IKNL PZP STU3
1.0.0-alpha1 - consultation International flag

IKNL PZP STU3, published by IKNL. This guide is not an authorized publication; it is the continuous build for version 1.0.0-alpha1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IKNL/PZP-FHIR-STU3/ and changes regularly. See the Directory of published versions

Resource Profile: Specific Care Wishes

Official URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-SpecificCareWishes Version: 1.0.0-alpha1
Draft as of 2025-10-27 Computable Name: ACPSpecificCareWishes

Copyright/Legal: Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.

The patient's wishes and expectations concerning their treatment, as an answer to the questions: 'What, according to the patient, should healthcare providers know to provide good care? Does this patient have specific wishes regarding their care (including cultural, religious, social, and spiritual aspects)?' Based on Observation resource.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Zib GeneralMeasurement(2.0.4) GeneralMeasurement
Constraints: obs-7, obs-6
... 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.
.... Slices for extension Content/Rules for all slices
..... extension:ResultStatusCodelist 0..1 (Complex) Provides the specific HCIM code for a FHIR element that has a required binding to a FHIR ValueSet
URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
Constraints: ext-1
...... extension 0..0
...... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/code-specification"
...... Slices for value[x] Content/Rules for all slices
....... value[x]:valueCodeableConcept 1..1 CodeableConcept ResultaatStatusCodelijst
Binding: ResultaatStatusCodelijst (2017-12-31T00:00:00) (extensible): ResultaatStatusCodelijst
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 153851000146100
..... 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(1.0.0-alpha1)) Who and/or what this is about
... context 0..1 Reference(Encounter(1.0.0-alpha1)) Healthcare event during which this observation is made
... effective[x] Σ 0..1 ResultDateTime
.... effectiveDateTime dateTime
.... effectivePeriod Period
... value[x] ΣC 0..1 string ResultValue
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... method 0..1 CodeableConcept MeasuringMethod
Binding: MeetmethodeCodelijst (2017-12-31T00:00:00) (extensible): SNOMED CT - all concepts
Required Pattern: At least the following
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 370819000
..... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍3.0.2 FHIR Std.
Observation.status.extension:ResultStatusCodelist.​value[x]:valueCodeableConcept Base extensible ResultaatStatusCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.code Base extensible MetingNaamCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.dataAbsentReason Base extensible Observation Value Absent Reason 📍3.0.2 FHIR Std.
Observation.method Base extensible MeetmethodeCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3

Constraints

Id Grade Path(s) Description Expression
dom-1 error Observation If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
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 contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error Observation.status.extension:ResultStatusCodelist 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 code is the same as a component code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from Zib GeneralMeasurement

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Zib GeneralMeasurement(2.0.4) GeneralMeasurement
... code 1..1 CodeableConcept Investigation or MeasurementName
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://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 153851000146100
... subject 1..1 Reference(Patient(1.0.0-alpha1)) Who and/or what this is about
... context 0..1 Reference(Encounter(1.0.0-alpha1)) Healthcare event during which this observation is made
... value[x] 0..1 string ResultValue
... dataAbsentReason 0..1 CodeableConcept Why the result is missing
... method 0..1 CodeableConcept MeasuringMethod
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://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 370819000

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Zib GeneralMeasurement(2.0.4) GeneralMeasurement
Constraints: obs-7, obs-6
... 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: Common Languages (extensible): A human language.
Additional BindingsPurpose
All Languages 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 | ProcedureRequest | ReferralRequest) Fulfills plan, proposal or order
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
..... extension:ResultStatusCodelist 0..1 (Complex) Provides the specific HCIM code for a FHIR element that has a required binding to a FHIR ValueSet
URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
Constraints: ext-1
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..0
...... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/code-specification"
...... Slices for value[x] Content/Rules for all slices
....... value[x]:valueCodeableConcept 1..1 CodeableConcept ResultaatStatusCodelijst
Binding: ResultaatStatusCodelijst (2017-12-31T00:00:00) (extensible): ResultaatStatusCodelijst
.... value 0..1 code Primitive value for code
... category 0..* CodeableConcept Classification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.
... code Σ 1..1 CodeableConcept Investigation or MeasurementName
Binding: MetingNaamCodelijst (2017-12-31T00:00:00) (extensible): OnderzoekCodelijst or MetingNaamCodelijst
Required Pattern: At least the following
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 153851000146100
..... 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(1.0.0-alpha1)) Who and/or what this is about
... context 0..1 Reference(Encounter(1.0.0-alpha1)) Healthcare event during which this observation is made
... effective[x] Σ 0..1 ResultDateTime
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this was made available
... performer Σ 0..* Reference(nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5)) Who is responsible for the observation
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
..... extension:practitionerRole 0..1 Reference(nl-core-practitionerrole) Optional Extensions Element
URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... value[x] ΣC 0..1 string ResultValue
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
... comment 0..1 string Comment
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept MeasuringMethod
Binding: MeetmethodeCodelijst (2017-12-31T00:00:00) (extensible): SNOMED CT - all concepts
Required Pattern: At least the following
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 370819000
..... 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
... 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 xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... 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: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes (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
... related Σ 0..* BackboneElement MeasurementResult
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... type 0..1 code has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
.... target 1..1 Reference(HCIM General Measurement(2.0.4)) Resource that is related to this one
... component Σ 0..* BackboneElement Component results
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueAttachment Attachment
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (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 extensible Common Languages 📍3.0.2 FHIR Std.
Observation.status Base required ObservationStatus 📍3.0.2 FHIR Std.
Observation.status.extension:ResultStatusCodelist.​value[x]:valueCodeableConcept Base extensible ResultaatStatusCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.category Base preferred Observation Category Codes 📍3.0.2 FHIR Std.
Observation.code Base extensible MetingNaamCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.dataAbsentReason Base extensible Observation Value Absent Reason 📍3.0.2 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍3.0.2 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍3.0.2 FHIR Std.
Observation.method Base extensible MeetmethodeCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.referenceRange.​type Base extensible Observation Reference Range Meaning Codes 📍3.0.2 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍3.0.2 FHIR Std.
Observation.related.​type Base required ObservationRelationshipType 📍3.0.2 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍3.0.2 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Observation Value Absent Reason 📍3.0.2 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍3.0.2 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-1 error Observation If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
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 contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error Observation.status.extension:ResultStatusCodelist, Observation.performer.extension:practitionerRole 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 code is the same as a component code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Zib GeneralMeasurement(2.0.4) GeneralMeasurement
Constraints: obs-7, obs-6
... 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.
.... Slices for extension Content/Rules for all slices
..... extension:ResultStatusCodelist 0..1 (Complex) Provides the specific HCIM code for a FHIR element that has a required binding to a FHIR ValueSet
URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
Constraints: ext-1
...... extension 0..0
...... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/code-specification"
...... Slices for value[x] Content/Rules for all slices
....... value[x]:valueCodeableConcept 1..1 CodeableConcept ResultaatStatusCodelijst
Binding: ResultaatStatusCodelijst (2017-12-31T00:00:00) (extensible): ResultaatStatusCodelijst
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 153851000146100
..... 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(1.0.0-alpha1)) Who and/or what this is about
... context 0..1 Reference(Encounter(1.0.0-alpha1)) Healthcare event during which this observation is made
... effective[x] Σ 0..1 ResultDateTime
.... effectiveDateTime dateTime
.... effectivePeriod Period
... value[x] ΣC 0..1 string ResultValue
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... method 0..1 CodeableConcept MeasuringMethod
Binding: MeetmethodeCodelijst (2017-12-31T00:00:00) (extensible): SNOMED CT - all concepts
Required Pattern: At least the following
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 370819000
..... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍3.0.2 FHIR Std.
Observation.status.extension:ResultStatusCodelist.​value[x]:valueCodeableConcept Base extensible ResultaatStatusCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.code Base extensible MetingNaamCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.dataAbsentReason Base extensible Observation Value Absent Reason 📍3.0.2 FHIR Std.
Observation.method Base extensible MeetmethodeCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3

Constraints

Id Grade Path(s) Description Expression
dom-1 error Observation If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
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 contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error Observation.status.extension:ResultStatusCodelist 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 code is the same as a component code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Differential View

This structure is derived from Zib GeneralMeasurement

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Zib GeneralMeasurement(2.0.4) GeneralMeasurement
... code 1..1 CodeableConcept Investigation or MeasurementName
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://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 153851000146100
... subject 1..1 Reference(Patient(1.0.0-alpha1)) Who and/or what this is about
... context 0..1 Reference(Encounter(1.0.0-alpha1)) Healthcare event during which this observation is made
... value[x] 0..1 string ResultValue
... dataAbsentReason 0..1 CodeableConcept Why the result is missing
... method 0..1 CodeableConcept MeasuringMethod
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://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 370819000

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Zib GeneralMeasurement(2.0.4) GeneralMeasurement
Constraints: obs-7, obs-6
... 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: Common Languages (extensible): A human language.
Additional BindingsPurpose
All Languages 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 | ProcedureRequest | ReferralRequest) Fulfills plan, proposal or order
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
..... extension:ResultStatusCodelist 0..1 (Complex) Provides the specific HCIM code for a FHIR element that has a required binding to a FHIR ValueSet
URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
Constraints: ext-1
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..0
...... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/code-specification"
...... Slices for value[x] Content/Rules for all slices
....... value[x]:valueCodeableConcept 1..1 CodeableConcept ResultaatStatusCodelijst
Binding: ResultaatStatusCodelijst (2017-12-31T00:00:00) (extensible): ResultaatStatusCodelijst
.... value 0..1 code Primitive value for code
... category 0..* CodeableConcept Classification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.
... code Σ 1..1 CodeableConcept Investigation or MeasurementName
Binding: MetingNaamCodelijst (2017-12-31T00:00:00) (extensible): OnderzoekCodelijst or MetingNaamCodelijst
Required Pattern: At least the following
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 153851000146100
..... 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(1.0.0-alpha1)) Who and/or what this is about
... context 0..1 Reference(Encounter(1.0.0-alpha1)) Healthcare event during which this observation is made
... effective[x] Σ 0..1 ResultDateTime
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this was made available
... performer Σ 0..* Reference(nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5)) Who is responsible for the observation
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
..... extension:practitionerRole 0..1 Reference(nl-core-practitionerrole) Optional Extensions Element
URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... value[x] ΣC 0..1 string ResultValue
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
... comment 0..1 string Comment
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept MeasuringMethod
Binding: MeetmethodeCodelijst (2017-12-31T00:00:00) (extensible): SNOMED CT - all concepts
Required Pattern: At least the following
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string xml:id (or equivalent in JSON)
..... extension 0..* Extension Additional Content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 370819000
..... 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
... 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 xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... 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: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: Observation Reference Range Applies To Codes (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
... related Σ 0..* BackboneElement MeasurementResult
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... type 0..1 code has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
.... target 1..1 Reference(HCIM General Measurement(2.0.4)) Resource that is related to this one
... component Σ 0..* BackboneElement Component results
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueAttachment Attachment
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..1 CodeableConcept High, low, normal, etc.
Binding: Observation Interpretation Codes (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 extensible Common Languages 📍3.0.2 FHIR Std.
Observation.status Base required ObservationStatus 📍3.0.2 FHIR Std.
Observation.status.extension:ResultStatusCodelist.​value[x]:valueCodeableConcept Base extensible ResultaatStatusCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.category Base preferred Observation Category Codes 📍3.0.2 FHIR Std.
Observation.code Base extensible MetingNaamCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.dataAbsentReason Base extensible Observation Value Absent Reason 📍3.0.2 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍3.0.2 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍3.0.2 FHIR Std.
Observation.method Base extensible MeetmethodeCodelijst 📍2017-12-31T00:00:00 Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.referenceRange.​type Base extensible Observation Reference Range Meaning Codes 📍3.0.2 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍3.0.2 FHIR Std.
Observation.related.​type Base required ObservationRelationshipType 📍3.0.2 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍3.0.2 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Observation Value Absent Reason 📍3.0.2 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍3.0.2 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-1 error Observation If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
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 contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error Observation.status.extension:ResultStatusCodelist, Observation.performer.extension:practitionerRole 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 code is the same as a component code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

 

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