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

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/Observation
copyright	Used by permission of HL7 International, all rights reserved Creative Commons License		Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date	2024-09-13	2025-08-04T20:07:18+00:00	Values Differ
description	The US Core Observation Advance Directive Information (ADI) Documentation Profile inherits from the FHIR [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile and the [US Core Observation ADI DocumentationReference Profile](StructureDefinition-us-core-adi-documentreference.html) meet the [U.S. Core Data for Interoperability (USCDI)](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi) *Advance Directive Observation* Data Element requirements. It is used to communicate whether a person has advance directive information (ADI) and, if one or more documents exist, their location. Examples of advance healthcare directive documents include physician order for life sustaining treatment (POLST), do not resuscitate order (DNR), and medical power of attorney. To communicate the type of advance directive document, the author, the verifier, and other properties, see the US Core ADI DocumentReference Profile. This profile sets minimum expectations for the Observation resource to record, search, and fetch findings about the presence of a patient's advance directives. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.	This profile is used to represent a patient's decisional capacity for medical decision-making.	Values Differ
experimental	false
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreObservationADIDocumentationProfile	ADIDecisionalCapacity	Values Differ
publisher	HL7 International / Cross-Group Projects	HL7 International / Patient Empowerment	Values Differ
purpose
status	active
title	US Core Observation ADI Documentation Profile	ADI Decisional Capacity	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-adi-documentation	http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DecisionalCapacity	Values Differ
version	8.0.0	2.0.0-ballot	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
Observation	C	0..*	Observation	US Core Observation ADI Presence Profile	C	0..*	Observation	Measurements and simple assertions
id	Σ	0..1	id	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? 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		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		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation.	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation. Required Pattern: final	Elements differ in definition for mustSupport: 'true' vs 'false'
Slices for category	S	0..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ?? (preferred): FHIR and US Core codes for high level observation categories.	S	1..1	CodeableConcept	Classification of type of observation Binding: ?? (preferred): Codes for high level observation categories. Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/observation-category","code":"survey"}]}	Element minimum cardinalities differ: '0' vs '1' Element maximum cardinalities differ: '2147483647' vs '1' Example/preferred bindings differ at Observation.category using binding from USCoreObservationADIDocumentationProfile
code	SΣ	1..1	CodeableConcept	Observation ADI Documentation code Binding: ?? (example): Codes identifying names of simple observations. Required Pattern: {"coding":[{"system":"http://loinc.org","code":"45473-6"}]}	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: ?? (example): Codes identifying names of simple observations. Required Pattern: {"coding":[{"system":"http://snomed.info/sct","code":"551781000124102"}]}
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	Σ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	Elements differ in definition for mustSupport: 'true' vs 'false'
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record	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	Σ	0..0			Element maximum cardinalities differ: '1' vs '0'
effective[x]	Σ	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation	Σ	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation
issued	SΣ	0..1	instant	Date/Time this observation was made available	Σ	0..1	instant	Date/Time this version was made available	Elements differ in definition for mustSupport: 'true' vs 'false'
performer	SΣ	0..*	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Who is responsible for the observation	Σ	0..*	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile)	Who is responsible for the observation	Elements differ in definition for mustSupport: 'true' vs 'false'
value[x]	SΣC	0..1	CodeableConcept	Actual result Binding: ?? (required): Answer Set with Yes No and Unknowns	ΣC	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this	Elements differ in definition for mustSupport: 'true' vs 'false'
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	C	0..1	CodeableConcept	Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality.		0..1	CodeableConcept	Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ?? (example): Methods for simple observations.		0..1	CodeableConcept	How it was done Binding: ?? (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	??	Low Range, if relevant	C	0..1	??	Low Range, if relevant
high	C	0..1	??	High Range, if relevant	C	0..1	??	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations.	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations.
value[x]	Σ	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result	Σ	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	C	0..1	CodeableConcept	Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	??	Low Range, if relevant	C	0..1	??	Low Range, if relevant
high	C	0..1	??	High Range, if relevant	C	0..1	??	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation		0..1	string	Text based reference range in an observation
Documentation for this format