Vital Records Death Reporting (VRDR) FHIR Implementation Guide
3.0.0 - STU3 United States of America flag

Vital Records Death Reporting (VRDR) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/vrdr/ and changes regularly. See the Directory of published versions

Resource Profile: Record Axis Cause Of Death

Official URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-record-axis-cause-of-death Version: 3.0.0
Active as of 2025-01-10 Computable Name: RecordAxisCauseOfDeath
Other Identifiers: OID:2.16.840.1.113883.4.642.40.10.42.47

Record Axis Cause Of Death (Observation): Up to 20 of instances of this profile may be included in a coding bundle.
Each instance is labeled with its position (1-20), forming an ordered collection of codes.

Record axis codes eliminate contradictions and repetitive codes to create a more concise and consistent set of codes than provided by the Entity Axis codes. They may combine or modify codes to better reflect the overall medical certification on the death certificate.

Additional information on Record Axis Cause of death can be found in the case of multiple causes of death can be found in this CDC publication . Previously a subset of records classified to ICD-10 CHAPTER XV - Pregnancy, childbirth and the puerperium (O00-O99) were flagged by the presence of a '1' in the 5th position of the 2nd condition (position = 2). These are instances where a decedent < 45 years of age has been classified as a maternal death using input from the information entered in the DecedentPregnancyStatus, and the 2nd condition represents the cause of death to which the given record would be classified had the causes of death been processed without National Vital Statistics Reports Volume 69, Number 2 January, 2020 (cdc.gov).

In the FHIR encoding, in lieu of using the 5th position of the ICD10 code, a flag has been added to each Record Cause of Death condition that should be set to true in these cases, and should be absent or false elsewhere.

IJE Mapping

Mortality (Decedent)
Use Case # Description IJE Name Field Type Value Set/Comments
Mortality 108 Record-axis codes RAC Each entry is a 3-tuple (value, component[position], component[WouldBeUnderlyingCauseOfDeathWithoutPregnancy]) codeable ICD10CausesOfDeathVS

Usage:

Changes since version true:

  • New Content

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: 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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... status ?!Σ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.


    ele-1: All FHIR elements must have a @value or children
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 80357-7
    ... subject Σ 1..1 Reference(Patient - Vital Records) Decedent
    ele-1: All FHIR elements must have a @value or children
    ... effective[x] Σ 0..1 dateTime Date/Time when added to death record
    ele-1: All FHIR elements must have a @value or children
    ... value[x] ΣC 1..1 CodeableConcept Actual result
    Binding: ICD10 Causes of Death ValueSet (required)
    ele-1: All FHIR elements must have a @value or children
    ... Slices for component Σ 1..* BackboneElement Component results
    Slice: Unordered, Open by value:code
    ele-1: All FHIR elements must have a @value or children
    .... component:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children
    .... component:position Σ 1..1 BackboneElement Position
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children
    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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: position
    ..... value[x] Σ 1..1 integer Actual component result
    ele-1: All FHIR elements must have a @value or children
    .... component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy Σ 0..1 BackboneElement Would be Underlying Cause of Death Without Pregnancy
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children
    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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    ..... Slices for value[x] Σ 1..1 boolean Actual component result
    Slice: Unordered, Closed by type:$this
    ele-1: All FHIR elements must have a @value or children
    ...... value[x]:valueBoolean Σ 0..1 boolean Position
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 80357-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]requiredICD10CausesOfDeathVS
    http://hl7.org/fhir/us/vrdr/ValueSet/vrdr-icd10-causes-of-death-vs
    from this IG
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:position.codeexamplePattern: position
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.codeexamplePattern: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard

    This structure is derived from Observation

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation Observation
    ... code 1..1 CodeableConcept Cause of death record axis code [Automated]
    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: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 80357-7
    ... subject 1..1 Reference(Patient - Vital Records) Decedent
    ... effective[x] 0..1 dateTime Date/Time when added to death record
    ... Slices for component 1..* BackboneElement Component results
    Slice: Unordered, Open by value:code
    .... component:position 1..1 BackboneElement Position
    ..... 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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: position
    ..... value[x] 1..1 integer Actual component result
    .... component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy 0..1 BackboneElement Would be Underlying Cause of Death Without Pregnancy
    ..... 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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    ..... Slices for value[x] 1..1 boolean Actual component result
    Slice: Unordered, Open by type:$this
    ...... value[x]:valueBoolean 0..1 boolean Position

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.value[x]requiredICD10CausesOfDeathVS
    http://hl7.org/fhir/us/vrdr/ValueSet/vrdr-icd10-causes-of-death-vs
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    ... status ?!Σ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... category 0..* CodeableConcept Classification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ... code Σ 1..1 CodeableConcept Cause of death record axis code [Automated]
    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: http://loinc.org
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 80357-7
    ..... 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
    ... subject Σ 1..1 Reference(Patient - Vital Records) Decedent
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] Σ 0..1 dateTime Date/Time when added to death record
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
    ... value[x] ΣC 1..1 CodeableConcept Actual result
    Binding: ICD10 Causes of Death ValueSet (required)
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ... note 0..* Annotation Comments about the observation
    ... 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.

    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember 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
    ... Slices for component Σ 1..* BackboneElement Component results
    Slice: Unordered, Open by value:code
    .... 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 ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    ..... value[x] Σ 0..1 Actual component result
    ...... valueQuantity Quantity
    ...... valueCodeableConcept CodeableConcept
    ...... valueString string
    ...... valueBoolean boolean
    ...... valueInteger integer
    ...... valueRange Range
    ...... valueRatio Ratio
    ...... valueSampledData SampledData
    ...... valueTime time
    ...... valueDateTime dateTime
    ...... valuePeriod Period
    ..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ..... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
    .... component:position Σ 1..1 BackboneElement Position
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: position
    ....... 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
    ..... value[x] Σ 1..1 integer Actual component result
    ..... 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:wouldBeUnderlyingCauseOfDeathWithoutPregnancy Σ 0..1 BackboneElement Would be Underlying Cause of Death Without Pregnancy
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    ....... 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] Σ 1..1 boolean Actual component result
    Slice: Unordered, Closed by type:$this
    ...... value[x]:valueBoolean Σ 0..1 boolean Position
    ..... 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

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 80357-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]requiredICD10CausesOfDeathVS
    http://hl7.org/fhir/us/vrdr/ValueSet/vrdr-icd10-causes-of-death-vs
    from this IG
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:position.codeexamplePattern: position
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:position.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:position.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.codeexamplePattern: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    This structure is derived from Observation

    Summary

    Mandatory: 5 elements(1 nested mandatory element)

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 1 is sliced based on the value of Observation.component
    • The element 1 is sliced based on the value of Observation.component.value[x]

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: 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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... status ?!Σ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.


    ele-1: All FHIR elements must have a @value or children
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 80357-7
    ... subject Σ 1..1 Reference(Patient - Vital Records) Decedent
    ele-1: All FHIR elements must have a @value or children
    ... effective[x] Σ 0..1 dateTime Date/Time when added to death record
    ele-1: All FHIR elements must have a @value or children
    ... value[x] ΣC 1..1 CodeableConcept Actual result
    Binding: ICD10 Causes of Death ValueSet (required)
    ele-1: All FHIR elements must have a @value or children
    ... Slices for component Σ 1..* BackboneElement Component results
    Slice: Unordered, Open by value:code
    ele-1: All FHIR elements must have a @value or children
    .... component:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children
    .... component:position Σ 1..1 BackboneElement Position
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children
    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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: position
    ..... value[x] Σ 1..1 integer Actual component result
    ele-1: All FHIR elements must have a @value or children
    .... component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy Σ 0..1 BackboneElement Would be Underlying Cause of Death Without Pregnancy
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children
    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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    ..... Slices for value[x] Σ 1..1 boolean Actual component result
    Slice: Unordered, Closed by type:$this
    ele-1: All FHIR elements must have a @value or children
    ...... value[x]:valueBoolean Σ 0..1 boolean Position
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 80357-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]requiredICD10CausesOfDeathVS
    http://hl7.org/fhir/us/vrdr/ValueSet/vrdr-icd10-causes-of-death-vs
    from this IG
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:position.codeexamplePattern: position
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.codeexamplePattern: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard

    Differential View

    This structure is derived from Observation

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation Observation
    ... code 1..1 CodeableConcept Cause of death record axis code [Automated]
    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: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 80357-7
    ... subject 1..1 Reference(Patient - Vital Records) Decedent
    ... effective[x] 0..1 dateTime Date/Time when added to death record
    ... Slices for component 1..* BackboneElement Component results
    Slice: Unordered, Open by value:code
    .... component:position 1..1 BackboneElement Position
    ..... 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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: position
    ..... value[x] 1..1 integer Actual component result
    .... component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy 0..1 BackboneElement Would be Underlying Cause of Death Without Pregnancy
    ..... 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: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    ..... Slices for value[x] 1..1 boolean Actual component result
    Slice: Unordered, Open by type:$this
    ...... value[x]:valueBoolean 0..1 boolean Position

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.value[x]requiredICD10CausesOfDeathVS
    http://hl7.org/fhir/us/vrdr/ValueSet/vrdr-icd10-causes-of-death-vs
    from this IG

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    ... status ?!Σ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... category 0..* CodeableConcept Classification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ... code Σ 1..1 CodeableConcept Cause of death record axis code [Automated]
    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: http://loinc.org
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 80357-7
    ..... 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
    ... subject Σ 1..1 Reference(Patient - Vital Records) Decedent
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] Σ 0..1 dateTime Date/Time when added to death record
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
    ... value[x] ΣC 1..1 CodeableConcept Actual result
    Binding: ICD10 Causes of Death ValueSet (required)
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ... note 0..* Annotation Comments about the observation
    ... 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.

    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember 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
    ... Slices for component Σ 1..* BackboneElement Component results
    Slice: Unordered, Open by value:code
    .... 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 ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    ..... value[x] Σ 0..1 Actual component result
    ...... valueQuantity Quantity
    ...... valueCodeableConcept CodeableConcept
    ...... valueString string
    ...... valueBoolean boolean
    ...... valueInteger integer
    ...... valueRange Range
    ...... valueRatio Ratio
    ...... valueSampledData SampledData
    ...... valueTime time
    ...... valueDateTime dateTime
    ...... valuePeriod Period
    ..... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ..... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ..... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result
    .... component:position Σ 1..1 BackboneElement Position
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: position
    ....... 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
    ..... value[x] Σ 1..1 integer Actual component result
    ..... 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:wouldBeUnderlyingCauseOfDeathWithoutPregnancy Σ 0..1 BackboneElement Would be Underlying Cause of Death Without Pregnancy
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    ....... 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] Σ 1..1 boolean Actual component result
    Slice: Unordered, Closed by type:$this
    ...... value[x]:valueBoolean Σ 0..1 boolean Position
    ..... 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

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC Code 80357-7
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]requiredICD10CausesOfDeathVS
    http://hl7.org/fhir/us/vrdr/ValueSet/vrdr-icd10-causes-of-death-vs
    from this IG
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:position.codeexamplePattern: position
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:position.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:position.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.codeexamplePattern: wouldBeUnderlyingCauseOfDeathWithoutPregnancy
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component:wouldBeUnderlyingCauseOfDeathWithoutPregnancy.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    This structure is derived from Observation

    Summary

    Mandatory: 5 elements(1 nested mandatory element)

    Structures

    This structure refers to these other structures:

    Slices

    This structure defines the following Slices:

    • The element 1 is sliced based on the value of Observation.component
    • The element 1 is sliced based on the value of Observation.component.value[x]

     

    Other representations of profile: CSV, Excel, Schematron