RIVO-Noord Zorgviewer Implementation Guide
1.21.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.21.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: VitalSign

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/VitalSign | Version: 1.21.0
Active as of 2025-10-28 | Computable Name: VitalSign

Vitale gegevens

> Dit Profiel is het resultaat van de vergelijking tussen de zib2017 FHIR Profiel en de implementaties in Epic, Chipsoft, Topicus en Nexus. De elementen die in ieder geval in alle output beschikbaar zullen zijn. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

### Zorginformatiebouwsteen

De volgende zibs vallen min of meer onder het thema vitale gegevens.

Gegevensset | zib | Zib element met de hoofd waarde
--- | --- | ---
BgZ, eOverdracht | ZIB Bloeddruk |
BgZ, eOverdracht | ZIB Gewicht | GewichtWaarde
BgZ, eOverdracht | ZIB Lengte | LengteWaarde
eOverdracht | ZIB Temperatuur | TemperatuurWaarde
eOverdracht | ZIB Ademhaling | Ademfrequentie
eOverdracht | ZIB Polsfrequentie | PolsfrequentieWaarde
Huisarts zelfmetingen | ZIB AlgemeneMeting | Uitslag/UitslagWaarde
nvt | ZIB O2Saturatie | SpO2Waarde
nvt | ZIB Hartfrequentie | HartfrequentieWaarde

### View Definition

ViewDefinition voor Vitale Gegevens

### UI Wireframe

Vitale gegevens

>< | Bron | Datum | Meting | Waarde | Waarde componenten | Uitvoerder | (Groep)
--- | --- | --- | --- | --- | --- | --- | ---
+ | Chipsoft-Bundle | 8-2-2013 | Body height | 183 cm |  |  | Lichaamsmaten
| Meting LOINC#8302-2 Body height
+ | Chipsoft-Bundle | 8-2-2013 | Body weight | 72 kg |  |  | Lichaamsmaten
| Meting LOINC#29463-7 Body weight
+ | Chipsoft | 7-2-2013 | Blood pressure panel with all children optional |  | 108/56/73/73 mm[Hg] |  | Bloeddruk
| Methode Niet-invasief MeetLocatie Linker bovenarm Meting LOINC#85354-9 Blood pressure panel with all children optional
+ | Epic-Bundle | 14-8-2025 | RR |  | 116/67 mm[Hg] | User. Inpatient, Verpleegkundige | Bloeddruk
| Methode Non-invasive MeetLocatie Body Site Meting LOINC#55284-4 Blood pressure systolic and diastolic
+ | Epic-Bundle | 13-8-2025 | RR |  | 114/65 mm[Hg] | User. Inpatient, Verpleegkundige | Bloeddruk
| Methode Non-invasive MeetLocatie Body Site Meting LOINC#55284-4 Blood pressure systolic and diastolic
+ | Epic-Bundle | 12-8-2025 | RR |  | 113/64 mm[Hg] | User. Inpatient, Verpleegkundige | Bloeddruk
| Methode Non-invasive MeetLocatie Body Site Meting LOINC#55284-4 Blood pressure systolic and diastolic
+ | Epic-Bundle | 25-7-2025 | RR |  | 112/63 mm[Hg] | P Havelaar | Bloeddruk
| Methode Non-invasive Meting LOINC#55284-4 Blood pressure systolic and diastolic
+ | Epic-Bundle | 24-7-2025 | RR |  | 110/60 mm[Hg] | User. Inpatient, Verpleegkundige | Bloeddruk
| Methode Non-invasive MeetLocatie Body Site Meting LOINC#55284-4 Blood pressure systolic and diastolic
+ | Epic-Bundle | 13-8-2025 | Temperatuur | 38 Cel |  | User. Inpatient, Verpleegkundige | Temperatuur
| Meting LOINC#8310-5 Body temperature
+ | Epic-Bundle | 25-7-2025 | Temperatuur | 37 Cel |  | User. Inpatient, Verpleegkundige | Temperatuur
| Meting LOINC#8310-5 Body temperature
+ | Epic-Bundle | 24-7-2025 | Temperatuur | 36.4 Cel |  | User. Inpatient, Verpleegkundige | Temperatuur
| Meting LOINC#8310-5 Body temperature
+ | Epic-Bundle | 26-8-2025 | Polsfrequentie | 60 /min |  | Arts. Interne Geneeskunde, Internist Oncoloog | Hartslag
| Meting LOINC#8716-3 Vital signs Toelichting Opmerking Zorgviewer
+ | Epic-Bundle | 14-8-2025 | Polsfrequentie | 61 /min |  | User. Inpatient, Verpleegkundige | Hartslag
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 13-8-2025 | Polsfrequentie | 60 /min |  | User. Inpatient, Verpleegkundige | Hartslag
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 12-8-2025 | Polsfrequentie | 62 /min |  | User. Inpatient, Verpleegkundige | Hartslag
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 25-7-2025 | Polsfrequentie | 59 /min |  | P Havelaar | Hartslag
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 24-7-2025 | Polsfrequentie | 58 /min |  | User. Inpatient, Verpleegkundige | Hartslag
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 25-7-2025 | Ademfreq. | 17 /min |  | P Havelaar | Ademhaling
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 24-7-2025 | Ademfreq. | 16 /min |  | User. Inpatient, Verpleegkundige | Ademhaling
| Meting LOINC#8716-3 Vital signs
+ | Epic-Bundle | 13-8-2025 | SpO2 | 100 % |  | User. Inpatient, Verpleegkundige | Ademhaling
| Meting LOINC#2708-6 Oxygen saturation in Arterial blood
+ | Epic-Bundle | 25-7-2025 | SpO2 | 99 % |  | P Havelaar | Ademhaling
| Meting LOINC#2708-6 Oxygen saturation in Arterial blood
+ | Epic-Bundle | 24-7-2025 | SpO2 | 98 % |  | User. Inpatient, Verpleegkundige | Ademhaling
| Meting LOINC#2708-6 Oxygen saturation in Arterial blood
+ | Epic-Bundle | 13-8-2025 | Lengte | 171 cm |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#8302-2 Body height
+ | Epic-Bundle | 25-7-2025 | Lengte | 172 cm |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#8302-2 Body height
+ | Epic-Bundle | 25-7-2025 | Lengte | 169 cm |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#8302-2 Body height
+ | Epic-Bundle | 24-7-2025 | Lengte | 170 cm |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#8302-2 Body height
+ | Epic-Bundle | 13-8-2025 | Gewicht | 71 kg |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#29463-7 Body weight
+ | Epic-Bundle | 25-7-2025 | Gewicht | 72 kg |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#29463-7 Body weight
+ | Epic-Bundle | 25-7-2025 | Gewicht | 69 kg |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#29463-7 Body weight
+ | Epic-Bundle | 24-7-2025 | Gewicht | 70 kg |  | User. Inpatient, Verpleegkundige | Lichaamsmaten
| Meting LOINC#29463-7 Body weight
+ | Epic | 3-8-2020 | Bloeddruk |  | 100/60 mm[Hg] | C Ooms | Bloeddruk
| Meting LOINC#85354-9 Blood pressure panel with all children optional
+ | Sanday-Bundle | 7-8-2025 | gewicht patiënt | 81 kg |  |  | Lichaamsmaten
| Meting NHG45#357 gewicht patiënt
+ | Sanday-Bundle | 20-8-2025 | gewicht patiënt | 43.535.0 kg |  |  | Lichaamsmaten
| Meting NHG45#357 gewicht patiënt
+ | Sanday-Bundle | 7-8-2025 | lengte patiënt | 1.81 m |  |  | Lichaamsmaten
| Meting NHG45#560 lengte patiënt
+ | Sanday-Bundle | 20-8-2025 | lengte patiënt | 35.354.00 m |  |  | Lichaamsmaten
| Meting NHG45#560 lengte patiënt
+ | Sanday-Bundle | 7-8-2025 | Quetelet-index (BMI) patiënt | 24.7 kg/m2 |  |  | Lichaamsmaten
| Meting NHG45#1272 Quetelet-index (BMI) patiënt
+ | Sanday-Bundle | 20-8-2025 | Quetelet-index (BMI) patiënt | 0 kg/m2 |  |  | Lichaamsmaten
| Meting NHG45#1272 Quetelet-index (BMI) patiënt
+ | Sanday-Bundle | 7-8-2025 | temperatuur patiënt | 37.3 °C |  |  | Temperatuur
| Meting NHG45#1357 temperatuur patiënt
+ | Sanday-Bundle | 20-8-2025 | temperatuur patiënt | 23 °C |  |  | Temperatuur
| Meting NHG45#1357 temperatuur patiënt Toelichting Waarde aangepast van heel veel naar 23
+ | Sanday-Bundle | 7-8-2025 | roken | nooit |  |  |
| Meting NHG45#1739 roken
+ | Sanday-Bundle | 7-8-2025 | diastolische bloeddruk | 80 mmHg |  |  | Bloeddruk
| Meting NHG45#1740 diastolische bloeddruk
+ | Sanday-Bundle | 20-8-2025 | diastolische bloeddruk | 23 mmHg |  |  | Bloeddruk
| Meting NHG45#1740 diastolische bloeddruk
+ | Sanday-Bundle | 7-8-2025 | systolische bloeddruk | 125 mmHg |  |  | Bloeddruk
| Meting NHG45#1744 systolische bloeddruk
+ | Sanday-Bundle | 20-8-2025 | systolische bloeddruk | 23 mmHg |  |  | Bloeddruk
| Meting NHG45#1744 systolische bloeddruk
+ | Sanday-Bundle | 20-8-2025 | polsfrequentie | 24.342 aantal/min |  |  | Hartslag
| Meting NHG45#1875 polsfrequentie Toelichting Dit is een opmerking
+ | Sanday-Bundle | 21-8-2025 | hoe vaak drinken van alcohol (FiveShot1) | 4 of meer keer per week (score 2) |  |  |
| Meting NHG45#2418 hoe vaak drinken van alcohol (FiveShot1)
+ | Sanday-Bundle | 21-8-2025 | aantal alcoh. dranken op dag (FiveShot2) | 10 of meer (score 2) |  |  |
| Meting NHG45#2419 aantal alcoh. dranken op dag (FiveShot2)
+ | Sanday-Bundle | 21-8-2025 | geërgerd aan opm. drankgew. (FiveShot3) | ja (score 1) |  |  |
| Meting NHG45#2420 geërgerd aan opm. drankgew. (FiveShot3)
+ | Sanday-Bundle | 21-8-2025 | schuldig over drankgewoonten (FiveShot4) | ja (score 1) |  |  |
| Meting NHG45#2421 schuldig over drankgewoonten (FiveShot4)
+ | Sanday-Bundle | 21-8-2025 | 's ochts drinken tegen kater (FiveShot5) | ja (score 1) |  |  |
| Meting NHG45#2422 's ochts drinken tegen kater (FiveShot5)
+ | Sanday-Bundle | 20-8-2025 | zuurstofsaturatie (pulsoximeter) | 23.424 % |  |  | Ademhaling
| Meting NHG45#2680 zuurstofsaturatie (pulsoximeter)
+ | Sanday-Bundle | 21-8-2025 | perifeer (enkel) oedeem, pitting | onduidelijk |  |  |
| Meting NHG45#3007 perifeer (enkel) oedeem, pitting Toelichting test bepaling toevoegen
+ | Sanday-Bundle | 7-8-2025 | lichaamsoppervlakte | 2 m2 |  |  | Lichaamsmaten
| Meting NHG45#3017 lichaamsoppervlakte
+ | Sanday-Bundle | 20-8-2025 | lichaamsoppervlakte | 6.538.6 m2 |  |  | Lichaamsmaten
| Meting NHG45#3017 lichaamsoppervlakte
+ | Sanday | 21-3-2024 | hartfrequentie (thuismeting) | 80 aantal/min |  |  | Hartslag
| Meting NHG45#3963 hartfrequentie (thuismeting)
+ | Epic | 23-8-2019 | Temperatuur | 38 Cel |  | S Brouwer | Temperatuur
| Meting LOINC#8310-5 Body temperature

### Kolom Definities

Kolom label | FHIR Path Expression | FHIR Type | Zib element | Toelichting of regels
Bron | `meta.extension('http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source').valueUri` | `string` | nvt | Lookup adhv uri (AGB-Z of OID) `<adressering-base>/Organization?identifier=<meta.tag.code>` en gebruik dan `Organization.name`
Datum | `effectiveDateTime` | `dateTime` | *DatumTijd |
Meting | `code.text | code.coding[0].display` | `string` | MetingNaam |
Waarde | `valueQuantity.value.toString()+' '+valueQuantity.unit | valueString | valueCodeableConcept.coding.display` | `string` | Uitslag/Waarde |
Waarde componenten | `component.valueQuantity.value.select(toString()).join('/')+' '+component[0].valueQuantity.unit` | `string` | *Waarde |
Uitvoerder | `performer.display` | `string` | Auteur |
UITKLAPVELD
+Methode | `method.text` | `string` | *Type |
+MeetLocatie | `bodySite.text` | `string` | MeetLocatie |
+Meting | `code.coding.where(system='http://loinc.org').select('LOINC#' + code + ' ' + display)` | `string` | MetingNaam | Meerdere codes mogelijk. Ignore NullFlavor. Lookup system label middels `<terminologie-base>/CodeSystem?url=<system>` en gebruik dan `CodeSystem.title`
+Meting | `code.coding.where(system='https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen').select('NHG45#' + code + ' ' + display)` | `string` | MetingNaam |
+Toelichting | `comment | note.text` | `string` | Toelichting | LET OP: `note.text` is een FHIR R4 veld
MARKERING
(Groep) | `code.coding.where(system='http://loinc.org' and code!='8716-3').translate('vital-signs-groups').target[0].display | code.coding.where(system='https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen').translate('vital-signs-groups').target[0].display` | `code` | nvt | Lookup LOINC 'groep' code middels `<terminologie-base>/ConceptMap/vital-signs-groups$translate?code=<code>` Gebruik deze om de regels te groeperen. Verberg regels die GEEN groep hebben.

### Zoeken naar codes

- LOINC - `system=http://loinc.org`
- NHG Tabel 45 Diagnostische Bepalingen Diagnostisch `system=https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen`

### Request

N.B. Eerste request is optimaal en wordt ondersteund door Epic en Sanday. De andere requests zijn de "officiele" BgZ requests en zijn nodig voor uitvragen van Zorgplatform.

1. Opvragen (search) vitale gegevens

   `GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&category=vital-signs`

2. Opvragen (search) bloeddruk (BgZ)

   `GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&code=http://loinc.org|85354-9`

3. Opvragen (search) gewicht (BgZ)

   `GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&code=http://loinc.org|29463-7`

4. Opvragen (search) lengte (BgZ)

   `GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&code=http://loinc.org|8302-2,http://loinc.org|8306-3,http://loinc.org|8308-9`

### Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

    "meta": {
        "extension": [ {
            "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
            "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
        } ]
    }

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (`<resource>.subject|patient`). Elke patient heeft een `Patient.managingOrganization` en in de gerefereerde `Organization.identifier` staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

Usages:

- This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Changes since version 1.20.0:

- The data elements list has changed

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions 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.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
coding | S Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | S Σ | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
comment | S | 0..1 | string | Comments about result
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: Observation Methods (example): Methods for simple observations.
component | Σ | 0..* | BackboneElement | Component results
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] | S Σ | 0..1 | Quantity S | Actual component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍3.0.2 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍3.0.2 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍3.0.2 | FHIR Std.
Observation.method | Base | example | Observation Methods | 📍3.0.2 | FHIR Std.
Observation.component.​code | Base | example | LOINC 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())`
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 Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
code | S | 1..1 | CodeableConcept | Type of observation (code / type)
coding | S | 0..* | Coding | Code defined by a terminology system
text | S | 0..1 | string | Plain text representation of the concept
effective[x] | S | 0..1 | dateTime, Period | Clinically relevant time/time-period for observation
performer | S | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S | 0..1 |  | Actual result
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
comment | S | 0..1 | string | Comments about result
bodySite | S | 0..1 | CodeableConcept | Observed body part
method | S | 0..1 | CodeableConcept | How it was done
component |  |  |  |
value[x] | S | 0..1 | Quantity S | Actual component result
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions 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 Bindings | Purpose
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.
category |  | 0..* | CodeableConcept | Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 0..1 | Reference(Patient | Group | Device | Location) | Who and/or what this is about
context |  | 0..1 | Reference(Encounter | EpisodeOfCare) | Healthcare event during which this observation is made
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | Date/Time this was made available
performer | S Σ | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
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 | S | 0..1 | string | Comments about result
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: Observation Methods (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 | 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 | Resource related to this observation
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(Observation | QuestionnaireResponse | Sequence) | 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] | S Σ | 0..1 | Quantity S | Actual component result
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
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.category | Base | preferred | Observation Category Codes | 📍3.0.2 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍3.0.2 | FHIR Std.
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 | example | Observation Methods | 📍3.0.2 | FHIR Std.
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())`
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()`

This structure is derived from Observation

Summary

Must-Support: 10 elements

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions 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.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
coding | S Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | S Σ | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
comment | S | 0..1 | string | Comments about result
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: Observation Methods (example): Methods for simple observations.
component | Σ | 0..* | BackboneElement | Component results
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] | S Σ | 0..1 | Quantity S | Actual component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.status | Base | required | ObservationStatus | 📍3.0.2 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍3.0.2 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍3.0.2 | FHIR Std.
Observation.method | Base | example | Observation Methods | 📍3.0.2 | FHIR Std.
Observation.component.​code | Base | example | LOINC 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())`
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 Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
code | S | 1..1 | CodeableConcept | Type of observation (code / type)
coding | S | 0..* | Coding | Code defined by a terminology system
text | S | 0..1 | string | Plain text representation of the concept
effective[x] | S | 0..1 | dateTime, Period | Clinically relevant time/time-period for observation
performer | S | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S | 0..1 |  | Actual result
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
comment | S | 0..1 | string | Comments about result
bodySite | S | 0..1 | CodeableConcept | Observed body part
method | S | 0..1 | CodeableConcept | How it was done
component |  |  |  |
value[x] | S | 0..1 | Quantity S | Actual component result
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions 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 Bindings | Purpose
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.
category |  | 0..* | CodeableConcept | Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 0..1 | Reference(Patient | Group | Device | Location) | Who and/or what this is about
context |  | 0..1 | Reference(Encounter | EpisodeOfCare) | Healthcare event during which this observation is made
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
issued | Σ | 0..1 | instant | Date/Time this was made available
performer | S Σ | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity S |
valueCodeableConcept |  |  | CodeableConcept S |
valueString |  |  | string S |
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 | S | 0..1 | string | Comments about result
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: Observation Methods (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 | 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 | Resource related to this observation
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(Observation | QuestionnaireResponse | Sequence) | 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] | S Σ | 0..1 | Quantity S | Actual component result
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
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.category | Base | preferred | Observation Category Codes | 📍3.0.2 | FHIR Std.
Observation.code | Base | example | LOINC Codes | 📍3.0.2 | FHIR Std.
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 | example | Observation Methods | 📍3.0.2 | FHIR Std.
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())`
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()`

This structure is derived from Observation

Summary

Must-Support: 10 elements

Other representations of profile: CSV, Excel, Schematron