Personal Health Device Implementation Guide
2.0.1 - STU 2
Personal Health Device Implementation Guide
2.0.1 - STU 2
Personal Health Device Implementation Guide, published by HL7 International / Devices. This guide is not an authorized publication; it is the continuous build for version 2.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/phd/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/uv/phd/StructureDefinition/PhdCoincidentTimeStampObservation | Version: 2.0.1 | ||||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: PhdCoincidentTimeStampObservation | |||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.73.42.6 | |||||
Observations containing a coincident timestamp.
The Coincident Timestamp Observation Profile is used to compare the timelines of the PHD with the timeline of the PHG. The primary elements are the Observation.effectiveDateTime, which has the time of the PHG at the moment of generating the observation, and the Observation.valueDateTime or Observation.valueQuantity, which has the corresponding time of the PHD. The valueDateTime is used when the PHD uses a time-of-day clock, and the valueQuantity is used when the PHD uses a tick counter (relative time). The PHG reports its current time at the time it reads the (current) time of the PHD.
In remote patient monitoring, data can arrive from any location on the planet. Given that PHDs can be unsynchronized, have time clocks set by the user, default factory times, or no time clock at all, providing accurate timestamps in the Observation resources is a challenge. The Coincident Timestamp Observation provides a mechanism to report the PHD clock status and links it to the timeline of the PHG.
For more details on the interpretation of the Coincident Timestamp, see the notes section below.
A PHD Observation may reference a Coincident Timestamp Observation if the measurement reported from the PHD contains a timestamp and is from the current timeline of the PHD and needed correction. It will not reference a Coincident Timestamp Observation if the measurement reported from the PHD contains no timestamp or is from an older timeline after which a time adjustment occurred.
A Coincident Timestamp Observation is created for every connection between PHG and PHD, so data duplication is not an issue. Therefore, the conditional create identifier element is not used in this profile.
If a PHD has its time clock altered during a connection, a new Coincident Timestamp Observation is generated, and all data sent after the adjustment will reference the new Coincident Timestamp Observation.
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  Observation |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 |
  implicitRules |
0..1 | uri | A set of rules under which this content was created | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final | |
  code |
1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |
   Slices for coding |
1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
   coding:MDCType |
1..1 | Coding | The type of time clock used by the PHD Binding: MDC Clock Types (required) | |
 subject |
1..1 | Reference(PhdDevice) | Reference to the PHD device for which the coincident timestamp measurement is reported | |
 reference |
C | 1..1 | string | Literal reference, Relative, internal or absolute URL |
 effective[x] |
0..1 | The current time of the PHG at the current time of the PHD. Absent if PHD is better synchronized | ||
| effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| effectiveTiming |
Timing | |||
| effectiveInstant |
instant | |||
| value[x] |
C | 0..1 | The current time of the PHD as a wallclock time (dateTime), relative time (Quantity), or if a time fault a dataAbsentReason | |
| valueQuantity |
Quantity | |||
| valueDateTime |
dateTime | |||
| device |
1..1 | Reference(PhgDevice) | (Measurement) Device | |
| reference |
C | 1..1 | string | Reference to the PHG device responsible for the coincident timestamp measurement |
| Slices for component |
0..* | BackboneElement | Component results Slice: Unordered, Open by value:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
  component:All Slices |
Content/Rules for all slices | |||
  modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |
 component:clockSyncMethod |
0..1 | BackboneElement | Clock Synchronization Method: The method used to synchronize the clock. | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
 code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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: urn:iso:std:iso:11073:10101 | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 68220 | |
| 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 | |
| Slices for value[x] |
0..1 | Actual component result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view | ||
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
 Slices for value[x] |
Content/Rules for all slices | |||
| value[x]:valueCodeableConcept |
0..1 | CodeableConcept | The clock synchronization method last used by the PHD/PHG to synchronize the clock of the PHD Binding: MDC Time Synchronization Methods (extensible) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.code.coding:MDCType | Base | required | MDC Clock Types | 📦2.0.1 | This IG |
| Observation.component.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.value[x]:valueCodeableConcept | Base | extensible | MDC Time Synchronization Methods | 📦2.0.1 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| 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()
|
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
0..* | Observation | Measurements and simple assertions | |
| status |
1..1 | code | registered | preliminary | final | amended + Fixed Value: final | |
| code |
||||
| Slices for coding |
1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:MDCType |
1..1 | Coding | The type of time clock used by the PHD Binding: MDC Clock Types (required) | |
| subject |
1..1 | Reference(PhdDevice) | Reference to the PHD device for which the coincident timestamp measurement is reported | |
| reference |
1..1 | string | Literal reference, Relative, internal or absolute URL | |
| focus |
0..0 | No focus in PHD. The coincident timestamp is not associated with a focus. | ||
| effective[x] |
0..1 | dateTime, Period, Timing, instant | The current time of the PHG at the current time of the PHD. Absent if PHD is better synchronized | |
| value[x] |
0..1 | The current time of the PHD as a wallclock time (dateTime), relative time (Quantity), or if a time fault a dataAbsentReason | ||
| valueQuantity |
Quantity | |||
| valueDateTime |
dateTime | |||
| dataAbsentReason |
||||
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:TimeFault |
0..1 | Coding | Time Fault: The PHD has a time fault Required Pattern: At least the following | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason | |
 code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: unknown | |
| specimen |
0..0 | No specimen in PHD. The coincident timestamp is not associated with a specimen. | ||
| device |
1..1 | Reference(PhgDevice) | (Measurement) Device | |
| reference |
1..1 | string | Reference to the PHG device responsible for the coincident timestamp measurement | |
| hasMember |
0..0 | No reference to a group observation in PHD. The coincident timestamp is not part of a group observation. | ||
| derivedFrom |
0..0 | No reference to a source observation in PHD. The coincident timestamp is not derived from another observation. | ||
| Slices for component |
0..* | BackboneElement | Component results Slice: Unordered, Open by value:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| component:clockSyncMethod |
0..1 | BackboneElement | Clock Synchronization Method: The method used to synchronize the clock. | |
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101 | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 68220 | |
| Slices for value[x] |
0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view | |
| Slices for value[x] |
Content/Rules for all slices | |||
| value[x]:valueCodeableConcept |
0..1 | CodeableConcept | The clock synchronization method last used by the PHD/PHG to synchronize the clock of the PHD Binding: MDC Time Synchronization Methods (extensible) | |
| dataAbsentReason |
0..0 | Why the component result is missing | ||
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.code.coding:MDCType | Base | required | MDC Clock Types | 📦2.0.1 | This IG |
| Observation.component:clockSyncMethod.value[x]:valueCodeableConcept | Base | extensible | MDC Time Synchronization Methods | 📦2.0.1 | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 | ||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
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.
| |||||
| 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 |
0..* | Identifier | Business Identifier for observation | |||||
| basedOn |
0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | |||||
| partOf |
0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | |||||
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final | |||||
| category |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code |
1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:MDCType |
1..1 | Coding | The type of time clock used by the PHD Binding: MDC Clock Types (required) | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subject |
1..1 | Reference(PhdDevice) | Reference to the PHD device for which the coincident timestamp measurement is reported | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
C | 1..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||
| identifier |
0..1 | Identifier | Logical reference, when literal reference is not known | |||||
| display |
0..1 | string | Text alternative for the resource | |||||
| encounter |
0..1 | Reference(Encounter) | Healthcare event during which this observation is made | |||||
| effective[x] |
0..1 | The current time of the PHG at the current time of the PHD. Absent if PHD is better synchronized | ||||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| effectiveTiming |
Timing | |||||||
| effectiveInstant |
instant | |||||||
| issued |
0..1 | instant | Date/Time this version was made available | |||||
| performer |
0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | |||||
| value[x] |
C | 0..1 | The current time of the PHD as a wallclock time (dateTime), relative time (Quantity), or if a time fault a dataAbsentReason | |||||
| valueQuantity |
Quantity | |||||||
| valueDateTime |
dateTime | |||||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:TimeFault |
0..1 | Coding | Time Fault: The PHD has a time fault Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: unknown | |||||
| 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 | |||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| note |
0..* | Annotation | Comments about the observation | |||||
| bodySite |
0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| method |
0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
| device |
1..1 | Reference(PhgDevice) | (Measurement) Device | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
C | 1..1 | string | Reference to the PHG device responsible for the coincident timestamp measurement | ||||
| type |
0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||
| identifier |
0..1 | Identifier | Logical reference, when literal reference is not known | |||||
| display |
0..1 | string | Text alternative for the resource | |||||
| 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 |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| low |
C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant Constraints: sqty-1 | ||||
| high |
C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant Constraints: sqty-1 | ||||
| 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 component |
0..* | BackboneElement | Component results Slice: Unordered, Open by value:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| component:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |||||
| value[x] |
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 | |||||
| component:clockSyncMethod |
0..1 | BackboneElement | Clock Synchronization Method: The method used to synchronize the clock. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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: urn:iso:std:iso:11073:10101 | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 68220 | |||||
| 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 | |||||
| Slices for value[x] |
0..1 | Actual component result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view | ||||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| Slices for value[x] |
Content/Rules for all slices | |||||||
| value[x]:valueCodeableConcept |
0..1 | CodeableConcept | The clock synchronization method last used by the PHD/PHG to synchronize the clock of the PHD Binding: MDC Time Synchronization Methods (extensible) | |||||
| 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 | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.code.coding:MDCType | Base | required | MDC Clock Types | 📦2.0.1 | This IG |
| Observation.subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std. |
| Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std. |
| Observation.device.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.value[x]:valueCodeableConcept | Base | extensible | MDC Time Synchronization Methods | 📦2.0.1 | This IG |
| Observation.component:clockSyncMethod.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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()
|
| sqty-1 | error | Observation.referenceRange.low, Observation.referenceRange.high | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
This structure is derived from Observation
Summary
Mandatory: 6 elements
Fixed: 1 element
Prohibited: 5 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Maturity: 2
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 |
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final | |
| code |
1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |
| Slices for coding |
1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:MDCType |
1..1 | Coding | The type of time clock used by the PHD Binding: MDC Clock Types (required) | |
| subject |
1..1 | Reference(PhdDevice) | Reference to the PHD device for which the coincident timestamp measurement is reported | |
| reference |
C | 1..1 | string | Literal reference, Relative, internal or absolute URL |
| effective[x] |
0..1 | The current time of the PHG at the current time of the PHD. Absent if PHD is better synchronized | ||
| effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| effectiveTiming |
Timing | |||
| effectiveInstant |
instant | |||
| value[x] |
C | 0..1 | The current time of the PHD as a wallclock time (dateTime), relative time (Quantity), or if a time fault a dataAbsentReason | |
| valueQuantity |
Quantity | |||
| valueDateTime |
dateTime | |||
| device |
1..1 | Reference(PhgDevice) | (Measurement) Device | |
| reference |
C | 1..1 | string | Reference to the PHG device responsible for the coincident timestamp measurement |
| Slices for component |
0..* | BackboneElement | Component results Slice: Unordered, Open by value:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| component:All Slices |
Content/Rules for all slices | |||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |
| component:clockSyncMethod |
0..1 | BackboneElement | Clock Synchronization Method: The method used to synchronize the clock. | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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: urn:iso:std:iso:11073:10101 | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 68220 | |
| 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 | |
| Slices for value[x] |
0..1 | Actual component result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view | ||
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| Slices for value[x] |
Content/Rules for all slices | |||
| value[x]:valueCodeableConcept |
0..1 | CodeableConcept | The clock synchronization method last used by the PHD/PHG to synchronize the clock of the PHD Binding: MDC Time Synchronization Methods (extensible) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.code.coding:MDCType | Base | required | MDC Clock Types | 📦2.0.1 | This IG |
| Observation.component.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.value[x]:valueCodeableConcept | Base | extensible | MDC Time Synchronization Methods | 📦2.0.1 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| 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()
|
Differential View
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
0..* | Observation | Measurements and simple assertions | |
| status |
1..1 | code | registered | preliminary | final | amended + Fixed Value: final | |
| code |
||||
| Slices for coding |
1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:MDCType |
1..1 | Coding | The type of time clock used by the PHD Binding: MDC Clock Types (required) | |
| subject |
1..1 | Reference(PhdDevice) | Reference to the PHD device for which the coincident timestamp measurement is reported | |
| reference |
1..1 | string | Literal reference, Relative, internal or absolute URL | |
| focus |
0..0 | No focus in PHD. The coincident timestamp is not associated with a focus. | ||
| effective[x] |
0..1 | dateTime, Period, Timing, instant | The current time of the PHG at the current time of the PHD. Absent if PHD is better synchronized | |
| value[x] |
0..1 | The current time of the PHD as a wallclock time (dateTime), relative time (Quantity), or if a time fault a dataAbsentReason | ||
| valueQuantity |
Quantity | |||
| valueDateTime |
dateTime | |||
| dataAbsentReason |
||||
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:TimeFault |
0..1 | Coding | Time Fault: The PHD has a time fault Required Pattern: At least the following | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: unknown | |
| specimen |
0..0 | No specimen in PHD. The coincident timestamp is not associated with a specimen. | ||
| device |
1..1 | Reference(PhgDevice) | (Measurement) Device | |
| reference |
1..1 | string | Reference to the PHG device responsible for the coincident timestamp measurement | |
| hasMember |
0..0 | No reference to a group observation in PHD. The coincident timestamp is not part of a group observation. | ||
| derivedFrom |
0..0 | No reference to a source observation in PHD. The coincident timestamp is not derived from another observation. | ||
| Slices for component |
0..* | BackboneElement | Component results Slice: Unordered, Open by value:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| component:clockSyncMethod |
0..1 | BackboneElement | Clock Synchronization Method: The method used to synchronize the clock. | |
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101 | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 68220 | |
| Slices for value[x] |
0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view | |
| Slices for value[x] |
Content/Rules for all slices | |||
| value[x]:valueCodeableConcept |
0..1 | CodeableConcept | The clock synchronization method last used by the PHD/PHG to synchronize the clock of the PHD Binding: MDC Time Synchronization Methods (extensible) | |
| dataAbsentReason |
0..0 | Why the component result is missing | ||
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.code.coding:MDCType | Base | required | MDC Clock Types | 📦2.0.1 | This IG |
| Observation.component:clockSyncMethod.value[x]:valueCodeableConcept | Base | extensible | MDC Time Synchronization Methods | 📦2.0.1 | This IG |
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7 | ||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
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.
| |||||
| 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 |
0..* | Identifier | Business Identifier for observation | |||||
| basedOn |
0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | |||||
| partOf |
0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | |||||
| status |
1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final | |||||
| category |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code |
1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:MDCType |
1..1 | Coding | The type of time clock used by the PHD Binding: MDC Clock Types (required) | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subject |
1..1 | Reference(PhdDevice) | Reference to the PHD device for which the coincident timestamp measurement is reported | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
C | 1..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||
| identifier |
0..1 | Identifier | Logical reference, when literal reference is not known | |||||
| display |
0..1 | string | Text alternative for the resource | |||||
| encounter |
0..1 | Reference(Encounter) | Healthcare event during which this observation is made | |||||
| effective[x] |
0..1 | The current time of the PHG at the current time of the PHD. Absent if PHD is better synchronized | ||||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| effectiveTiming |
Timing | |||||||
| effectiveInstant |
instant | |||||||
| issued |
0..1 | instant | Date/Time this version was made available | |||||
| performer |
0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | |||||
| value[x] |
C | 0..1 | The current time of the PHD as a wallclock time (dateTime), relative time (Quantity), or if a time fault a dataAbsentReason | |||||
| valueQuantity |
Quantity | |||||||
| valueDateTime |
dateTime | |||||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:TimeFault |
0..1 | Coding | Time Fault: The PHD has a time fault Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: unknown | |||||
| 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 | |||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| note |
0..* | Annotation | Comments about the observation | |||||
| bodySite |
0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| method |
0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
| device |
1..1 | Reference(PhgDevice) | (Measurement) Device | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
C | 1..1 | string | Reference to the PHG device responsible for the coincident timestamp measurement | ||||
| type |
0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||
| identifier |
0..1 | Identifier | Logical reference, when literal reference is not known | |||||
| display |
0..1 | string | Text alternative for the resource | |||||
| 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 |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| low |
C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant Constraints: sqty-1 | ||||
| high |
C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant Constraints: sqty-1 | ||||
| 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 component |
0..* | BackboneElement | Component results Slice: Unordered, Open by value:code Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| component:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | |||||
| value[x] |
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 | |||||
| component:clockSyncMethod |
0..1 | BackboneElement | Clock Synchronization Method: The method used to synchronize the clock. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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: urn:iso:std:iso:11073:10101 | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 68220 | |||||
| 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 | |||||
| Slices for value[x] |
0..1 | Actual component result Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view | ||||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| Slices for value[x] |
Content/Rules for all slices | |||||||
| value[x]:valueCodeableConcept |
0..1 | CodeableConcept | The clock synchronization method last used by the PHD/PHG to synchronize the clock of the PHD Binding: MDC Time Synchronization Methods (extensible) | |||||
| 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 | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.code.coding:MDCType | Base | required | MDC Clock Types | 📦2.0.1 | This IG |
| Observation.subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std. |
| Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std. |
| Observation.device.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std. |
| Observation.referenceRange.appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std. |
| Observation.component:clockSyncMethod.value[x]:valueCodeableConcept | Base | extensible | MDC Time Synchronization Methods | 📦2.0.1 | This IG |
| Observation.component:clockSyncMethod.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| 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()
|
| sqty-1 | error | Observation.referenceRange.low, Observation.referenceRange.high | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
This structure is derived from Observation
Summary
Mandatory: 6 elements
Fixed: 1 element
Prohibited: 5 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Maturity: 2
Other representations of profile: CSV, Excel, Schematron
Further notes on elements and the use of the PhdCoincidentTimeObservation resource:
The code element is used to report the type of time clock used by the PHD. The PHG obtains the type of time clock and its current setting by inspecting the PHD's measurement timestamp and the PHD's clock. The ACOM clock types are mapped as follows:
| ACOM clock type | Observation.code.coding |
|---|---|
| Wall Clock with DST and Time Zone offset | Mdc#68225 |
| Wall Clock without DST and Time Zone offset | Mdc#67975 |
| Time counter | Mdc#67983 |
Observation.effectiveDateTimeThe PHG is required to have the capability to report local time and offset to UTC. The PHG records its current time in the Observation.effectiveDateTime element regardless of the type of time clock used by the PHD unless the PHD has superior time synchronization than the PHG. In that case, the Observation.effective[x] element is not populated.
Observation.value[x]If the PHD uses a wall clock, the current time of the PHD is reported in an Observation.valueDateTime element. FHIR requires the presence of an offset to UTC, so if the PHD does not provide that, the PHG adds its offset to the value. It is reasonable to assume that the PHD and PHG are in the same time zone and thus have the same offset to UTC. However, PHDs can be mobile, and if the PHD is reporting an offset, the offset reported by the PHD is used even if it is NOT the offset of the PHG.
If the PHD uses a time counter, the current tick time is reported in an Observation.valueQuantity element scaled to microseconds or milliseconds as appropriate for the resolution of the counter.
PHDs may also use tick counters of a specified resolution that report a tick count or relative time. GHS supports resolutions of 1 second to 100 microseconds. With relative times, there is no check for which device is better synchronized. The PHG must always map the value to UTC plus offset. The PHD's current time is reported in the Observation.valueQuantity element scaled to the tick counter's resolution. This time provides the anchor time allowing the PHG to map the relative times reported in measurements to its own timeline in UTC plus offset format.
A relative timestamp value in a measurement is mapped to UTC plus offset by taking the difference between the measurement timestamp and the synchronization point's relative time. That difference is added to the synchronization point's UTC time plus offset.
Observation.component.valueCodeableConceptThe PHD synchronization method is reported in the Observation.component.valueCodeableConcept element. The code is a code from the MDC Time Synchronization Methods value set. The synchronization method is present in the timestamps supported by GHS and ACOM.
If the PHD has a time fault, the Observation.value[x] element is absent, and an Observation.dataAbsentReason.coding.code element is present with the code "unknown". A time fault is reported when the PHD reports its clock is unsynchronized and when a PHD measurement indicates an unsynchronized clock.
The Observation.device element is a reference to the Device resource representing the PHG that generated the coincident timestamp.
The PHG may use the following logic to report Coincident Timestamps and adjust PHD observation timestamps, assuming the PHD and PHG are in close proximity and share the same UTC time zone and DST offset:
Observation.effectiveDateTime element.Observation.value[x] element is left empty.dataAbsentReason is set to unknown.effective[x] element or chooses not to report the observation.Observation.effectiveDateTime element.Observation.valueDateTime element.Observation.effectiveDateTime element empty.Observation.valueDateTime element.Observation.effectiveDateTime element.Observation.valueDateTime or Observation.valueQuantity element.Suppose the PHG reads the current time of the PHD and finds it is six minutes behind its own time. If the PHG is better synchronized to NTP, it will add six minutes to all timestamps reported by the PHD on its current timeline.
IG © 2016+ HL7 International / Devices.
Package hl7.fhir.uv.phd#2.0.1 based on FHIR 4.0.1.
Generated
2026-10-15
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