Vital Records Death Reporting (VRDR) FHIR Implementation Guide
3.0.0 - STU3 US

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: Decedent Pregnancy

Official URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-decedent-pregnancy-status Version: 3.0.0
Standards status: Draft Computable Name: DecedentPregnancyStatus
Other Identifiers: OID:2.16.840.1.113883.4.642.40.10.42.30

The Decedent Pregnancy Status profile (Observation) provides an indication of the pregnancy status of the decedent. This profile is designed to support VRDR and MDI

IJE Mapping

Mortality (Decedent)
Use Case # Description IJE Name Field Type Value Set/Comments
Mortality 112 Pregnancy PREG value codeable DeathPregnancyStatusVS
Mortality 113 If Female--Edit Flag: From EDR only PREG_BYPASS value.extension[BypassEditFlag].value codeable EditBypass012VS

Form Mapping

Form Mapping
Item # Form Field FHIR Profile Field Reference
36 Pregnancy Status value Certificate of Death

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version true:

  • New Content

    • Formal Views of Profile Content

    Description Differentials, Snapshots, and other representations.

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    Constraints: obs-6, obs-7
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!Σ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.
    .... 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: 69442-2
    ..... 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) subject
    ... value[x] ΣC 1..1 CodeableConcept Whether the decedent was pregnant at or around the time of death.
    Binding: Death Pregnancy Status ValueSet (required): A set of codes that reflect whether the decedent was pregnant at or around the time of death.
    .... Slices for extension Content/Rules for all slices
    ..... extension:bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
    URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
    ...... extension 0..0 Extension
    Slice: Unordered, Open by value:url
    ...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
    ...... value[x] 1..1 CodeableConcept Value of extension
    Binding: Edit Bypass 012 (required)

    doco Documentation for this format

    Terminology Bindings

    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.value[x] Base required Death Pregnancy Status ValueSet 📦3.0.0 This IG
    Observation.value[x].​extension:bypassEditFlag.​value[x] Base required Edit Bypass 012 📦3.0.0 This IG

    Constraints

    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()

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation Observation
    ... code 1..1 CodeableConcept Timing of recent pregnancy in relation to death
    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: 69442-2
    ... subject 1..1 Reference(Patient - Vital Records) subject
    ... value[x] 1..1 CodeableConcept Whether the decedent was pregnant at or around the time of death.
    Binding: Death Pregnancy Status ValueSet (required): A set of codes that reflect whether the decedent was pregnant at or around the time of death.
    .... Slices for extension Content/Rules for all slices
    ..... extension:bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
    URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
    ...... value[x] 1..1 CodeableConcept Value of extension
    Binding: Edit Bypass 012 (required)

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Observation.value[x] Base required Death Pregnancy Status ValueSet 📦3.0.0 This IG
    Observation.value[x].​extension:bypassEditFlag.​value[x] Base required Edit Bypass 012 📦3.0.0 This IG
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    Constraints: obs-6, obs-7
    ... 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
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    ... status ?!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 Timing of recent pregnancy in relation to death
    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: 69442-2
    ..... 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) subject
    ... 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 Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... 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 Whether the decedent was pregnant at or around the time of death.
    Binding: Death Pregnancy Status ValueSet (required): A set of codes that reflect whether the decedent was pregnant at or around the time of death.
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... extension:bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
    URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..0 Extension
    Slice: Unordered, Open by value:url
    ...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
    ...... value[x] 1..1 CodeableConcept Value of extension
    Binding: Edit Bypass 012 (required)
    .... coding Σ 0..* Coding Code defined by a terminology system
    .... text Σ 0..1 string Plain text representation of the concept
    ... 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
    Constraints: obs-3
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
    .... high C 0..1 SimpleQuantity(4.0.1) 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
    ... component Σ 0..* BackboneElement Component results
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.
    .... value[x] Σ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    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.value[x] Base required Death Pregnancy Status ValueSet 📦3.0.0 This IG
    Observation.value[x].​extension:bypassEditFlag.​value[x] Base required Edit Bypass 012 📦3.0.0 This IG
    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.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.

    Constraints

    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()

    Summary

    Mandatory: 2 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    Constraints: obs-6, obs-7
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!Σ 1..1 code registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.
    .... 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: 69442-2
    ..... 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) subject
    ... value[x] ΣC 1..1 CodeableConcept Whether the decedent was pregnant at or around the time of death.
    Binding: Death Pregnancy Status ValueSet (required): A set of codes that reflect whether the decedent was pregnant at or around the time of death.
    .... Slices for extension Content/Rules for all slices
    ..... extension:bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
    URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
    ...... extension 0..0 Extension
    Slice: Unordered, Open by value:url
    ...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
    ...... value[x] 1..1 CodeableConcept Value of extension
    Binding: Edit Bypass 012 (required)

    doco Documentation for this format

    Terminology Bindings

    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.value[x] Base required Death Pregnancy Status ValueSet 📦3.0.0 This IG
    Observation.value[x].​extension:bypassEditFlag.​value[x] Base required Edit Bypass 012 📦3.0.0 This IG

    Constraints

    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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation Observation
    ... code 1..1 CodeableConcept Timing of recent pregnancy in relation to death
    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: 69442-2
    ... subject 1..1 Reference(Patient - Vital Records) subject
    ... value[x] 1..1 CodeableConcept Whether the decedent was pregnant at or around the time of death.
    Binding: Death Pregnancy Status ValueSet (required): A set of codes that reflect whether the decedent was pregnant at or around the time of death.
    .... Slices for extension Content/Rules for all slices
    ..... extension:bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
    URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
    ...... value[x] 1..1 CodeableConcept Value of extension
    Binding: Edit Bypass 012 (required)

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Observation.value[x] Base required Death Pregnancy Status ValueSet 📦3.0.0 This IG
    Observation.value[x].​extension:bypassEditFlag.​value[x] Base required Edit Bypass 012 📦3.0.0 This IG

    Snapshot ViewView

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* Observation Measurements and simple assertions
    Constraints: obs-6, obs-7
    ... 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
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    ... status ?!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 Timing of recent pregnancy in relation to death
    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: 69442-2
    ..... 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) subject
    ... 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 Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... 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 Whether the decedent was pregnant at or around the time of death.
    Binding: Death Pregnancy Status ValueSet (required): A set of codes that reflect whether the decedent was pregnant at or around the time of death.
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... extension:bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
    URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..0 Extension
    Slice: Unordered, Open by value:url
    ...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
    ...... value[x] 1..1 CodeableConcept Value of extension
    Binding: Edit Bypass 012 (required)
    .... coding Σ 0..* Coding Code defined by a terminology system
    .... text Σ 0..1 string Plain text representation of the concept
    ... 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
    Constraints: obs-3
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
    .... high C 0..1 SimpleQuantity(4.0.1) 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
    ... component Σ 0..* BackboneElement Component results
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.
    .... value[x] Σ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    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.value[x] Base required Death Pregnancy Status ValueSet 📦3.0.0 This IG
    Observation.value[x].​extension:bypassEditFlag.​value[x] Base required Edit Bypass 012 📦3.0.0 This IG
    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.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.

    Constraints

    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()

    Summary

    Mandatory: 2 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

     

    Other representations of profile: CSV, Excel, Schematron