	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation
Observation.issued	S This element must be supported. Σ This element is included in summaries.	0..1	instant	Date/Time this observation was made available	Σ This element is included in summaries.	0..1	instant	Date/Time this version was made available	Elements differ in definition for mustSupport: 'true' vs 'false'
Observation.performer	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(US Core Practitioner Profile S This type must be supported. | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Who is responsible for the observation	Σ This element is included in summaries.	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation	Elements differ in definition for mustSupport: 'true' vs 'false'
Observation.value[x]	S This element must be supported. Σ This element is included in summaries. C	0..1	CodeableConcept	Actual result Binding: ?? (required): Answer Set with Yes No and Unknowns	S This element must be supported. Σ This element is included in summaries. C	1..1	string	Actual result	Element minimum cardinalities differ: '0' vs '1'
Observation.dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	C	0..1	CodeableConcept	Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.
Observation.note		0..*	Annotation	Comments about the observation		0..*	Annotation	Comments about the observation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality.		0..1	CodeableConcept	Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality.
Observation.method		0..1	CodeableConcept	How it was done Binding: ?? (example): Methods for simple observations.		0..1	CodeableConcept	How it was done Binding: ?? (example): Methods for simple observations.
Observation.specimen		0..1	Reference(Specimen)	Specimen used for this observation		0..1	Reference(Specimen)	Specimen used for this observation
Observation.device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
Observation.referenceRange	C	0..*	BackboneElement	Provides guide for interpretation	C	0..*	BackboneElement	Provides guide for interpretation
Observation.referenceRange.id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Observation.referenceRange.extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low	C	0..1	??	Low Range, if relevant	C	0..1	??	Low Range, if relevant
Observation.referenceRange.high	C	0..1	??	High Range, if relevant	C	0..1	??	High Range, if relevant
Observation.referenceRange.type		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age		0..1	Range	Applicable age range, if relevant		0..1	Range	Applicable age range, if relevant
Observation.referenceRange.text		0..1	string	Text based reference range in an observation		0..1	string	Text based reference range in an observation
Observation.hasMember	Σ This element is included in summaries.	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group	Σ This element is included in summaries.	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
Observation.derivedFrom	Σ This element is included in summaries.	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from	Σ This element is included in summaries.	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Observation.component	Σ This element is included in summaries.	0..*	BackboneElement	Component results	Σ This element is included in summaries.	0..*	BackboneElement	Component results
Observation.component.id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Observation.component.extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations.	Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations.
Observation.component.value[x]	Σ This element is included in summaries.	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result	Σ This element is included in summaries.	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
Observation.component.dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	C	0..1	CodeableConcept	Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format