PACIO Cognitive Status Implementation Guide, published by HL7 Patient Care Work Group. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-cognitive-status/ and changes regularly. See the Directory of published versions

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• Detailed Descriptions
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Resource Profile: PACIO Cognitive Status

An exchange of cognitive status observation for a patient. This profile is used for exchanging a single observation data generally included in a set of observation data collected through the use of a structured resource (e.g. assessment tool, instrument, or screen).

Usage:

• Refer to this Resource Profile: PACIO Cognitive Status Collection
• Examples for this Resource Profile: Observation/CSC-Hospital-MMSE-1-Ob-Question-31, Observation/CSC-Hospital-MOCA-1-Ob-Question-1, Observation/CSC-SNF-BIMS-1-Ob-Question-10, Observation/CSC-SNF-BIMS-1-Ob-Question-3... Show 28 more, Observation/CSC-SNF-BIMS-1-Ob-Question-4, Observation/CSC-SNF-BIMS-1-Ob-Question-5, Observation/CSC-SNF-BIMS-1-Ob-Question-6, Observation/CSC-SNF-BIMS-1-Ob-Question-7, Observation/CSC-SNF-BIMS-1-Ob-Question-8, Observation/CSC-SNF-BIMS-1-Ob-Question-9, Observation/CSC-SNF-CAM-Admission-1-Ob-Question-1, Observation/CSC-SNF-CAM-Admission-1-Ob-Question-3, Observation/CSC-SNF-CAM-Admission-1-Ob-Question-5, Observation/CSC-SNF-PHQ9-1-Ob-Question-11, Observation/CSC-SNF-PHQ9-1-Ob-Question-12, Observation/CSC-SNF-PHQ9-1-Ob-Question-13, Observation/CSC-SNF-PHQ9-1-Ob-Question-14, Observation/CSC-SNF-PHQ9-1-Ob-Question-15, Observation/CSC-SNF-PHQ9-1-Ob-Question-16, Observation/CSC-SNF-PHQ9-1-Ob-Question-17, Observation/CSC-SNF-PHQ9-1-Ob-Question-18, Observation/CSC-SNF-PHQ9-1-Ob-Question-19, Observation/CSC-SNF-PHQ9-1-Ob-Question-20, Observation/CSC-SNF-PHQ9-1-Ob-Question-21, Observation/CSC-SNF-PHQ9-1-Ob-Question-22, Observation/CSC-SNF-PHQ9-1-Ob-Question-23, Observation/CSC-SNF-PHQ9-1-Ob-Question-24, Observation/CSC-SNF-PHQ9-1-Ob-Question-25, Observation/CSC-SNF-PHQ9-1-Ob-Question-26, Observation/CSC-SNF-PHQ9-1-Ob-Question-27, Observation/CSC-SNF-PHQ9-1-Ob-Question-28 and Observation/CSC-SNF-PHQ9-1-Ob-Question-29

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
event-location	S	0..1	Reference(US Core Location Profile)	An extension to indicate where the observation event occurred. URL: http://hl7.org/fhir/StructureDefinition/event-location profiled by http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location
basedOn		0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Currently not used in CognitiveStatus.
partOf		0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Currently not used in CognitiveStatus.
status		1..1	code	Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used.
Slices for category		1..*	CodeableConcept	A second category code may be used along with the code “functioning”. For example, for assessment tool/survey instrument observations use “survey” as a second code. Slice: Unordered, Open by pattern:coding
category:functioning		1..1	CodeableConcept	Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible)
coding		1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-cs/CodeSystem/pacio-cat-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: functioning
display		1..1	string	Representation defined by the system Fixed Value: Functioning
code		1..1	CodeableConcept	For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: LOINCCodes (extensible)
subject		1..1	Reference(US Core Patient Profile)	Should only reference a Patient resource.
focus		0..*	Reference(Resource)	Currently not used in CognitiveStatus.
encounter		0..1	Reference(US Core Encounter Profile)	Healthcare event during which this observation is made
effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation
issued		0..1	instant	Currently not used in CognitiveStatus.
performer		1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Whenever possible should use the CodeableConcept datatype to provide a suitable code to define the concept for the observation data. As for values like an assessment score or roll-up value, the datatype for this element should be determined by Observation.code. However, for values that are ordinal, may use the CodeableConcept datatype along with the Ordinal Value Extension.
interpretation		0..*	CodeableConcept	Currently not used in CognitiveStatus.
bodySite		0..1	CodeableConcept	Currently not used in CognitiveStatus.
method		0..1	CodeableConcept	Currently not used in CognitiveStatus.
specimen		0..1	Reference(Specimen)	Currently not used in CognitiveStatus.
device		0..1	Reference(Device | DeviceMetric)	Currently not used in CognitiveStatus.
referenceRange		0..*	BackboneElement	Currently not used in CognitiveStatus.
hasMember		0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Currently not used in CognitiveStatus.
derivedFrom	S	0..*	Reference(SDC Questionnaire Response)	Should point back to the SDC QuestionnaireResponse that this resource is derived from.
component		0..*	BackboneElement	Currently not used in CognitiveStatus.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.category:functioning	extensible	PACIOFunctioningCategoryVS http://hl7.org/fhir/us/pacio-cs/ValueSet/pacio-cat-vs from this IG
Observation.code	extensible	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
event-location	S	0..1	Reference(US Core Location Profile)	An extension to indicate where the observation event occurred. URL: http://hl7.org/fhir/StructureDefinition/event-location profiled by http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Currently not used in CognitiveStatus.
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Currently not used in CognitiveStatus.
status	?!Σ	1..1	code	Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConcept	A second category code may be used along with the code “functioning”. For example, for assessment tool/survey instrument observations use “survey” as a second code. Slice: Unordered, Open by pattern:coding Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:functioning		1..1	CodeableConcept	Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible)
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-cs/CodeSystem/pacio-cat-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: functioning
display		1..1	string	Representation defined by the system Fixed Value: Functioning
code	Σ	1..1	CodeableConcept	For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: LOINCCodes (extensible)
subject	Σ	1..1	Reference(US Core Patient Profile)	Should only reference a Patient resource.
focus	Σ	0..*	Reference(Resource)	Currently not used in CognitiveStatus.
encounter	Σ	0..1	Reference(US Core Encounter Profile)	Healthcare event during which this observation is made
effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Currently not used in CognitiveStatus.
performer	Σ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
value[x]	ΣC	0..1		Whenever possible should use the CodeableConcept datatype to provide a suitable code to define the concept for the observation data. As for values like an assessment score or roll-up value, the datatype for this element should be determined by Observation.code. However, for values that are ordinal, may use the CodeableConcept datatype along with the Ordinal Value Extension.
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
interpretation		0..*	CodeableConcept	Currently not used in CognitiveStatus. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
bodySite		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Currently not used in CognitiveStatus.
device		0..1	Reference(Device | DeviceMetric)	Currently not used in CognitiveStatus.
referenceRange	C	0..*	BackboneElement	Currently not used in CognitiveStatus. obs-3: Must have at least a low or a high or text
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Currently not used in CognitiveStatus.
derivedFrom	SΣ	0..*	Reference(SDC Questionnaire Response)	Should point back to the SDC QuestionnaireResponse that this resource is derived from.
component	Σ	0..*	BackboneElement	Currently not used in CognitiveStatus.
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.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:functioning	extensible	PACIOFunctioningCategoryVS http://hl7.org/fhir/us/pacio-cs/ValueSet/pacio-cat-vs from this IG
Observation.code	extensible	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
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 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
event-location	S	0..1	Reference(US Core Location Profile)	An extension to indicate where the observation event occurred. URL: http://hl7.org/fhir/StructureDefinition/event-location profiled by http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location
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)	Currently not used in CognitiveStatus.
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Currently not used in CognitiveStatus.
status	?!Σ	1..1	code	Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConcept	A second category code may be used along with the code “functioning”. For example, for assessment tool/survey instrument observations use “survey” as a second code. Slice: Unordered, Open by pattern:coding Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:functioning		1..1	CodeableConcept	Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
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://hl7.org/fhir/us/pacio-cs/CodeSystem/pacio-cat-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: functioning
display		1..1	string	Representation defined by the system Fixed Value: Functioning
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: LOINCCodes (extensible)
subject	Σ	1..1	Reference(US Core Patient Profile)	Should only reference a Patient resource.
focus	Σ	0..*	Reference(Resource)	Currently not used in CognitiveStatus.
encounter	Σ	0..1	Reference(US Core Encounter Profile)	Healthcare event during which this observation is made
effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Currently not used in CognitiveStatus.
performer	Σ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
value[x]	ΣC	0..1		Whenever possible should use the CodeableConcept datatype to provide a suitable code to define the concept for the observation data. As for values like an assessment score or roll-up value, the datatype for this element should be determined by Observation.code. However, for values that are ordinal, may use the CodeableConcept datatype along with the Ordinal Value Extension.
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	Currently not used in CognitiveStatus. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Currently not used in CognitiveStatus.
device		0..1	Reference(Device | DeviceMetric)	Currently not used in CognitiveStatus.
referenceRange	C	0..*	BackboneElement	Currently not used in CognitiveStatus. 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)	Currently not used in CognitiveStatus.
derivedFrom	SΣ	0..*	Reference(SDC Questionnaire Response)	Should point back to the SDC QuestionnaireResponse that this resource is derived from.
component	Σ	0..*	BackboneElement	Currently not used in CognitiveStatus.
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:functioning	extensible	PACIOFunctioningCategoryVS http://hl7.org/fhir/us/pacio-cs/ValueSet/pacio-cat-vs from this IG
Observation.code	extensible	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from Observation

Summary

Mandatory: 6 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• SDC Questionnaire Response (http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.category

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
event-location	S	0..1	Reference(US Core Location Profile)	An extension to indicate where the observation event occurred. URL: http://hl7.org/fhir/StructureDefinition/event-location profiled by http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location
basedOn		0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Currently not used in CognitiveStatus.
partOf		0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Currently not used in CognitiveStatus.
status		1..1	code	Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used.
Slices for category		1..*	CodeableConcept	A second category code may be used along with the code “functioning”. For example, for assessment tool/survey instrument observations use “survey” as a second code. Slice: Unordered, Open by pattern:coding
category:functioning		1..1	CodeableConcept	Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible)
coding		1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-cs/CodeSystem/pacio-cat-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: functioning
display		1..1	string	Representation defined by the system Fixed Value: Functioning
code		1..1	CodeableConcept	For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: LOINCCodes (extensible)
subject		1..1	Reference(US Core Patient Profile)	Should only reference a Patient resource.
focus		0..*	Reference(Resource)	Currently not used in CognitiveStatus.
encounter		0..1	Reference(US Core Encounter Profile)	Healthcare event during which this observation is made
effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation
issued		0..1	instant	Currently not used in CognitiveStatus.
performer		1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Whenever possible should use the CodeableConcept datatype to provide a suitable code to define the concept for the observation data. As for values like an assessment score or roll-up value, the datatype for this element should be determined by Observation.code. However, for values that are ordinal, may use the CodeableConcept datatype along with the Ordinal Value Extension.
interpretation		0..*	CodeableConcept	Currently not used in CognitiveStatus.
bodySite		0..1	CodeableConcept	Currently not used in CognitiveStatus.
method		0..1	CodeableConcept	Currently not used in CognitiveStatus.
specimen		0..1	Reference(Specimen)	Currently not used in CognitiveStatus.
device		0..1	Reference(Device | DeviceMetric)	Currently not used in CognitiveStatus.
referenceRange		0..*	BackboneElement	Currently not used in CognitiveStatus.
hasMember		0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Currently not used in CognitiveStatus.
derivedFrom	S	0..*	Reference(SDC Questionnaire Response)	Should point back to the SDC QuestionnaireResponse that this resource is derived from.
component		0..*	BackboneElement	Currently not used in CognitiveStatus.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.category:functioning	extensible	PACIOFunctioningCategoryVS http://hl7.org/fhir/us/pacio-cs/ValueSet/pacio-cat-vs from this IG
Observation.code	extensible	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
event-location	S	0..1	Reference(US Core Location Profile)	An extension to indicate where the observation event occurred. URL: http://hl7.org/fhir/StructureDefinition/event-location profiled by http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Currently not used in CognitiveStatus.
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Currently not used in CognitiveStatus.
status	?!Σ	1..1	code	Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConcept	A second category code may be used along with the code “functioning”. For example, for assessment tool/survey instrument observations use “survey” as a second code. Slice: Unordered, Open by pattern:coding Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:functioning		1..1	CodeableConcept	Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible)
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/pacio-cs/CodeSystem/pacio-cat-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: functioning
display		1..1	string	Representation defined by the system Fixed Value: Functioning
code	Σ	1..1	CodeableConcept	For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: LOINCCodes (extensible)
subject	Σ	1..1	Reference(US Core Patient Profile)	Should only reference a Patient resource.
focus	Σ	0..*	Reference(Resource)	Currently not used in CognitiveStatus.
encounter	Σ	0..1	Reference(US Core Encounter Profile)	Healthcare event during which this observation is made
effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Currently not used in CognitiveStatus.
performer	Σ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
value[x]	ΣC	0..1		Whenever possible should use the CodeableConcept datatype to provide a suitable code to define the concept for the observation data. As for values like an assessment score or roll-up value, the datatype for this element should be determined by Observation.code. However, for values that are ordinal, may use the CodeableConcept datatype along with the Ordinal Value Extension.
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
interpretation		0..*	CodeableConcept	Currently not used in CognitiveStatus. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
bodySite		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Currently not used in CognitiveStatus.
device		0..1	Reference(Device | DeviceMetric)	Currently not used in CognitiveStatus.
referenceRange	C	0..*	BackboneElement	Currently not used in CognitiveStatus. obs-3: Must have at least a low or a high or text
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Currently not used in CognitiveStatus.
derivedFrom	SΣ	0..*	Reference(SDC Questionnaire Response)	Should point back to the SDC QuestionnaireResponse that this resource is derived from.
component	Σ	0..*	BackboneElement	Currently not used in CognitiveStatus.
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.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:functioning	extensible	PACIOFunctioningCategoryVS http://hl7.org/fhir/us/pacio-cs/ValueSet/pacio-cat-vs from this IG
Observation.code	extensible	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
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 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
event-location	S	0..1	Reference(US Core Location Profile)	An extension to indicate where the observation event occurred. URL: http://hl7.org/fhir/StructureDefinition/event-location profiled by http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location
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)	Currently not used in CognitiveStatus.
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Currently not used in CognitiveStatus.
status	?!Σ	1..1	code	Should have the value 'final' when the observation is complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used. Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConcept	A second category code may be used along with the code “functioning”. For example, for assessment tool/survey instrument observations use “survey” as a second code. Slice: Unordered, Open by pattern:coding Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:functioning		1..1	CodeableConcept	Classification of type of observation Binding: PACIO Functioning Category Value Set (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
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://hl7.org/fhir/us/pacio-cs/CodeSystem/pacio-cat-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: functioning
display		1..1	string	Representation defined by the system Fixed Value: Functioning
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: LOINCCodes (extensible)
subject	Σ	1..1	Reference(US Core Patient Profile)	Should only reference a Patient resource.
focus	Σ	0..*	Reference(Resource)	Currently not used in CognitiveStatus.
encounter	Σ	0..1	Reference(US Core Encounter Profile)	Healthcare event during which this observation is made
effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Currently not used in CognitiveStatus.
performer	Σ	1..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
value[x]	ΣC	0..1		Whenever possible should use the CodeableConcept datatype to provide a suitable code to define the concept for the observation data. As for values like an assessment score or roll-up value, the datatype for this element should be determined by Observation.code. However, for values that are ordinal, may use the CodeableConcept datatype along with the Ordinal Value Extension.
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	Currently not used in CognitiveStatus. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	Currently not used in CognitiveStatus. Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Currently not used in CognitiveStatus.
device		0..1	Reference(Device | DeviceMetric)	Currently not used in CognitiveStatus.
referenceRange	C	0..*	BackboneElement	Currently not used in CognitiveStatus. 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)	Currently not used in CognitiveStatus.
derivedFrom	SΣ	0..*	Reference(SDC Questionnaire Response)	Should point back to the SDC QuestionnaireResponse that this resource is derived from.
component	Σ	0..*	BackboneElement	Currently not used in CognitiveStatus.
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:functioning	extensible	PACIOFunctioningCategoryVS http://hl7.org/fhir/us/pacio-cs/ValueSet/pacio-cat-vs from this IG
Observation.code	extensible	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from Observation

Summary

Mandatory: 6 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• SDC Questionnaire Response (http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/pacio-cs/StructureDefinition/event-location

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.category

Other representations of profile: CSV, Excel, Schematron