Dit profiel is het resultaat van de vergelijking tussen de zib2017 STU3 en zibs2020 R4 FHIR Profiel, relevante informatiestandarden en de implementaties in de ontsloten systemen en instellingen. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

Zorginformatiebouwsteen

ZIB Laboratorium uitslag

View Definition

ViewDefinition voor labuitslagen

UI Wireframe

Laboratoriumuitslagen

Gegevensherkomst

Zoeken naar codes

• LOINC lab-uitslagen - system=http://loinc.org
• NHG Tabel 45 Diagnostische Bepalingen Labcodes system=https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen

Request

1. Opvragen (search) laatst bekende labuitslag per type (inclusief materiaalsoort) voor een patient

   GET <ontsluiten-bronsysteem-base>/Observation/$lastn?patient=<fhir_patient_id>&category=http://snomed.info/sct|275711006&_include=Observation:specimen

2. Sanday: Opvragen (search) labuitslagen per type voor een patient

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&category=http://hl7.org/fhir/observation-category|laboratory

   N.B. Alleen klinische chemie resultaten zijn op dit moment beschikbaar.

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.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Zib LaboratoryTestResult Observation	LaboratoryTestResult Constraints: obs-7, obs-6
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	TestUitslagStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.status.Slices for extension				Content/Rules for all slices
Observation.status.Slices for extension.extension:TestResultStatus		0..1	(Complex)	TestResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints: ext-1
Observation.status.Slices for extension.extension:TestResultStatus.extension		0..0		Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.status.Slices for extension.extension:TestResultStatus.url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/code-specification"
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x]				Content/Rules for all slices
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x].value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ResultaatStatusCodelijst (extensible): TestResultStatusCodelist
Observation.Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: Observation Category Codes (preferred): Codes for high level observation categories.
Observation.Slices for category.category:LaboratoryTestResultCode		1..1	CodeableConcept	LaboratoryTestResultCode Binding: Observation Category Codes (preferred): Codes for high level observation categories. Required Pattern: { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "49581000146104" } ] }
Observation.Slices for category.category:ResultType		0..1	CodeableConcept	ResultType Binding: ResultaatTypeCodelijst (required): ResultaatTypeCodelijst
Observation.code	Σ This element is included in summaries.	1..1	CodeableConcept	TestCode or PanelOrBattery Binding: LOINC Codes (example): Codes identifying names of simple observations.
Observation.code.coding	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system
Observation.code.coding.display	S This element must be supported. Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.code.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.subject	Σ This element is included in summaries.	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Patient
Observation.Slices for effective[x]	Σ This element is included in summaries.	0..1	dateTime	TestDateTime Slice: Unordered, Closed by type:$this
Observation.Slices for effective[x].effective[x]:effectiveDateTime	S This element must be supported. Σ This element is included in summaries.	0..1	dateTime	TestDateTime
Observation.Slices for value[x]	Σ This element is included in summaries. C	0..1	Quantity	TestResult Slice: Unordered, Closed by type:$this
Observation.Slices for value[x].value[x]:valueQuantity	S This element must be supported. Σ This element is included in summaries. C	0..1	Quantity	TestResult
Observation.Slices for value[x].value[x]:valueQuantity.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
Observation.interpretation.Slices for coding	Σ This element is included in summaries. C	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this Constraints: zib-LaboratoryTestResult-Observation-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.interpretation.Slices for coding.coding:All Slices				Content/Rules for all slices
Observation.interpretation.Slices for coding.coding:All Slices.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.interpretation.Slices for coding.coding:ObservationInterpretation	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system Binding: Observation Interpretation Codes (required): Observation Interpretation Codes
Observation.interpretation.Slices for coding.coding:InterpretatieVlaggenCodelijst	Σ This element is included in summaries.	0..*	Coding	ResultFlags Binding: InterpretatieVlaggenCodelijst (required): InterpretatieVlaggenCodelijst
Observation.interpretation.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.specimen	S This element must be supported.	0..1	Reference(Specimen)	Specimen
Observation.referenceRange	C	0..*	BackboneElement	Reference Constraints: obs-3
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.referenceRange.low	C	0..1	SimpleQuantity	ReferenceRangeLowerLimit Constraints: sqty-1
Observation.referenceRange.low.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.low.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.referenceRange.high	C	0..1	SimpleQuantity	ReferenceRangeUpperLimit Constraints: sqty-1
Observation.referenceRange.high.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.high.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
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:TestResultStatus.​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.category:LaboratoryTestResultCode	Base	preferred	Observation Category Codes	📦3.0.2	FHIR Std.
Observation.category:ResultType	Base	required	ResultaatTypeCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.code	Base	example	LOINC Codes	📦3.0.2	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍3.0.2	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦3.0.2	FHIR Std.
Observation.interpretation.​coding:ObservationInterpretation	Base	required	Observation Interpretation Codes	📦3.0.2	FHIR Std.
Observation.interpretation.​coding:InterpretatieVlaggenCodelijst	Base	required	InterpretatieVlaggenCodelijst	📦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:TestResultStatus	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()
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()
zib-LaboratoryTestResult-Observation-1	error	Observation.interpretation.coding	If a value from the HCIM ValueSet 'InterpretatieVlaggenCodelijst' is present a mapped code from the FHIR ValueSet 'Observation Interpretation Codes' is also expected. A ConceptMap is available that maps the HCIM values to the FHIR values.	coding.where(system = 'http://snomed.info/sct' and (code = '281302008' or '281300000' or '11896004' or '30714006' or '131196009') ).exists() implies coding.where(system = 'http://hl7.org/fhir/v2/0078').exists()

This structure is derived from Zib LaboratoryTestResult Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Zib LaboratoryTestResult Observation	LaboratoryTestResult
Observation.status	S This element must be supported.	1..1	code	TestUitslagStatus
Observation.code
Observation.code.coding
Observation.code.coding.display	S This element must be supported.	0..1	string	Representation defined by the system
Observation.code.text	S This element must be supported.	0..1	string	Plain text representation of the concept
Observation.effectiveDateTime	S This element must be supported.	0..1	dateTime	TestDateTime
Observation.valueQuantity	S This element must be supported.	0..1	Quantity	TestResult
Observation.valueQuantity.value	S This element must be supported.	0..1	decimal	Numerical value (with implicit precision)
Observation.valueQuantity.code	S This element must be supported.	0..1	code	Coded form of the unit
Observation.interpretation
Observation.interpretation.coding
Observation.interpretation.coding.code	S This element must be supported.	0..1	code	Symbol in syntax defined by the system
Observation.interpretation.text	S This element must be supported.	0..1	string	Plain text representation of the concept
Observation.specimen	S This element must be supported.	0..1	Reference(Specimen)	Specimen
Observation.referenceRange
Observation.referenceRange.low
Observation.referenceRange.low.value	S This element must be supported.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.low.code	S This element must be supported.	0..1	code	Coded form of the unit
Observation.referenceRange.high
Observation.referenceRange.high.value	S This element must be supported.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.high.code	S This element must be supported.	0..1	code	Coded form of the unit
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Zib LaboratoryTestResult Observation	LaboratoryTestResult Constraints: obs-7, obs-6
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
Observation.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
Observation.contained		0..*	Resource	Contained, inline Resources
Observation.extension		0..*	Extension	Additional Content defined by implementations
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.identifier	Σ This element is included in summaries.	0..*	Identifier	Identifier
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order including requester information.
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	TestUitslagStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.status.id		0..1	string	xml:id (or equivalent in JSON)
Observation.status.Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.status.Slices for extension.extension:TestResultStatus		0..1	(Complex)	TestResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints: ext-1
Observation.status.Slices for extension.extension:TestResultStatus.id		0..1	string	xml:id (or equivalent in JSON)
Observation.status.Slices for extension.extension:TestResultStatus.extension		0..0		Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.status.Slices for extension.extension:TestResultStatus.url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/code-specification"
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x]				Content/Rules for all slices
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x].value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ResultaatStatusCodelijst (extensible): TestResultStatusCodelist
Observation.status.value		0..1	code	Primitive value for code
Observation.Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: Observation Category Codes (preferred): Codes for high level observation categories.
Observation.Slices for category.category:LaboratoryTestResultCode		1..1	CodeableConcept	LaboratoryTestResultCode Binding: Observation Category Codes (preferred): Codes for high level observation categories. Required Pattern: { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "49581000146104" } ] }
Observation.Slices for category.category:LaboratoryTestResultCode.id		0..1	string	xml:id (or equivalent in JSON)
Observation.Slices for category.category:LaboratoryTestResultCode.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for category.category:LaboratoryTestResultCode.coding	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.id		0..1	string	xml:id (or equivalent in JSON)
Observation.Slices for category.category:LaboratoryTestResultCode.coding.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for category.category:LaboratoryTestResultCode.coding.system	Σ This element is included in summaries.	0..1	uri	Identity of the terminology system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Observation.Slices for category.category:LaboratoryTestResultCode.coding.code	Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Observation.Slices for category.category:LaboratoryTestResultCode.text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.Slices for category.category:ResultType		0..1	CodeableConcept	ResultType Binding: ResultaatTypeCodelijst (required): ResultaatTypeCodelijst
Observation.code	Σ This element is included in summaries.	1..1	CodeableConcept	TestCode or PanelOrBattery Binding: LOINC Codes (example): Codes identifying names of simple observations.
Observation.code.id		0..1	string	xml:id (or equivalent in JSON)
Observation.code.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.code.coding	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system
Observation.code.coding.id		0..1	string	xml:id (or equivalent in JSON)
Observation.code.coding.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.code.coding.system	Σ This element is included in summaries.	0..1	uri	Identity of the terminology system
Observation.code.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Observation.code.coding.code	Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.code.coding.display	S This element must be supported. Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.code.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Observation.code.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.subject	Σ This element is included in summaries.	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Patient
Observation.context		0..1	Reference(nl-core-episodeofcare | HCIM Encounter | gp-Encounter)	Encounter during which this observation is made
Observation.Slices for effective[x]	Σ This element is included in summaries.	0..1	dateTime	TestDateTime Slice: Unordered, Closed by type:$this
Observation.Slices for effective[x].effective[x]:effectiveDateTime	S This element must be supported. Σ This element is included in summaries.	0..1	dateTime	TestDateTime
Observation.issued	Σ This element is included in summaries.	0..1	instant	Date/Time this was made available
Observation.performer	Σ This element is included in summaries.	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
Observation.performer.id		0..1	string	xml:id (or equivalent in JSON)
Observation.performer.Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.performer.Slices for extension.extension:practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
Observation.performer.reference	Σ This element is included in summaries. C	0..1	string	Literal reference, Relative, internal or absolute URL
Observation.performer.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Observation.performer.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Observation.Slices for value[x]	Σ This element is included in summaries. C	0..1	Quantity	TestResult Slice: Unordered, Closed by type:$this
Observation.Slices for value[x].value[x]:valueQuantity	S This element must be supported. Σ This element is included in summaries. C	0..1	Quantity	TestResult
Observation.Slices for value[x].value[x]:valueQuantity.id		0..1	string	xml:id (or equivalent in JSON)
Observation.Slices for value[x].value[x]:valueQuantity.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for value[x].value[x]:valueQuantity.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.Slices for value[x].value[x]:valueQuantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
Observation.Slices for value[x].value[x]:valueQuantity.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.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.
Observation.interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
Observation.interpretation.id		0..1	string	xml:id (or equivalent in JSON)
Observation.interpretation.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.interpretation.Slices for coding	Σ This element is included in summaries. C	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this Constraints: zib-LaboratoryTestResult-Observation-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.interpretation.Slices for coding.coding:All Slices				Content/Rules for all slices
Observation.interpretation.Slices for coding.coding:All Slices.id		0..1	string	xml:id (or equivalent in JSON)
Observation.interpretation.Slices for coding.coding:All Slices.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.interpretation.Slices for coding.coding:All Slices.system	Σ This element is included in summaries.	0..1	uri	Identity of the terminology system
Observation.interpretation.Slices for coding.coding:All Slices.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Observation.interpretation.Slices for coding.coding:All Slices.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.interpretation.Slices for coding.coding:All Slices.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.interpretation.Slices for coding.coding:All Slices.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Observation.interpretation.Slices for coding.coding:ObservationInterpretation	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system Binding: Observation Interpretation Codes (required): Observation Interpretation Codes
Observation.interpretation.Slices for coding.coding:InterpretatieVlaggenCodelijst	Σ This element is included in summaries.	0..*	Coding	ResultFlags Binding: InterpretatieVlaggenCodelijst (required): InterpretatieVlaggenCodelijst
Observation.interpretation.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.comment		0..1	string	Comment or ResultInterpretation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
Observation.method		0..1	CodeableConcept	TestMethod Binding: TestmethodeCodelijst (extensible): SNOMED CT (2.16.840.1.113883.6.96): All values
Observation.specimen	S This element must be supported.	0..1	Reference(Specimen)	Specimen
Observation.device		0..1	Reference(HCIM MedicalDevice Product)	(Measurement) Device
Observation.referenceRange	C	0..*	BackboneElement	Reference Constraints: obs-3
Observation.referenceRange.id		0..1	string	xml:id (or equivalent in JSON)
Observation.referenceRange.extension		0..*	Extension	Additional Content defined by implementations
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.referenceRange.low	C	0..1	SimpleQuantity	ReferenceRangeLowerLimit Constraints: sqty-1
Observation.referenceRange.low.id		0..1	string	xml:id (or equivalent in JSON)
Observation.referenceRange.low.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.referenceRange.low.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.low.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.referenceRange.low.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
Observation.referenceRange.low.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.referenceRange.high	C	0..1	SimpleQuantity	ReferenceRangeUpperLimit Constraints: sqty-1
Observation.referenceRange.high.id		0..1	string	xml:id (or equivalent in JSON)
Observation.referenceRange.high.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.referenceRange.high.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.high.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.referenceRange.high.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
Observation.referenceRange.high.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.referenceRange.type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age		0..1	Range	Applicable age range, if relevant
Observation.referenceRange.text		0..1	string	Text based reference range in an observation
Observation.related	Σ This element is included in summaries.	0..*	BackboneElement	RelatedResults
Observation.related.id		0..1	string	xml:id (or equivalent in JSON)
Observation.related.extension		0..*	Extension	Additional Content defined by implementations
Observation.related.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.related.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.
Observation.related.target		1..1	Reference(QuestionnaireResponse | Sequence | HCIM LaboratoryTestResult Observation)	Resource that is related to this one
Observation.component	Σ This element is included in summaries.	0..*	BackboneElement	LaboratoryTest
Observation.component.id		0..1	string	xml:id (or equivalent in JSON)
Observation.component.extension		0..*	Extension	Additional Content defined by implementations
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.component.code	Σ This element is included in summaries.	1..1	CodeableConcept	TestCode Binding: TestCodeCodelijst (extensible): LOINC (2.16.840.1.113883.6.1): All values
Observation.component.value[x]	Σ This element is included in summaries.	0..1		TestResult
Observation.component.value[x].valueQuantity			Quantity
Observation.component.value[x].valueCodeableConcept			CodeableConcept
Observation.component.value[x].valueString			string
Observation.component.value[x].valueRange			Range
Observation.component.value[x].valueRatio			Ratio
Observation.component.value[x].valueSampledData			SampledData
Observation.component.value[x].valueAttachment			Attachment
Observation.component.value[x].valueTime			time
Observation.component.value[x].valueDateTime			dateTime
Observation.component.value[x].valuePeriod			Period
Observation.component.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.
Observation.component.interpretation		0..1	CodeableConcept	ResultFlags Binding: InterpretatieVlaggenCodelijst (extensible): InterpretatieVlaggenCodelijst
Observation.component.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.status.extension:TestResultStatus.​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.category:LaboratoryTestResultCode	Base	preferred	Observation Category Codes	📦3.0.2	FHIR Std.
Observation.category:ResultType	Base	required	ResultaatTypeCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.code	Base	example	LOINC Codes	📦3.0.2	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍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.interpretation.​coding:ObservationInterpretation	Base	required	Observation Interpretation Codes	📦3.0.2	FHIR Std.
Observation.interpretation.​coding:InterpretatieVlaggenCodelijst	Base	required	InterpretatieVlaggenCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦3.0.2	FHIR Std.
Observation.method	Base	extensible	TestmethodeCodelijst	📦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	extensible	TestCodeCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.component.​dataAbsentReason	Base	extensible	Observation Value Absent Reason	📦3.0.2	FHIR Std.
Observation.component.​interpretation	Base	extensible	InterpretatieVlaggenCodelijst	📦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:TestResultStatus, 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()
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()
zib-LaboratoryTestResult-Observation-1	error	Observation.interpretation.coding	If a value from the HCIM ValueSet 'InterpretatieVlaggenCodelijst' is present a mapped code from the FHIR ValueSet 'Observation Interpretation Codes' is also expected. A ConceptMap is available that maps the HCIM values to the FHIR values.	coding.where(system = 'http://snomed.info/sct' and (code = '281302008' or '281300000' or '11896004' or '30714006' or '131196009') ).exists() implies coding.where(system = 'http://hl7.org/fhir/v2/0078').exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Zib LaboratoryTestResult Observation	LaboratoryTestResult Constraints: obs-7, obs-6
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	TestUitslagStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.status.Slices for extension				Content/Rules for all slices
Observation.status.Slices for extension.extension:TestResultStatus		0..1	(Complex)	TestResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints: ext-1
Observation.status.Slices for extension.extension:TestResultStatus.extension		0..0		Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.status.Slices for extension.extension:TestResultStatus.url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/code-specification"
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x]				Content/Rules for all slices
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x].value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ResultaatStatusCodelijst (extensible): TestResultStatusCodelist
Observation.Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: Observation Category Codes (preferred): Codes for high level observation categories.
Observation.Slices for category.category:LaboratoryTestResultCode		1..1	CodeableConcept	LaboratoryTestResultCode Binding: Observation Category Codes (preferred): Codes for high level observation categories. Required Pattern: { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "49581000146104" } ] }
Observation.Slices for category.category:ResultType		0..1	CodeableConcept	ResultType Binding: ResultaatTypeCodelijst (required): ResultaatTypeCodelijst
Observation.code	Σ This element is included in summaries.	1..1	CodeableConcept	TestCode or PanelOrBattery Binding: LOINC Codes (example): Codes identifying names of simple observations.
Observation.code.coding	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system
Observation.code.coding.display	S This element must be supported. Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.code.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.subject	Σ This element is included in summaries.	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Patient
Observation.Slices for effective[x]	Σ This element is included in summaries.	0..1	dateTime	TestDateTime Slice: Unordered, Closed by type:$this
Observation.Slices for effective[x].effective[x]:effectiveDateTime	S This element must be supported. Σ This element is included in summaries.	0..1	dateTime	TestDateTime
Observation.Slices for value[x]	Σ This element is included in summaries. C	0..1	Quantity	TestResult Slice: Unordered, Closed by type:$this
Observation.Slices for value[x].value[x]:valueQuantity	S This element must be supported. Σ This element is included in summaries. C	0..1	Quantity	TestResult
Observation.Slices for value[x].value[x]:valueQuantity.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
Observation.interpretation.Slices for coding	Σ This element is included in summaries. C	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this Constraints: zib-LaboratoryTestResult-Observation-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.interpretation.Slices for coding.coding:All Slices				Content/Rules for all slices
Observation.interpretation.Slices for coding.coding:All Slices.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.interpretation.Slices for coding.coding:ObservationInterpretation	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system Binding: Observation Interpretation Codes (required): Observation Interpretation Codes
Observation.interpretation.Slices for coding.coding:InterpretatieVlaggenCodelijst	Σ This element is included in summaries.	0..*	Coding	ResultFlags Binding: InterpretatieVlaggenCodelijst (required): InterpretatieVlaggenCodelijst
Observation.interpretation.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.specimen	S This element must be supported.	0..1	Reference(Specimen)	Specimen
Observation.referenceRange	C	0..*	BackboneElement	Reference Constraints: obs-3
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.referenceRange.low	C	0..1	SimpleQuantity	ReferenceRangeLowerLimit Constraints: sqty-1
Observation.referenceRange.low.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.low.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.referenceRange.high	C	0..1	SimpleQuantity	ReferenceRangeUpperLimit Constraints: sqty-1
Observation.referenceRange.high.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.high.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
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:TestResultStatus.​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.category:LaboratoryTestResultCode	Base	preferred	Observation Category Codes	📦3.0.2	FHIR Std.
Observation.category:ResultType	Base	required	ResultaatTypeCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.code	Base	example	LOINC Codes	📦3.0.2	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍3.0.2	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦3.0.2	FHIR Std.
Observation.interpretation.​coding:ObservationInterpretation	Base	required	Observation Interpretation Codes	📦3.0.2	FHIR Std.
Observation.interpretation.​coding:InterpretatieVlaggenCodelijst	Base	required	InterpretatieVlaggenCodelijst	📦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:TestResultStatus	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()
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()
zib-LaboratoryTestResult-Observation-1	error	Observation.interpretation.coding	If a value from the HCIM ValueSet 'InterpretatieVlaggenCodelijst' is present a mapped code from the FHIR ValueSet 'Observation Interpretation Codes' is also expected. A ConceptMap is available that maps the HCIM values to the FHIR values.	coding.where(system = 'http://snomed.info/sct' and (code = '281302008' or '281300000' or '11896004' or '30714006' or '131196009') ).exists() implies coding.where(system = 'http://hl7.org/fhir/v2/0078').exists()

Differential View

This structure is derived from Zib LaboratoryTestResult Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Zib LaboratoryTestResult Observation	LaboratoryTestResult
Observation.status	S This element must be supported.	1..1	code	TestUitslagStatus
Observation.code
Observation.code.coding
Observation.code.coding.display	S This element must be supported.	0..1	string	Representation defined by the system
Observation.code.text	S This element must be supported.	0..1	string	Plain text representation of the concept
Observation.effectiveDateTime	S This element must be supported.	0..1	dateTime	TestDateTime
Observation.valueQuantity	S This element must be supported.	0..1	Quantity	TestResult
Observation.valueQuantity.value	S This element must be supported.	0..1	decimal	Numerical value (with implicit precision)
Observation.valueQuantity.code	S This element must be supported.	0..1	code	Coded form of the unit
Observation.interpretation
Observation.interpretation.coding
Observation.interpretation.coding.code	S This element must be supported.	0..1	code	Symbol in syntax defined by the system
Observation.interpretation.text	S This element must be supported.	0..1	string	Plain text representation of the concept
Observation.specimen	S This element must be supported.	0..1	Reference(Specimen)	Specimen
Observation.referenceRange
Observation.referenceRange.low
Observation.referenceRange.low.value	S This element must be supported.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.low.code	S This element must be supported.	0..1	code	Coded form of the unit
Observation.referenceRange.high
Observation.referenceRange.high.value	S This element must be supported.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.high.code	S This element must be supported.	0..1	code	Coded form of the unit
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Zib LaboratoryTestResult Observation	LaboratoryTestResult Constraints: obs-7, obs-6
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Observation.language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
Observation.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
Observation.contained		0..*	Resource	Contained, inline Resources
Observation.extension		0..*	Extension	Additional Content defined by implementations
Observation.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Observation.identifier	Σ This element is included in summaries.	0..*	Identifier	Identifier
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order including requester information.
Observation.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	TestUitslagStatus Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.status.id		0..1	string	xml:id (or equivalent in JSON)
Observation.status.Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.status.Slices for extension.extension:TestResultStatus		0..1	(Complex)	TestResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints: ext-1
Observation.status.Slices for extension.extension:TestResultStatus.id		0..1	string	xml:id (or equivalent in JSON)
Observation.status.Slices for extension.extension:TestResultStatus.extension		0..0		Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.status.Slices for extension.extension:TestResultStatus.url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/code-specification"
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x]				Content/Rules for all slices
Observation.status.Slices for extension.extension:TestResultStatus.Slices for value[x].value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ResultaatStatusCodelijst (extensible): TestResultStatusCodelist
Observation.status.value		0..1	code	Primitive value for code
Observation.Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: Observation Category Codes (preferred): Codes for high level observation categories.
Observation.Slices for category.category:LaboratoryTestResultCode		1..1	CodeableConcept	LaboratoryTestResultCode Binding: Observation Category Codes (preferred): Codes for high level observation categories. Required Pattern: { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "49581000146104" } ] }
Observation.Slices for category.category:LaboratoryTestResultCode.id		0..1	string	xml:id (or equivalent in JSON)
Observation.Slices for category.category:LaboratoryTestResultCode.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for category.category:LaboratoryTestResultCode.coding	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.id		0..1	string	xml:id (or equivalent in JSON)
Observation.Slices for category.category:LaboratoryTestResultCode.coding.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for category.category:LaboratoryTestResultCode.coding.system	Σ This element is included in summaries.	0..1	uri	Identity of the terminology system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Observation.Slices for category.category:LaboratoryTestResultCode.coding.code	Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.Slices for category.category:LaboratoryTestResultCode.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Observation.Slices for category.category:LaboratoryTestResultCode.text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.Slices for category.category:ResultType		0..1	CodeableConcept	ResultType Binding: ResultaatTypeCodelijst (required): ResultaatTypeCodelijst
Observation.code	Σ This element is included in summaries.	1..1	CodeableConcept	TestCode or PanelOrBattery Binding: LOINC Codes (example): Codes identifying names of simple observations.
Observation.code.id		0..1	string	xml:id (or equivalent in JSON)
Observation.code.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.code.coding	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system
Observation.code.coding.id		0..1	string	xml:id (or equivalent in JSON)
Observation.code.coding.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.code.coding.system	Σ This element is included in summaries.	0..1	uri	Identity of the terminology system
Observation.code.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Observation.code.coding.code	Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.code.coding.display	S This element must be supported. Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.code.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Observation.code.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.subject	Σ This element is included in summaries.	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Patient
Observation.context		0..1	Reference(nl-core-episodeofcare | HCIM Encounter | gp-Encounter)	Encounter during which this observation is made
Observation.Slices for effective[x]	Σ This element is included in summaries.	0..1	dateTime	TestDateTime Slice: Unordered, Closed by type:$this
Observation.Slices for effective[x].effective[x]:effectiveDateTime	S This element must be supported. Σ This element is included in summaries.	0..1	dateTime	TestDateTime
Observation.issued	Σ This element is included in summaries.	0..1	instant	Date/Time this was made available
Observation.performer	Σ This element is included in summaries.	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
Observation.performer.id		0..1	string	xml:id (or equivalent in JSON)
Observation.performer.Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.performer.Slices for extension.extension:practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
Observation.performer.reference	Σ This element is included in summaries. C	0..1	string	Literal reference, Relative, internal or absolute URL
Observation.performer.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Observation.performer.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Observation.Slices for value[x]	Σ This element is included in summaries. C	0..1	Quantity	TestResult Slice: Unordered, Closed by type:$this
Observation.Slices for value[x].value[x]:valueQuantity	S This element must be supported. Σ This element is included in summaries. C	0..1	Quantity	TestResult
Observation.Slices for value[x].value[x]:valueQuantity.id		0..1	string	xml:id (or equivalent in JSON)
Observation.Slices for value[x].value[x]:valueQuantity.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.Slices for value[x].value[x]:valueQuantity.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.Slices for value[x].value[x]:valueQuantity.comparator	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Observation.Slices for value[x].value[x]:valueQuantity.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.Slices for value[x].value[x]:valueQuantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
Observation.Slices for value[x].value[x]:valueQuantity.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.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.
Observation.interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
Observation.interpretation.id		0..1	string	xml:id (or equivalent in JSON)
Observation.interpretation.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.interpretation.Slices for coding	Σ This element is included in summaries. C	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this Constraints: zib-LaboratoryTestResult-Observation-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.interpretation.Slices for coding.coding:All Slices				Content/Rules for all slices
Observation.interpretation.Slices for coding.coding:All Slices.id		0..1	string	xml:id (or equivalent in JSON)
Observation.interpretation.Slices for coding.coding:All Slices.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.interpretation.Slices for coding.coding:All Slices.system	Σ This element is included in summaries.	0..1	uri	Identity of the terminology system
Observation.interpretation.Slices for coding.coding:All Slices.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
Observation.interpretation.Slices for coding.coding:All Slices.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Symbol in syntax defined by the system
Observation.interpretation.Slices for coding.coding:All Slices.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
Observation.interpretation.Slices for coding.coding:All Slices.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
Observation.interpretation.Slices for coding.coding:ObservationInterpretation	Σ This element is included in summaries.	0..*	Coding	Code defined by a terminology system Binding: Observation Interpretation Codes (required): Observation Interpretation Codes
Observation.interpretation.Slices for coding.coding:InterpretatieVlaggenCodelijst	Σ This element is included in summaries.	0..*	Coding	ResultFlags Binding: InterpretatieVlaggenCodelijst (required): InterpretatieVlaggenCodelijst
Observation.interpretation.text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Observation.comment		0..1	string	Comment or ResultInterpretation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
Observation.method		0..1	CodeableConcept	TestMethod Binding: TestmethodeCodelijst (extensible): SNOMED CT (2.16.840.1.113883.6.96): All values
Observation.specimen	S This element must be supported.	0..1	Reference(Specimen)	Specimen
Observation.device		0..1	Reference(HCIM MedicalDevice Product)	(Measurement) Device
Observation.referenceRange	C	0..*	BackboneElement	Reference Constraints: obs-3
Observation.referenceRange.id		0..1	string	xml:id (or equivalent in JSON)
Observation.referenceRange.extension		0..*	Extension	Additional Content defined by implementations
Observation.referenceRange.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.referenceRange.low	C	0..1	SimpleQuantity	ReferenceRangeLowerLimit Constraints: sqty-1
Observation.referenceRange.low.id		0..1	string	xml:id (or equivalent in JSON)
Observation.referenceRange.low.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.referenceRange.low.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.low.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.referenceRange.low.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
Observation.referenceRange.low.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.referenceRange.high	C	0..1	SimpleQuantity	ReferenceRangeUpperLimit Constraints: sqty-1
Observation.referenceRange.high.id		0..1	string	xml:id (or equivalent in JSON)
Observation.referenceRange.high.extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Observation.referenceRange.high.value	S This element must be supported. Σ This element is included in summaries.	0..1	decimal	Numerical value (with implicit precision)
Observation.referenceRange.high.unit	Σ This element is included in summaries.	0..1	string	Unit representation
Observation.referenceRange.high.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
Observation.referenceRange.high.code	S This element must be supported. Σ This element is included in summaries.	0..1	code	Coded form of the unit
Observation.referenceRange.type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age		0..1	Range	Applicable age range, if relevant
Observation.referenceRange.text		0..1	string	Text based reference range in an observation
Observation.related	Σ This element is included in summaries.	0..*	BackboneElement	RelatedResults
Observation.related.id		0..1	string	xml:id (or equivalent in JSON)
Observation.related.extension		0..*	Extension	Additional Content defined by implementations
Observation.related.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.related.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.
Observation.related.target		1..1	Reference(QuestionnaireResponse | Sequence | HCIM LaboratoryTestResult Observation)	Resource that is related to this one
Observation.component	Σ This element is included in summaries.	0..*	BackboneElement	LaboratoryTest
Observation.component.id		0..1	string	xml:id (or equivalent in JSON)
Observation.component.extension		0..*	Extension	Additional Content defined by implementations
Observation.component.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Observation.component.code	Σ This element is included in summaries.	1..1	CodeableConcept	TestCode Binding: TestCodeCodelijst (extensible): LOINC (2.16.840.1.113883.6.1): All values
Observation.component.value[x]	Σ This element is included in summaries.	0..1		TestResult
Observation.component.value[x].valueQuantity			Quantity
Observation.component.value[x].valueCodeableConcept			CodeableConcept
Observation.component.value[x].valueString			string
Observation.component.value[x].valueRange			Range
Observation.component.value[x].valueRatio			Ratio
Observation.component.value[x].valueSampledData			SampledData
Observation.component.value[x].valueAttachment			Attachment
Observation.component.value[x].valueTime			time
Observation.component.value[x].valueDateTime			dateTime
Observation.component.value[x].valuePeriod			Period
Observation.component.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.
Observation.component.interpretation		0..1	CodeableConcept	ResultFlags Binding: InterpretatieVlaggenCodelijst (extensible): InterpretatieVlaggenCodelijst
Observation.component.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.status.extension:TestResultStatus.​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.category:LaboratoryTestResultCode	Base	preferred	Observation Category Codes	📦3.0.2	FHIR Std.
Observation.category:ResultType	Base	required	ResultaatTypeCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.code	Base	example	LOINC Codes	📦3.0.2	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍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.interpretation.​coding:ObservationInterpretation	Base	required	Observation Interpretation Codes	📦3.0.2	FHIR Std.
Observation.interpretation.​coding:InterpretatieVlaggenCodelijst	Base	required	InterpretatieVlaggenCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦3.0.2	FHIR Std.
Observation.method	Base	extensible	TestmethodeCodelijst	📦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	extensible	TestCodeCodelijst	📦2017-12-31T00:00:00	Nictiz FHIR NL STU3 Zib2017 v2.3
Observation.component.​dataAbsentReason	Base	extensible	Observation Value Absent Reason	📦3.0.2	FHIR Std.
Observation.component.​interpretation	Base	extensible	InterpretatieVlaggenCodelijst	📦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:TestResultStatus, 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()
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()
zib-LaboratoryTestResult-Observation-1	error	Observation.interpretation.coding	If a value from the HCIM ValueSet 'InterpretatieVlaggenCodelijst' is present a mapped code from the FHIR ValueSet 'Observation Interpretation Codes' is also expected. A ConceptMap is available that maps the HCIM values to the FHIR values.	coding.where(system = 'http://snomed.info/sct' and (code = '281302008' or '281300000' or '11896004' or '30714006' or '131196009') ).exists() implies coding.where(system = 'http://hl7.org/fhir/v2/0078').exists()

This structure is derived from Zib LaboratoryTestResult Observation

Summary

Must-Support: 14 elements

Structures

This structure refers to these other structures:

• Specimen (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Specimen)