Segment OBX to Observation Map - HL7 Version 2 to FHIR v1.0.0-ballot

HL7 Version 2 to FHIR, published by HL7 International / Orders and Observations. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/v2-to-fhir/ and changes regularly. See the Directory of published versions

ConceptMap: Segment OBX to Observation Map (Experimental)

Official URL: http://hl7.org/fhir/uv/v2mappings/segment-obx-to-observation				Version: 1.0.0-ballot
Active as of 2024-12-20				Computable Name: SegmentOBXToObservation
Copyright/Legal: Copyright (c) 2020, HL7 International, Inc., All Rights Reserved.

This ConceptMap represents a mapping from the HL7 V2 Segment OBX to the FHIR Observation Resource.

This ConceptMap represents the mapping from the HL7 V2 OBX Segment to the FHIR Observation Resource. See also the FHIR Shorthand or the CSV Source.

HL7 v2						Condition (IF True, args)			HL7 FHIR								Comments
Sort Order	Identifier	Name	Data Type	Cardinality - Min	Cardinality - Max	Computable ANTLR	Computable FHIRPath	Narrative	FHIR Attribute	Extension	Data Type	Cardinality - Min	Cardinality - Max	Data Type Mapping	Vocabulary Mapping (IS, ID, CE, CEN, CWE)	Assignment	Comments
1	OBX-1	Set ID – OBX	SI	0	1
2	OBX-2	Value Type	ID	0	1												OBX-2 determines the flavor of Observation.value[x] is used in OBX-5. The logic defined to date is part of OBX-5 mapping.
3	OBX-3	Observation Identifier	CWE	1	1				Observation.code		Observation.CodeableConcept	1	1	CWE[CodeableConcept]			Note that in Observation there is category field that depending on implementation guide and/or realm is required. MSH-9.2 Trigger Event, the MSH-3 Sending Application and OBX-3 Observation Identifier's code system ontology would inform how to value Observation.category.
4	OBX-4	Observation Sub-ID	OG	0	1			Map to Observation.partOf or Observation.hasMember or Observation.DerivedFrom according to the implementation guidance for the v2 message at hand, otherwise map to the extension-sub-id to enable the final destination to determine how to structure the observations.	Observation.$this					OG[Extension-Subidentifier]			OBX-4 Sub Identifier would determine how to use Observation.partOf or Observation.hasMember or Observation.DerivedFrom, but is highly dependent on the local implementation of OBX-4 or an implementation guide (e.g., LRI, Clinical Genomics). That is not known at the standard level, so we cannot provide specific mapping guidance here. However, if the mapper does not have access to the syntax used and its meaning, we need to be able to pass on OBX-4 Sub Identifier to the final destination that should know how to then structure it using FHIR attributes.
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "NM"			Observation.valueQuantity.value		Observation.quantity	0	1	NM[Quantity]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 IN ("ST", "FT", "TX")		Any markup in ST, FT or TX data may not present properly given that valueString is a string data type	Observation.valueString		Observation.string	0	1
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "CF"			Observation.valueCodeableConcept		Observation.CodeableConcept	0	1	CF[CodeableConcept]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "CNE"			Observation.valueCodeableConcept		Observation.CodeableConcept	0	1	CNE[CodeableConcept]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "CE"			Observation.valueCodeableConcept		Observation.CodeableConcept	0	1	CE[CodeableConcept]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "CWE"			Observation.valueCodeableConcept		Observation.CodeableConcept	0	1	CWE[CodeableConcept]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "IS"			Observation.valueCodeableConcept		Observation.CodeableConcept	0	1	IS[CodeableConcept]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "DR"			Observation.valuePeriod		Observation.Period	0	1	DR[Period]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 IN ("DTM", "DT")			Observation.valueDateTime		Observation.dateTime	0	1
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "NR"			Observation.valueRange		Observation.Range	0	1	NR[Range]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "VR"			Observation.valueString		Observation.string	0	1			OBX-5.1+"-"+OBX-5.2
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "TM"			Observation.valueTime		Observation.time	0	1
5	OBX-5	Observation Value	varies	0	-1	IF (OBX-2 EQUALS "SN" AND OBX-5.1 EQUALS "<>"			Observation.valueString		Observation.string	0	1			OBX-5.1+" "+OBX-5.2+" "+OBX-5.3+" "+OBX-5.4" "OBX-6"
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 IN (":", "/")			Observation.valueRatio		Observation.Ratio	0	1	SN[Ratio]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 EQUALS "-"			Observation.valueRange		Observation.Range	0	1	SN[Range]
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 EQUALS "+"			Observation.valueString		Observation.string	0	1			OBX-5.1+" "+OBX-5.2+" "+OBX-5.3+" "+OBX-5.4" "OBX-6"
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 NOT IN (":", "/", "-", "+")			Observation.valueQuantity		Observation.Quantity	0	1	SN[Quantity]			Note that OBX-5 and OBX-6 resolve to different components for the same Quantity data type.
5	OBX-5	Observation Value	varies	0	-1			If line 19 through 23 all fail while OBX-2 = SN	Observation.valueString		Observation.string	0	1			OBX-5.1+" "+OBX-5.2+" "+OBX-5.3+" "+OBX-5.4" "OBX-6"
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "NA"			Observation.valueSampledData		Observation.SampledData						Need to add text on converting NA to SampledData
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "ED" AND IF OBX-5.4 EQUALS "Base64"			Observation.extension.url		Observation.uri	1	1			"https://hl7.org/fhir/R5/StructureDefinition/extension-Observation.valueAttachment
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "ED" AND IF OBX-5.4 EQUALS "Base64"			Observation.extension.valueAttachment		Observation.Attachment	1	1	ED[Attachment]			We are for now addressing Base64 that cover .pdf, pictures and other binaries. If somebody does this, we will address those.
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "EI"											Requires more work to properly map. Use case: An OBX under OBR that points to the calibration/quality control/etc. settings/values/result/etc. that the other OBX-s under the OBR would be "subject" to.
	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "RP"			Observation.extension.url		Observation.uri	1	1			"https://hl7.org/fhir/R5/StructureDefinition/extension-Observation.valueAttachment
5	OBX-5	Observation Value	varies	0	-1	IF OBX-2 EQUALS "RP"			Observation.extension.valueAttachment		Observation.Attachment	1	1	ED[Attachment]			To be resolved when we resolve DocumentReference and valueAttachment
6	OBX-6	Units	CWE	0	1	IF OBX-2 IN ("NA", "NM")			Observation.valueQuantity		Observation.Quantity			CWE[Quantity]			Note that OBX-5 and OBX-6 resolve to different components for the same Quantity data type.
6	OBX-6	Units	CWE	0	1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 NOT IN (":", "/", "-", "+")			Observation.valueQuantity		Observation.Quantity			CWE[Quantity]			Note that OBX-5 and OBX-6 resolve to different components for the same Quantity data type.
6	OBX-6	Units	CWE	0	1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 EQUALS "-"			Observation.valueRange.low		Observation.SimpleQuantity			CWE[Quantity]
6	OBX-6	Units	CWE	0	1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 EQUALS "-"			Observation.valueRange.high		Observation.SimpleQuantity			CWE[Quantity]
6	OBX-6	Units	CWE	0	1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 IN (":", "/")			Observation.valueRatio.numerator		Observation.Quantity			CWE[Quantity]
6	OBX-6	Units	CWE	0	1	IF OBX-2 EQUALS "SN" AND OBX-5.1 NOT EQUALS "<>" AND OBX-5.3 IN (":", "/")			Observation.valueRatio.denominator		Observation.Quantity			CWE[Quantity]
7	OBX-7	References Range	ST	0	1				Observation.referenceRange.text		Observation.string	0	-1				If OBX-7 is sufficiently parseable, then the low, high, type, appliesTo, and/or age may be used.
8	OBX-8	Interpretation Codes	CWE	0	-1				Observation.interpretation		Observation.CodeableConcept	0	-1	CWE[CodeableConcept]	InterpretationCodes
9	OBX-9	Probability	NM	0	1
10	OBX-10	Nature of Abnormal Test	ID	0	-1				Observation.extension.uri		Observation.uri	0	-1			"http://hl7.org/fhir/StructureDefinition/observation-nature-of-abnormal-test"
10	OBX-10	Nature of Abnormal Test	ID	0	-1				Observation.extension.valueCodeableConcept		Observation.CodeableConcept	0	-1	CWE[CodeableConcept]	NatureOfAbnormalTesting
11	OBX-11	Observation Result Status	ID	1	1				Observation.status		Observation.code	1	1		ObservationResultStatusCodesInterpretation
11	OBX-11	Observation Result Status	ID	1	1	IF OBX-11 IS "X"			Observation.status.extension.url		Observation.uri					"http://hl7.org/fhir/StructureDefinition/alternate-codes"
11	OBX-11	Observation Result Status	ID	1	1	IF OBX-11 IS "X"			Observation.status.extension.valueCodeableConcept.coding.code		Observation.CodeableConcept					"X"
11	OBX-11	Observation Result Status	ID	1	1	IF OBX-11 IS "X"			Observation.status.extension.valueCodeableConcept.coding.system		Observation.string					"http://terminology.hl7.org/CodeSystem/v2-0085"
11	OBX-11	Observation Result Status	ID	1	1	IF OBX-11 IS "N"			Observation.dataAbsentReason.coding.code							"not-asked"
11	OBX-11	Observation Result Status	ID	1	1	IF OBX-11 IS "N"			Observation.dataAbsentReason.coding.system							"http://terminology.hl7.org/CodeSystem/data-absent-reason"
12	OBX-12	Effective Date of Reference Range	DTM	0	1
13	OBX-13	User Defined Access Checks	ST	0	1
14	OBX-14	Date/Time of the Observation	DTM	0	1				Observation.effectiveDateTime		Observation.dateTime	0	1
15	OBX-15	Producer's ID	CWE	0	1				Observation.performer(Observation.Organization)		Observation.identifier	0	1	CWE[Organization]			We are mapping this to an identifier considering the definition (used for a unique identifier of the producer), although that does not fit the use of the CWE data type in HL7 v2. Depending on context (e.g., US CLIA or IHE LTW, or ILW) this may reflect a location (US CLIA) or an organization (IHE LTW or ILW).
15	OBX-15	Producer's ID	CWE	0	1				Observation.performer(Observation.PractitionerRole)
16	OBX-16	Responsible Observer	XCN	0	-1				Observation.performer(Observation.PractitionerRole.practitioner(Observation.Practitioner)		Reference(Observation.PractitionerRole)	0	-1	XCN[Practitioner]
16	OBX-16	Responsible Observer	XCN	0	-1				Observation.performer(Observation.PractitionerRole.code.coding.code)		Observation.CodeableConcept	0	-1			"responsibleObserver"
16	OBX-16	Responsible Observer	XCN	0	-1				Observation.performer(Observation.PractitionerRole.code.coding.system)		Observation.CodeableConcept	0	-1			"http://terminology.hl7.org/CodeSystem/practitioner-role"
17	OBX-17	Observation Method	CWE	0	-1				Observation.method		Observation.CodeableConcept	0	1	CWE[CodeableConcept]			The cardinality of Observation.method is 0..1 while the source allows for multiple methods. As we are not aware of anybody populating multiples in HL7 v2, we did not provide further mapping guidance. If you need to support multiples, please submit a gForge to OO for the HL7 v2 to FHIR mapping Implementation Guide.
18	OBX-18	Equipment Instance Identifier	EI	0	-1				Observation.device(Observation.Device.identifier)		Observation.Identifier	0	1	EI[Identifier-Extension]
19	OBX-19	Date/Time of the Analysis	DTM	0	1				Observation.extension.url		Observation.uri	0	1				"http://hl7.org/fhir/StructureDefinition/observation-analysis-date-time"
19	OBX-19	Date/Time of the Analysis	DTM	0	1				Observation.extension.valueDateTime		Observation.dateTime	0	1
20	OBX-20	Observation Site	CWE	0	-1				Observation.bodySite		Observation.CodeableConcept	0	1	CWE[CodeableConcept]			The cardinality of Observation.bodySite is 0..1 while the source allows for multiple body sites. As we are not aware of anybody populating multiples in HL7 v2, we did not provide further mapping guidance. If you need to support multiples, please submit a gForge to OO for the HL7 v2 to FHIR mapping Implementation Guide.
21	OBX-21	Observation Instance Identifier	EI	0	1				Observation.identifier		Observation.Identifier	0	-1	EI[Identifier-Extension]
21	OBX-21	Observation Instance Identifier	EI	0	1				Observation.identifier.type.coding.code		Observation.code	0	1			"FILL"
22	OBX-22	Mood Code	CNE	0	1
23	OBX-23	Performing Organization Name	XON	0	1	IF OBX-25 NOT VALUED			Observation.performer(Observation.Organization)		Reference(Observation.Organization)	0	-1	XON[Organization]
23	OBX-23	Performing Organization Name	XON	0	1	IF OBX-25 VALUED			Observation.performer(Observation.PractitionerRole.organization(Observation.Organization)		Reference(Observation.Organization)	0	-1	XON[Organization]
24	OBX-24	Performing Organization Address	XAD	0	1	IF OBX-25 NOT VALUED			Observation.performer(Observation.Organization.address)		Observation.Address	0	-1	XAD[Address]
24	OBX-24	Performing Organization Address	XAD	0	1	IF OBX-25 VALUED			Observation.performer(Observation.PractitionerRole.organization(Observation.Organization.address)		Observation.Address	0	-1	XAD[Address]
25	OBX-25	Performing Organization Medical Director	XCN	0	1				Observation.performer(Observation.PractitionerRole.practitioner)		Reference(Observation.PractitionerRole)	0	1	XCN[PractitionerRole]
25	OBX-25	Performing Organization Medical Director	XCN	0	1				Observation.performer(Observation.PractitionerRole.code.coding.code)		Observation.code					"MDIR"
25	OBX-25	Performing Organization Medical Director	XCN	0	1				Observation.performer(Observation.PractitionerRole.code.coding.system)							"http://terminology.hl7.org/CodeSystem/v2-0912"
26	OBX-26	Patient Results Release Category	ID	0	1
27	OBX-27	Root Cause	CWE	0	1
28	OBX-28	Local Process Control	CWE	0	-1
29	OBX-29	Observation Type	ID	0	1				Observation.category.coding.code		Observation.code	0	-1
29	OBX-29	Observation Type	ID	0	1				Observation.category.coding.system		Observation.uri	0	-1
30	OBX-30	Observation Sub-Type	ID	0	1				Observation.extension.url		Observation.uri	0	1			"http://hl7.org/fhir/StructureDefinition/observation-structure-type"	The sub type was necessary in v2 to distinguish purpose of the observation when it appears in a message in the same group (e.g., answers to ask at order entry questions with actual results ). Within FHIR flagging the observation may not be necessary, but that is not yet clear. Until then, we will keep the thought of needing an extension, but not create it yet.
30	OBX-30	Observation Sub-Type	ID	0	1				Observation.extension.valueCodeableConcept.coding.code		Observation.code	0	1
30	OBX-30	Observation Sub-Type	ID	0	1				Observation.extension.valueCodeableConcept.coding.system		Observation.uri	0	1			"http://hl7.org/fhir/StructureDefinition/observation-structure-type"
31	OBX-31	Action Code	ID	0	1
32	OBX-32	Observation Value Absent Reason	CWE	0	-1
33	OBX-33	Observation Related Specimen Identifier	EIP	0	-1	IF OBX-33 COUNT>1			Observation.extension.uri		Reference	0	1			"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.specimen	Note that in v2 messages the observations that a calculated observation is derived from on and involve multiple specimens are typically not included with the message. To enable relating the calculated observation to the correct specimens it relates to, the v2 message should include the originating observations that in turn use OBX-33 to link to the correct specimens. Without that, and if there are multiple specimens in OBX-33, there is no standard method to correctly associate the observation with the correct specimens. The implementer will have to devise an appropriate method for that in their context.
33	OBX-33	Observation Related Specimen Identifier	EIP	0	-1	IF OBX-33 COUNT>1			Observation.extension.valueReference(Observation.Group.member.entity(Observation.Specimen.identifier)			0	1
33	OBX-33	Observation Related Specimen Identifier	EIP	0	-1	IF OBX-33 COUNT>1			Observation.extension.uri			0	1			"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.specimen
33	OBX-33	Observation Related Specimen Identifier	EIP	0	-1	IF OBX-33 COUNT>1			Observation.extension.valueReference(Observation.Group.member.entity(Observation.Specimen.identifier)			0	1
33	OBX-33	Observation Related Specimen Identifier	EIP	0	-1	IF OBX-33 COUNT=1			Observation.specimen(Observation.Specimen.identifier)		Observation.Identifier			EIP[Identifier-PlacerAssignedIdentifier]
33	OBX-33	Observation Related Specimen Identifier	EIP	0	-1	IF OBX-33 COUNT=1			Observation.specimen(Observation.Specimen.identifier)		Observation.Identifier			EIP[Identifier-FillerAssignedIdentifier]

Generated Narrative: ConceptMap segment-obx-to-observation

Mapping from OBX to Observation

Group 1 Mapping from unspecified code system to unspecified code system

Source Code

Relationship

Target Code

Comment

OBX-3 (Observation Identifier)

ConceptMap: Segment OBX to Observation Map (Experimental)

Notes: