Left: | US Core Observation Clinical Result Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result) |
Right: | PACIO Cognitive Status (http://hl7.org/fhir/us/pacio-cs/StructureDefinition/pacio-cs) |
Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result' vs 'http://hl7.org/fhir/us/pacio-cs/StructureDefinition/pacio-cs' |
Error | StructureDefinition.version | Values for version differ: '7.0.0' vs '1.0.0' |
Information | StructureDefinition.name | Values for name differ: 'USCoreObservationClinicalResultProfile' vs 'CognitiveStatus' |
Information | StructureDefinition.title | Values for title differ: 'US Core Observation Clinical Result Profile' vs 'PACIO Cognitive Status' |
Information | StructureDefinition.date | Values for date differ: '2023-10-17' vs '2024-11-05T07:56:05+00:00' |
Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International / Cross-Group Projects' vs 'HL7 Patient Care Work Group' |
Information | StructureDefinition.short | Values for short differ: 'Additional content defined by implementations' vs 'Extension' |
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension' |
Information | StructureDefinition.short | Values for short differ: 'Fulfills plan, proposal or order' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Part of referenced event' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'registered | preliminary | final | amended +' vs '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.' |
Warning | Observation.status | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Classification of type of observation' vs '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.' |
Warning | Observation.category | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Clinical Test or Procedure Name' vs 'For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name.' |
Information | StructureDefinition.definition | Values for definition differ: 'The name of the clinical test or procedure performed on a patient. A LOINC **SHALL** be used if the concept is present in LOINC.' vs 'Describes what was observed. Sometimes this is called the observation 'name'.' |
Information | StructureDefinition.comment | Values for comment differ: 'The typical patterns for codes are: 1) a LOINC code either as a translation from a 'local' code or as a primary code, or 2) a local code only if no suitable LOINC exists, or 3) both the local and the LOINC translation. Systems SHALL be capable of sending the local code if one exists. When using LOINC , Use either the SHORTNAME or LONG_COMMON_NAME field for the display.' vs '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.' |
Warning | Observation.code | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Who and/or what the observation is about' vs 'Should only reference a Patient resource.' |
Warning | Observation.subject | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'What the observation is about, when it is not about the subject of record' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Encounter associated with Observation' vs 'Healthcare event during which this observation is made' |
Warning | Observation.encounter | Elements differ in definition for mustSupport: 'true' vs 'false' |
Warning | Observation.effective[x] | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | Observation.effective[x] | Element minimum cardinalities differ: '0' vs '1' |
Information | StructureDefinition.short | Values for short differ: 'Date/Time this version was made available' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Who is responsible for the observation' vs '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.' |
Information | Observation.performer | Element minimum cardinalities differ: '0' vs '1' |
Information | StructureDefinition.short | Values for short differ: 'Result Value' vs '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.' |
Information | StructureDefinition.definition | Values for definition differ: 'The clinical test or procedure result value. If a numeric value, valueQuantity.code **SHALL** be selected from [UCUM](http://unitsofmeasure.org). A FHIR [UCUM Codes value set](http://hl7.org/fhir/STU3/valueset-ucum-units.html) that defines all UCUM codes is in the FHIR specification.' vs 'The information determined as a result of making the observation, if the information has a simple value.' |
Warning | Observation.value[x] | Elements differ in definition for mustSupport: 'true' vs 'false' |
Warning | Observation.dataAbsentReason | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'High, low, normal, etc.' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Observed body part' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'How it was done' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Specimen used for this observation' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: '(Measurement) Device' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Provides guide for interpretation' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.short | Values for short differ: 'Related resource that belongs to the Observation group' vs 'Currently not used in CognitiveStatus.' |
Information | StructureDefinition.comment | Values for comment differ: 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](questionnaireresponse.html) into a final score and represent the score as an Observation.' vs 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html) into a final score and represent the score as an Observation.' |
Information | StructureDefinition.short | Values for short differ: 'Related measurements the observation is made from' vs 'Should point back to the SDC QuestionnaireResponse that this resource is derived from.' |
Warning | Observation.derivedFrom | Elements differ in definition for mustSupport: 'false' vs 'true' |
Error | Observation.derivedFrom | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse]]) |
Information | StructureDefinition.short | Values for short differ: 'Component results' vs 'Currently not used in CognitiveStatus.' |
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 |
| |
date | 2023-10-17 | 2024-11-05T07:56:05+00:00 |
|
description | The US Core Observation Clinical Result Profile is based upon the core FHIR Observation Resource and, along with the US Core DiagnosticReport Profile, meets the US Core Data for Interoperability (USCDI) requirements for *Diagnostic Imaging* and *Clinical Tests* Data Classes. This profile sets minimum expectations for the Observation resource to record and search non-laboratory clinical test results (e.g., radiology and other clinical observations generated from procedures). An example would be when a gastroenterologist reports the size of a polyp observed during a colonoscopy. This profile is the basis for the US Core Laboratory Result Observation Profile, which defines additional data elements to record and search laboratory test results. The US Core Observation Clinical Result Profile sets minimum expectations to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases. | 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). |
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experimental | |||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | USCoreObservationClinicalResultProfile | CognitiveStatus |
|
publisher | HL7 International / Cross-Group Projects | HL7 Patient Care Work Group |
|
purpose | |||
status | active | ||
title | US Core Observation Clinical Result Profile | PACIO Cognitive Status |
|
type | Observation | ||
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result | http://hl7.org/fhir/us/pacio-cs/StructureDefinition/pacio-cs |
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version | 7.0.0 | 1.0.0 |
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Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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 us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present | 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 | Σ | 0..1 | id | Logical id of this artifact | |||||||||
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
identifier | Σ | 0..* | Identifier | Business Identifier for observation | Σ | 0..* | Identifier | Business Identifier for observation | |||||||||
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Currently not used in CognitiveStatus. | |||||||||
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Currently not used in CognitiveStatus. | |||||||||
status | ?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation. | ?!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: ?? (required): Codes providing the status of an observation. |
| ||||||||
Slices for category | S | 1..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ?? (preferred): Codes for high level observation categories. | 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: ?? (preferred): Codes for high level observation categories. |
| |||||||||
code | SΣ | 1..1 | CodeableConcept | Clinical Test or Procedure Name Binding: ?? (extensible) | Σ | 1..1 | CodeableConcept | For a Post-Acute Care Assessment, should include a LOINC code and text for the question or concept name. Binding: ?? (extensible) |
| ||||||||
subject | SΣ | 1..1 | Reference(US Core Patient Profile S | Group | Device | US Core Location Profile) | Who and/or what the observation is about | Σ | 1..1 | Reference(US Core Patient Profile) | Should only reference a Patient resource. |
| ||||||||
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | Σ | 0..* | Reference(Resource) | Currently not used in CognitiveStatus. | |||||||||
encounter | SΣ | 0..1 | Reference(US Core Encounter Profile) | Encounter associated with Observation | Σ | 0..1 | Reference(US Core Encounter Profile) | Healthcare event during which this observation is made |
| ||||||||
effective[x] | SΣC | 0..1 | dateTime S, Period, Timing, instant | Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day. | Σ | 1..1 | dateTime | Clinically relevant time/time-period for observation |
| ||||||||
issued | Σ | 0..1 | instant | Date/Time this version was made available | Σ | 0..1 | instant | Currently not used in CognitiveStatus. | |||||||||
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | 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] | SΣC | 0..1 | Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Result Value us-core-3: SHALL use UCUM for coded quantity units. | ΣC | 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. |
| ||||||||
dataAbsentReason | SC | 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. |
| ||||||||
interpretation | 0..* | CodeableConcept | High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations. | 0..* | CodeableConcept | Currently not used in CognitiveStatus. Binding: ?? (extensible): Codes identifying interpretations of observations. | |||||||||||
note | 0..* | Annotation | Comments about the observation | 0..* | Annotation | Comments about the observation | |||||||||||
bodySite | 0..1 | CodeableConcept | Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality. | 0..1 | CodeableConcept | Currently not used in CognitiveStatus. Binding: ?? (example): Codes describing anatomical locations. May include laterality. | |||||||||||
method | 0..1 | CodeableConcept | How it was done Binding: ?? (example): Methods for simple observations. | 0..1 | CodeableConcept | Currently not used in CognitiveStatus. Binding: ?? (example): Methods for simple observations. | |||||||||||
specimen | 0..1 | Reference(Specimen) | Specimen used for this observation | 0..1 | Reference(Specimen) | Currently not used in CognitiveStatus. | |||||||||||
device | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device | 0..1 | Reference(Device | DeviceMetric) | Currently not used in CognitiveStatus. | |||||||||||
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text | 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 | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
low | C | 0..1 | ?? | Low Range, if relevant | C | 0..1 | ?? | Low Range, if relevant | |||||||||
high | C | 0..1 | ?? | High Range, if relevant | C | 0..1 | ?? | High Range, if relevant | |||||||||
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. | |||||||||||
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. | |||||||||||
age | 0..1 | Range | Applicable age range, if relevant | 0..1 | Range | Applicable age range, if relevant | |||||||||||
text | 0..1 | string | Text based reference range in an observation | 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 | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Currently not used in CognitiveStatus. | |||||||||
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | SΣ | 0..* | Reference(SDC Questionnaire Response) | Should point back to the SDC QuestionnaireResponse that this resource is derived from. |
| ||||||||
component | Σ | 0..* | BackboneElement | Component results | Σ | 0..* | BackboneElement | Currently not used in CognitiveStatus. | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations. | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations. | |||||||||
value[x] | Σ | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result | Σ | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result | |||||||||
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. | |||||||||
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. | |||||||||||
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 |