SDOH Clinical Care
3.0.0 - STU 3

SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions

## Resource Profile: SDOHCC Observation Screening Response

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse | Version: 3.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: SDOHCCObservationScreeningResponse

Profile for observations that represent question and answer pairs from Social Determinants of Health (SDOH) screening instruments.

### Purpose

SDOHCC Observation Screening Response (OSR) is intended to represent question-answer pairs from Social Determinants of Health (SDOH) assessment instruments. An OSR that identifies a social risk or need can be referenced as evidence for an SDOHCC Condition. Additionally, an OSR may be addressed by, or be the outcome of, an SDOHCC Goal, or the reason for an SDOHCC ServiceRequest or SDOHCC Procedure. See the Data Modeling Framework for more detail on the relationships between OSR and other profiles in this IG.

This IG focuses on a workflow where completed assessment instruments are captured using QuestionnaireResponse. To facilitate querying and searching, individual question-answer pairs from a QuestionnaireResponse can be converted into Observations. The decision as to which responses from a QuestionnaireResponse to convert into Observations will generally be driven by the usage need. For more information on this topic see Representing Assessment Instrument Data in a FHIR Format.

In the future, for standardized assessment instruments, a StructureMap instance would ideally be provided by a Questionnaire steward to ensure consistency in the Observations and Conditions (i.e., unconfirmed health concerns) generated from the assessment instrument. For more information on this topic, see Using StructureMap to Generate Observations or Conditions from QuestionnaireResponse.

### Usage

`Observation.code` has bindings to US Core Survey Codes (required) and `Observation.value` has bindings to LOINCCodes (preferred). `Observation.code` and `Observation.value` also have additional bindings to SDOH domain-specific value sets (e.g., for Food Insecurity, Inadequate Housing, etc.) which are determined by the value selected for `Observation.category`. If `Observation.category` references only one value from SDOHCC ValueSet SDOH Category (e.g., food-insecurity), `Observation.code` and `Observation.value` SHALL be selected from the corresponding domain-specific value set found in Additional Bindings. If more than one value is selected from SDOHCC ValueSet SDOH Category (e.g., food-insecurity and financial-insecurity) for `Observation.category`, then `Observation.code` and `Observation.value` SHALL be selected from one of the corresponding domain-specific value sets found in Additional Bindings (e.g. Food Insecurity Screening Assessments And Questions for `Observation.code` and Food Insecurity Screening Assessments Answers for `Observation.value`).

Occasionally, questions that are reused across different assessment instruments are represented by the same LOINC code, but the question’s allowed answer set may vary on different assessment instruments. Therefore, the allowed answer set (for `Observation.value`) for a question (`Observation.code`) is determined by the assessment instrument. For this reason, Gravity provides downloadable Assessment Instrument Spreadsheets that link Gravity-vetted questions to the assessment instruments from which they were chosen and their allowed answer sets. For access to the Spreadsheets and more information on this topic, see Social Risk Terminology Value Sets on the Gravity Confluence site and specifically the Assessment Instruments Spreadsheet Guidance document.

Of note, Gravity Project is continuously developing terminology for new SDOH domains. Sometimes a new SDOH domain may already be represented by a category code in SDOHCC ValueSet SDOH Category, but a domain-specific value set may not yet be available in VSAC. In this case, the Additional Binding for the new SDOH domain/category is the default binding for the profile element. Additionally, sometimes a domain-specific value set for a new domain is available in VSAC but does not yet include all standardized codes identified during the domain’s terminology development cycle. In this case, the value set’s “Description” tab in VSAC will state, “In progress”. If a domain-specific value set is available in VSAC but does not yet include all standardized codes identified during the domain’s terminology development cycle, the value set’s VSAC “Description” tab will state, “In progress”. Additional information related to Gravity value sets is provided on the Social Risk Terminology Value Sets page on the Gravity Project Confluence site.

Additionally, some SDOH domains may not yet be represented in SDOHCC ValueSet SDOH Category. In this case, `Observation.category`: sdoh-category-unspecified can be used and, if desired, `Observation.category.text` can also be used to further specify the domain. For example, at the time of publication of this IG, “disability-status” is not yet included in SDOHCC ValueSet SDOH Category. In this case, `Observation.category`: sdoh-category-unspecified can be used along with `Observation.category.text`: Disability Status. For `Observation.category`: sdoh-category-unspecified, there will not be domain-specific value sets and Additional Bindings for `Observation.code` and `Observation.value` will be the default bindings to US Core Survey Codes (required) and LOINCCodes (preferred) respectively.

For more information on the correlation between `Observation.category` and the domain-specific value sets in Additional Bindings for `Observation.code` and `Observation.value`, see Gravity Project Value Sets.

When `Observation.category` is used to tag Observations by SDOH domain (e.g., Food Insecurity, Housing Instability), `Observation.interpretation`: POS (Positive) can be used to flag Observations that might represent a health-related social need (HRSN) in the specified SDOH domain(s) (see SDOHCC Observation Response Hunger Vital Sign Question 3 Example). For more information on the use of `Observation.category` and `Observation.interpretation` and their interplay when used with OSR, see Additional Guidance on SDOHCC Observation Screening Response Elements.

Observation can also reference other artifacts. For example:

- If a question-answer pair is not answered directly on an assessment instrument (e.g., when a score or value is based on other question-answer pairs), OSR can reference one or more other OSRs via `Observation.derivedFrom` (see SDOHCC Observation Response NHANES Question 6 Example).
- If assessment instrument context is needed, Observations generated from a QuestionnaireResponse can reference QuestionnaireResponse via `Observation.derivedFrom`.
- In addition to representing instances of question-answer pairs, SDOHCC Observation Screening Response can be used as an Observation Grouping that, via `Observation.member`, references the OSR instances that result from a completed assessment instrument. For this reason, in addition to codes that represent questions, the value sets bound to `Observation.code` include codes that represent assessment instruments (LOINC panel codes). For an Observation Grouping, `Observation.code` SHALL be a LOINC panel code and `Observation.member` SHALL reference the OSR instances generated from that LOINC panel (assessment instrument). Observation Grouping is most useful when additional assessment instrument context is needed and a QuestionnaireResponse has not been created. For more information on Observation Grouping, see Using Observation Screening Response to Group Observations.

Usages:

- Refer to this Profile: SDOHCC Condition, SDOHCC Goal, SDOHCC Observation Screening Response, SDOHCC Procedure... Show 2 more, SDOHCC ServiceRequest and SDOHCC Task For Referral Management
- Examples for this Profile: Observation/SDOHCC-ObservationResponseHungerVitalSignQuestion3Example, Observation/SDOHCC-ObservationResponseNHANESGroupingExample, Observation/SDOHCC-ObservationResponseNHANESQuestion1Example, Observation/SDOHCC-ObservationResponseNHANESQuestion2Example... Show 8 more, Observation/SDOHCC-ObservationResponseNHANESQuestion3Example, Observation/SDOHCC-ObservationResponseNHANESQuestion4Example, Observation/SDOHCC-ObservationResponseNHANESQuestion5Example, Observation/SDOHCC-ObservationResponseNHANESQuestion6Example, Observation/SDOHCC-ObservationResponsePRAPAREChildCareNeedExample, Observation/SDOHCC-ObservationResponsePRAPAREClothingNeedExample, Observation/SDOHCC-ObservationResponsePRAPAREEmploymentStatusExample and Observation/SDOHCC-ObservationResponsePRAPAREHousingStatusExample
- CapabilityStatements using this Profile: SDOHCC Coordination Platform, SDOHCC Patient Application, SDOHCC Referral Recipient, SDOHCC Referral Recipient - Light and SDOHCC Referral Source

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | USCoreObservationScreeningAssessmentProfile(7.0.0) | SDOH screening questionnaire observations Constraints: obs-6, obs-7, us-core-2, SDOH-Obs-4
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
Slices for category | S | 2..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey | S | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: survey
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
category:screening-assessment | S C | 1..* | CodeableConcept | Requires at least a category code 'sdoh' Binding: USCoreScreeningAssessmentObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:SDOHCC | S | 0..* | CodeableConcept | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: USCoreSurveyCodes (7.0.0) (required): Codes identifying names of simple observations.
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
Health Literacy Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
Social Connection Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
Utility Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who and/or what the observation is about
effective[x] | S Σ C | 1..1 |  | Clinically relevant time/time-period for observation Constraints: us-core-1
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
performer | S Σ | 0..* | Reference(US Core RelatedPerson Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core Practitioner Profile(7.0.0) | SDOHCC PractitionerRole | US Core Organization Profile(7.0.0) | US Core CareTeam Profile(7.0.0)) | Who is responsible for the observation
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this Constraints: us-core-3
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueQuantity | S Σ C | 0..1 | Quantity S | Actual result Binding: UnitsOfMeasureCaseSensitive (3.0.0) (required): This is the entire UCUM code set. Constraints: us-core-3
value[x]:valueCodeableConcept | S Σ C | 0..1 | CodeableConcept S | Actual result Binding: LOINCCodes (preferred): This value set includes all LOINC codes
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
HealthLiteracyScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
SocialConnectionScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
UtilityInsecurityScreeningAssessmentsAnswers (20240524) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
Constraints: us-core-3
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Slices for hasMember | S Σ | 0..* | Reference(US Core Observation Screening Assessment Profile(7.0.0) S | QuestionnaireResponse | MolecularSequence) | References the child observations of a grouping observation Slice: Unordered, Open by profile:$this.resolve()
hasMember:SupportedHasMember | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | For an Observation Grouping, the Observations generated from an assessment instrument
Slices for derivedFrom | S Σ | 0..* | Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | US Core Observation Screening Assessment Profile(7.0.0) S) | ADDITIONAL USCDI: Related Observation(s) or other resource the observation is made from Slice: Unordered, Open by profile:$this.resolve()
derivedFrom:SupportedDerivedFrom | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | Related questionnaire responses or observations that the observation is made from
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.status | required | SDOHCCValueSetObservationStatus `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus` From this IG
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:survey | preferred | Pattern Value: survey `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:screening-assessment | required | USCoreScreeningAssessmentObservationCategory `http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category|7.0.0`
Observation.category:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Observation.code | required | USCoreSurveyCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes|7.0.0`
Observation.value[x]:valueQuantity | required | UnitsOfMeasureCaseSensitive(a valid code from UCUM) `http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive|3.0.0`
Observation.value[x]:valueCodeableConcept | preferred | 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

#### Constraints

Id | Grade | Path(s) | Details | Requirements
SDOH-Obs-4 | error | Observation | At least one Observation.category SHALL be sdoh : category.where(coding.where(system = 'http://hl7.org/fhir/us/core/CodeSystem/us-core-category' and code='sdoh').exists()).exists() |
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() |
us-core-1 | error | Observation.effective[x] | Datetime must be at least to day. : $this is dateTime implies $this.toString().length() >= 10 |
us-core-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) |
us-core-3 | error | Observation.value[x], Observation.value[x]:valueQuantity, Observation.value[x]:valueCodeableConcept | SHALL use UCUM for coded quantity units. : ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org' |

This structure is derived from USCoreObservationScreeningAssessmentProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | USCoreObservationScreeningAssessmentProfile(7.0.0) | SDOH screening questionnaire observations Constraints: SDOH-Obs-4
status |  | 1..1 | code | final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
category |  | 2..* | CodeableConcept | Classification of type of observation
Slices for category |  |  |  | Content/Rules for all slices
category:screening-assessment | C | 1..* | CodeableConcept | Requires at least a category code 'sdoh'
category:SDOHCC | S | 0..* | CodeableConcept | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code |  | 1..1 | CodeableConcept | Type of observation (code / type) Binding: USCoreSurveyCodes (7.0.0) (required): Codes identifying names of simple observations.
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
Health Literacy Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
Social Connection Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
Utility Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
subject |  | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who and/or what the observation is about
effective[x] |  | 1..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer |  | 0..* | Reference(US Core RelatedPerson Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core Practitioner Profile(7.0.0) | SDOHCC PractitionerRole | US Core Organization Profile(7.0.0) | US Core CareTeam Profile(7.0.0)) | Who is responsible for the observation
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]:valueQuantity |  | 0..1 | Quantity | Actual result Binding: UnitsOfMeasureCaseSensitive (3.0.0) (required): This is the entire UCUM code set.
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Actual result Binding: LOINCCodes (preferred): This value set includes all LOINC codes
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
HealthLiteracyScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
SocialConnectionScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
UtilityInsecurityScreeningAssessmentsAnswers (20240524) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
bodySite |  | 0..0 |  |
specimen |  | 0..0 |  |
Slices for hasMember |  | 0..* | Reference(US Core Observation Screening Assessment Profile(7.0.0) | QuestionnaireResponse | MolecularSequence) | References the child observations of a grouping observation Slice: Unordered, Open by profile:$this.resolve()
hasMember:SupportedHasMember | S | 0..* | Reference(SDOHCC Observation Screening Response) | For an Observation Grouping, the Observations generated from an assessment instrument
Slices for derivedFrom |  | 0..* | Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | US Core Observation Screening Assessment Profile(7.0.0)) | ADDITIONAL USCDI: Related Observation(s) or other resource the observation is made from Slice: Unordered, Open by profile:$this.resolve()
derivedFrom:SupportedDerivedFrom | S | 0..* | Reference(SDOHCC Observation Screening Response) | Related questionnaire responses or observations that the observation is made from
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Observation.status | required | SDOHCCValueSetObservationStatus `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus` From this IG
Observation.category:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Observation.code | required | USCoreSurveyCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes|7.0.0`
Observation.value[x]:valueQuantity | required | UnitsOfMeasureCaseSensitive(a valid code from UCUM) `http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive|3.0.0`
Observation.value[x]:valueCodeableConcept | preferred | LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
SDOH-Obs-4 | error | Observation | At least one Observation.category SHALL be sdoh : category.where(coding.where(system = 'http://hl7.org/fhir/us/core/CodeSystem/us-core-category' and code='sdoh').exists()).exists() |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | USCoreObservationScreeningAssessmentProfile(7.0.0) | SDOH screening questionnaire observations Constraints: obs-6, obs-7, us-core-2, SDOH-Obs-4
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 | ?!S Σ | 1..1 | code | final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
Slices for category | S | 2..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey | S | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: survey
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
category:screening-assessment | S C | 1..* | CodeableConcept | Requires at least a category code 'sdoh' Binding: USCoreScreeningAssessmentObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:SDOHCC | S | 0..* | CodeableConcept | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: USCoreSurveyCodes (7.0.0) (required): Codes identifying names of simple observations.
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
Health Literacy Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
Social Connection Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
Utility Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who and/or what the observation is about
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | S Σ C | 1..1 |  | Clinically relevant time/time-period for observation Constraints: us-core-1
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 0..* | Reference(US Core RelatedPerson Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core Practitioner Profile(7.0.0) | SDOHCC PractitionerRole | US Core Organization Profile(7.0.0) | US Core CareTeam Profile(7.0.0)) | Who is responsible for the observation
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this Constraints: us-core-3
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueQuantity | S Σ C | 0..1 | Quantity S | Actual result Binding: UnitsOfMeasureCaseSensitive (3.0.0) (required): This is the entire UCUM code set. Constraints: us-core-3
value[x]:valueCodeableConcept | S Σ C | 0..1 | CodeableConcept S | Actual result Binding: LOINCCodes (preferred): This value set includes all LOINC codes
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
HealthLiteracyScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
SocialConnectionScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
UtilityInsecurityScreeningAssessmentsAnswers (20240524) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
Constraints: us-core-3
dataAbsentReason | S 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
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
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 | 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
Slices for hasMember | S Σ | 0..* | Reference(US Core Observation Screening Assessment Profile(7.0.0) S | QuestionnaireResponse | MolecularSequence) | References the child observations of a grouping observation Slice: Unordered, Open by profile:$this.resolve()
hasMember:SupportedHasMember | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | For an Observation Grouping, the Observations generated from an assessment instrument
Slices for derivedFrom | S Σ | 0..* | Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | US Core Observation Screening Assessment Profile(7.0.0) S) | ADDITIONAL USCDI: Related Observation(s) or other resource the observation is made from Slice: Unordered, Open by profile:$this.resolve()
derivedFrom:SupportedDerivedFrom | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | Related questionnaire responses or observations that the observation is made from
component | Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | SDOHCCValueSetObservationStatus `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus` From this IG
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:survey | preferred | Pattern Value: survey `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:screening-assessment | required | USCoreScreeningAssessmentObservationCategory `http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category|7.0.0`
Observation.category:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Observation.code | required | USCoreSurveyCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes|7.0.0`
Observation.value[x]:valueQuantity | required | UnitsOfMeasureCaseSensitive(a valid code from UCUM) `http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive|3.0.0`
Observation.value[x]:valueCodeableConcept | preferred | 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.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

#### Constraints

Id | Grade | Path(s) | Details | Requirements
SDOH-Obs-4 | error | Observation | At least one Observation.category SHALL be sdoh : category.where(coding.where(system = 'http://hl7.org/fhir/us/core/CodeSystem/us-core-category' and code='sdoh').exists()).exists() |
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() |
us-core-1 | error | Observation.effective[x] | Datetime must be at least to day. : $this is dateTime implies $this.toString().length() >= 10 |
us-core-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) |
us-core-3 | error | Observation.value[x], Observation.value[x]:valueQuantity, Observation.value[x]:valueCodeableConcept | SHALL use UCUM for coded quantity units. : ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org' |

This structure is derived from USCoreObservationScreeningAssessmentProfile

Summary

Mandatory: 2 elements
Must-Support: 3 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)
- US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson|7.0.0)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0)
- SDOHCC PractitionerRole (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-practitionerrole)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|7.0.0)
- US Core CareTeam Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam|7.0.0)
- SDOHCC Observation Screening Response (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse)
- US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|7.0.0)
- US Core QuestionnaireResponse Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|7.0.0)
- US Core Observation Screening Assessment Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment|7.0.0)

Slices

This structure defines the following Slices:

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

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | USCoreObservationScreeningAssessmentProfile(7.0.0) | SDOH screening questionnaire observations Constraints: obs-6, obs-7, us-core-2, SDOH-Obs-4
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
Slices for category | S | 2..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey | S | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: survey
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
category:screening-assessment | S C | 1..* | CodeableConcept | Requires at least a category code 'sdoh' Binding: USCoreScreeningAssessmentObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:SDOHCC | S | 0..* | CodeableConcept | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: USCoreSurveyCodes (7.0.0) (required): Codes identifying names of simple observations.
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
Health Literacy Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
Social Connection Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
Utility Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who and/or what the observation is about
effective[x] | S Σ C | 1..1 |  | Clinically relevant time/time-period for observation Constraints: us-core-1
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
performer | S Σ | 0..* | Reference(US Core RelatedPerson Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core Practitioner Profile(7.0.0) | SDOHCC PractitionerRole | US Core Organization Profile(7.0.0) | US Core CareTeam Profile(7.0.0)) | Who is responsible for the observation
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this Constraints: us-core-3
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueQuantity | S Σ C | 0..1 | Quantity S | Actual result Binding: UnitsOfMeasureCaseSensitive (3.0.0) (required): This is the entire UCUM code set. Constraints: us-core-3
value[x]:valueCodeableConcept | S Σ C | 0..1 | CodeableConcept S | Actual result Binding: LOINCCodes (preferred): This value set includes all LOINC codes
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
HealthLiteracyScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
SocialConnectionScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
UtilityInsecurityScreeningAssessmentsAnswers (20240524) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
Constraints: us-core-3
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Slices for hasMember | S Σ | 0..* | Reference(US Core Observation Screening Assessment Profile(7.0.0) S | QuestionnaireResponse | MolecularSequence) | References the child observations of a grouping observation Slice: Unordered, Open by profile:$this.resolve()
hasMember:SupportedHasMember | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | For an Observation Grouping, the Observations generated from an assessment instrument
Slices for derivedFrom | S Σ | 0..* | Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | US Core Observation Screening Assessment Profile(7.0.0) S) | ADDITIONAL USCDI: Related Observation(s) or other resource the observation is made from Slice: Unordered, Open by profile:$this.resolve()
derivedFrom:SupportedDerivedFrom | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | Related questionnaire responses or observations that the observation is made from
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.status | required | SDOHCCValueSetObservationStatus `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus` From this IG
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:survey | preferred | Pattern Value: survey `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:screening-assessment | required | USCoreScreeningAssessmentObservationCategory `http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category|7.0.0`
Observation.category:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Observation.code | required | USCoreSurveyCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes|7.0.0`
Observation.value[x]:valueQuantity | required | UnitsOfMeasureCaseSensitive(a valid code from UCUM) `http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive|3.0.0`
Observation.value[x]:valueCodeableConcept | preferred | 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

#### Constraints

Id | Grade | Path(s) | Details | Requirements
SDOH-Obs-4 | error | Observation | At least one Observation.category SHALL be sdoh : category.where(coding.where(system = 'http://hl7.org/fhir/us/core/CodeSystem/us-core-category' and code='sdoh').exists()).exists() |
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() |
us-core-1 | error | Observation.effective[x] | Datetime must be at least to day. : $this is dateTime implies $this.toString().length() >= 10 |
us-core-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) |
us-core-3 | error | Observation.value[x], Observation.value[x]:valueQuantity, Observation.value[x]:valueCodeableConcept | SHALL use UCUM for coded quantity units. : ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org' |

Differential View

This structure is derived from USCoreObservationScreeningAssessmentProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | USCoreObservationScreeningAssessmentProfile(7.0.0) | SDOH screening questionnaire observations Constraints: SDOH-Obs-4
status |  | 1..1 | code | final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
category |  | 2..* | CodeableConcept | Classification of type of observation
Slices for category |  |  |  | Content/Rules for all slices
category:screening-assessment | C | 1..* | CodeableConcept | Requires at least a category code 'sdoh'
category:SDOHCC | S | 0..* | CodeableConcept | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code |  | 1..1 | CodeableConcept | Type of observation (code / type) Binding: USCoreSurveyCodes (7.0.0) (required): Codes identifying names of simple observations.
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
Health Literacy Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
Social Connection Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
Utility Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
subject |  | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who and/or what the observation is about
effective[x] |  | 1..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer |  | 0..* | Reference(US Core RelatedPerson Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core Practitioner Profile(7.0.0) | SDOHCC PractitionerRole | US Core Organization Profile(7.0.0) | US Core CareTeam Profile(7.0.0)) | Who is responsible for the observation
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]:valueQuantity |  | 0..1 | Quantity | Actual result Binding: UnitsOfMeasureCaseSensitive (3.0.0) (required): This is the entire UCUM code set.
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Actual result Binding: LOINCCodes (preferred): This value set includes all LOINC codes
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
HealthLiteracyScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
SocialConnectionScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
UtilityInsecurityScreeningAssessmentsAnswers (20240524) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
bodySite |  | 0..0 |  |
specimen |  | 0..0 |  |
Slices for hasMember |  | 0..* | Reference(US Core Observation Screening Assessment Profile(7.0.0) | QuestionnaireResponse | MolecularSequence) | References the child observations of a grouping observation Slice: Unordered, Open by profile:$this.resolve()
hasMember:SupportedHasMember | S | 0..* | Reference(SDOHCC Observation Screening Response) | For an Observation Grouping, the Observations generated from an assessment instrument
Slices for derivedFrom |  | 0..* | Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | US Core Observation Screening Assessment Profile(7.0.0)) | ADDITIONAL USCDI: Related Observation(s) or other resource the observation is made from Slice: Unordered, Open by profile:$this.resolve()
derivedFrom:SupportedDerivedFrom | S | 0..* | Reference(SDOHCC Observation Screening Response) | Related questionnaire responses or observations that the observation is made from
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Observation.status | required | SDOHCCValueSetObservationStatus `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus` From this IG
Observation.category:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Observation.code | required | USCoreSurveyCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes|7.0.0`
Observation.value[x]:valueQuantity | required | UnitsOfMeasureCaseSensitive(a valid code from UCUM) `http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive|3.0.0`
Observation.value[x]:valueCodeableConcept | preferred | LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
SDOH-Obs-4 | error | Observation | At least one Observation.category SHALL be sdoh : category.where(coding.where(system = 'http://hl7.org/fhir/us/core/CodeSystem/us-core-category' and code='sdoh').exists()).exists() |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | USCoreObservationScreeningAssessmentProfile(7.0.0) | SDOH screening questionnaire observations Constraints: obs-6, obs-7, us-core-2, SDOH-Obs-4
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 | ?!S Σ | 1..1 | code | final | corrected | entered-in-error | unknown Binding: SDOHCC ValueSet Observation Status (required)
Slices for category | S | 2..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey | S | 1..1 | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: survey
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
category:screening-assessment | S C | 1..* | CodeableConcept | Requires at least a category code 'sdoh' Binding: USCoreScreeningAssessmentObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:SDOHCC | S | 0..* | CodeableConcept | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: USCoreSurveyCodes (7.0.0) (required): Codes identifying names of simple observations.
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
Health Literacy Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
Social Connection Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
Utility Insecurity Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments And Questions | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
USCoreSurveyCodes (7.0.0) | Required | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who and/or what the observation is about
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | S Σ C | 1..1 |  | Clinically relevant time/time-period for observation Constraints: us-core-1
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 0..* | Reference(US Core RelatedPerson Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core Practitioner Profile(7.0.0) | SDOHCC PractitionerRole | US Core Organization Profile(7.0.0) | US Core CareTeam Profile(7.0.0)) | Who is responsible for the observation
Slices for value[x] | S Σ C | 0..1 |  | Actual result Slice: Unordered, Open by type:$this Constraints: us-core-3
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
value[x]:valueQuantity | S Σ C | 0..1 | Quantity S | Actual result Binding: UnitsOfMeasureCaseSensitive (3.0.0) (required): This is the entire UCUM code set. Constraints: us-core-3
value[x]:valueCodeableConcept | S Σ C | 0..1 | CodeableConcept S | Actual result Binding: LOINCCodes (preferred): This value set includes all LOINC codes
Additional Bindings | Purpose | Usage
Digital Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = digital-access
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = digital-literacy
Less Than High School Education Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = educational-attainment
Elder Abuse Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = elder-abuse
Unemployment Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = employment-status
Financial Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = financial-insecurity
Food Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = food-insecurity
Health Insurance Coverage Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = health-insurance-coverage-status
Homelessness Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = homelessness
Housing Instability Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = housing-instability
Inadequate Housing Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = inadequate-housing
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = incarceration-status
Intimate Partner Violence Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = intimate-partner-violence
Language Access Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = language-access
Material Hardship Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = material-hardship
Medical Cost Burden Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = medical-cost-burden
HealthLiteracyScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = personal-health-literacy
SocialConnectionScreeningAssessmentsAnswers (20231205) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = social-connection
Stress Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = stress
Transportation Insecurity Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = transportation-insecurity
UtilityInsecurityScreeningAssessmentsAnswers (20240524) | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = utility-insecurity
Veteran Status Screening Assessments Answers | Extensible | SDOHCCObservationScreeningResponse#`Observation.category` = veteran-status
LOINCCodes | Preferred | SDOHCCObservationScreeningResponse#`Observation.category` = sdoh-category-unspecified
Constraints: us-core-3
dataAbsentReason | S 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
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
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 | 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
Slices for hasMember | S Σ | 0..* | Reference(US Core Observation Screening Assessment Profile(7.0.0) S | QuestionnaireResponse | MolecularSequence) | References the child observations of a grouping observation Slice: Unordered, Open by profile:$this.resolve()
hasMember:SupportedHasMember | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | For an Observation Grouping, the Observations generated from an assessment instrument
Slices for derivedFrom | S Σ | 0..* | Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | US Core Observation Screening Assessment Profile(7.0.0) S) | ADDITIONAL USCDI: Related Observation(s) or other resource the observation is made from Slice: Unordered, Open by profile:$this.resolve()
derivedFrom:SupportedDerivedFrom | S Σ | 0..* | Reference(SDOHCC Observation Screening Response) | Related questionnaire responses or observations that the observation is made from
component | Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Observation.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | SDOHCCValueSetObservationStatus `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus` From this IG
Observation.category | preferred | ObservationCategoryCodes `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:survey | preferred | Pattern Value: survey `http://hl7.org/fhir/ValueSet/observation-category` From the FHIR Standard
Observation.category:screening-assessment | required | USCoreScreeningAssessmentObservationCategory `http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category|7.0.0`
Observation.category:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Observation.code | required | USCoreSurveyCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes|7.0.0`
Observation.value[x]:valueQuantity | required | UnitsOfMeasureCaseSensitive(a valid code from UCUM) `http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive|3.0.0`
Observation.value[x]:valueCodeableConcept | preferred | 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.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

#### Constraints

Id | Grade | Path(s) | Details | Requirements
SDOH-Obs-4 | error | Observation | At least one Observation.category SHALL be sdoh : category.where(coding.where(system = 'http://hl7.org/fhir/us/core/CodeSystem/us-core-category' and code='sdoh').exists()).exists() |
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() |
us-core-1 | error | Observation.effective[x] | Datetime must be at least to day. : $this is dateTime implies $this.toString().length() >= 10 |
us-core-2 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists()) |
us-core-3 | error | Observation.value[x], Observation.value[x]:valueQuantity, Observation.value[x]:valueCodeableConcept | SHALL use UCUM for coded quantity units. : ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org' |

This structure is derived from USCoreObservationScreeningAssessmentProfile

Summary

Mandatory: 2 elements
Must-Support: 3 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)
- US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson|7.0.0)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0)
- SDOHCC PractitionerRole (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-practitionerrole)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|7.0.0)
- US Core CareTeam Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam|7.0.0)
- SDOHCC Observation Screening Response (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse)
- US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|7.0.0)
- US Core QuestionnaireResponse Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|7.0.0)
- US Core Observation Screening Assessment Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment|7.0.0)

Slices

This structure defines the following Slices:

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

Maturity: 2

Other representations of profile: CSV, Excel, Schematron