Para observaciones derivadas de encuestas (cuestionarios de detección de SDOH.)

Se utiliza para observaciones simples, como el estado educativo, observaciones sobre la inseguridad alimentaria, etc. Este perfil permite la representación de observaciones de los Determinantes Sociales de la Salud (SDOH) basadas en las respuestas a cuestionarios de detección de SDOH (que también pueden ser representadas utilizando SDC QuestionnaireResponse).

Muchos de los perfiles de SDOHCC hacen referencia entre sí. Un flujo soportado por esta IG es que las respuestas a los cuestionarios resultan en observaciones que pueden ser usadas como evidencia para condiciones que pueden llevar a metas, solicitudes de servicios y procedimientos. Sin embargo, también son posibles caminos alternativos.

Limitado adicionalmente a valores que son relevantes para los SDOH.

Para identificar que una respuesta de detección de una observación SDOH se deriva de una cuestionario SDOH, se requieren los códigos "social-history" y "survey".

Se utiliza para filtrar observaciones de la historia social.

Se utiliza para filtrar observaciones derivadas de una encuesta/cuestionario.

Una categoría de SDOH asignada a la observación.

Códigos para categorías de SDOH de alto nivel.

Los códigos de este value set pueden usarse para asignar una o más categorías de SDOH (por ejemplo,inseguridad alimentaria, inseguridad en el transporte,etc.) a una observación.Se recomienda que se utilicen los códigos de categorías de SDOH para facilitar la búsqueda de observaciones de SDOH.

Códigos que identifican nombres de observaciones simples.

Conocer qué tipo de observación se está realizando es esencial para entender la observación.

La guía de implementación restringe las observaciones de cuestionarios/encuestas a LOINC para mover a la industria hacia el uso de paneles/encuestas LOINC (estructura que no están disponibles en otros sistemas de terminología) con el fin de estandarizar la codificación de los instrumentos de evaluación de riesgos relacionados con los SDOH.

La cardinalidad es 1..1

El tiempo o período de tiempo en el que se afirma que el valor observado es verdadero.Para sujetos biológicos, por ejemplo, pacientes humanos, esto se llama generalmente el "tiempo fisiológicamente relevante".

Al menos una fecha debe estar presente a menos que esta observación sea un informe histórico.

Algunas preguntas en un cuestionario de detección de SDOH no son respondidas directamente (por ejemplo, afirmadas) por la persona que completa el cuestionario.En cambio,la respuesta a algunas preguntas (por ejemplo,el signo vital de hambre 88124-3 "riesgo de inseguridad alimentaria") puede derivarse de las respuestas a una o más otras preguntas.Para una respuesta de detección de observación que es derivada, en lugar de respondida directamente, no se debe especificar el Observation.performer.

Una observación existe para tener un valor, aunque podría no tenerlo si está en error, si representa un grupo de observaciones, o si una razón para su omisión está capturada por Observation.dataAbsentReason.

Una observación existe para tener un valor,aunque podría no tenerlo si está en error, si representa un grupo de observaciones, o si una razón para su omisión está capturada por Observation.dataAbsentReason.

Esté es el conjunto completo de códigos UCUM.

El conjunto de códigos permitidos será determinado por Observation.code.Se utilizaría un CodeableConcept con solo un texto en lugar de una cadena si el campo normalmente se codifica, o si el tipo asociado con Observation.code define un valor codificado.

Esté value set incluye todos los códigos LOINC.

Los valores "nulos" o excepcionales pueden ser representados de dos maneras en las observaciones FHIR. Una forma es incluirlos simplemente en el conjunto de valores y representar las excepciones en el valor.La otra forma es usar el elemento de valor para observaciones reales y utilizar el elemento explícito dataAbsentReason para registrar valores excepcionales.Para una pregunta LOINC dada, si la lista de respuestas LOINC incluye conceptos como "desconocido" o "no disponible", deben usarse para Observation.value.Cuando estos conceptos no son parte del conjunto de valores para Observation.value.Cuando estos conceptos no son parte del conjunto de valores para Observation.value, se puede utilizar Observation.dataAbsentReason si es necesario y apropiado.

Referencia las observaciones hijas de una observación de agrupamiento.

Este es el conjunto de observaciones hijas que se espera que sean soportadas por las implementaciones de SDOH.

Se pueden enviar otros tipos de observaciones o recursos, pero los sistemas SDOH no están obligados a prestarles atención.

Proporciona contexto a las observaciones hijas sobre "en qué instrumento/panel se recopiló esta información", lo cual es crítico en situaciones donde las observaciones hijas no tienen relaciones derivedFrom con un QuestionnaireResponse.

El recurso objetivo representa un QuestionnaireResponse u otra observación de la cual se infirió o calculó el valor de esta observación.

Todas las opciones de referencia que se enumeran en este elemento pueden representar observaciones clínicas y otras mediciones que pueden ser la fuente de un valor derivado.

Los tipos de recursos "derivedFrom" que deben ser soportados por las implementaciones que se ajustan a esta IG.

Se permiten objetivos de derivación adicionales (según lo admitido por el recurso de observación subyacente), pero no se espera que los implementadores de esta IG les presten atención.

Permite la trazabilidad (y el contexto) para las observaciones derivadas de un QuestionnaireResponse y también establece vínculos para observaciones que fueron calculadas o inferidas basándose en otras observaciones (por ejemplo,para puntajes calculados).

Para observaciones derivadas de encuestas (cuestionarios de detección de SDOH.)

Se utiliza para observaciones simples, como el estado educativo, observaciones sobre la inseguridad alimentaria, etc. Este perfil permite la representación de observaciones de los Determinantes Sociales de la Salud (SDOH) basadas en las respuestas a cuestionarios de detección de SDOH (que también pueden ser representadas utilizando SDC QuestionnaireResponse).

Muchos de los perfiles de SDOHCC hacen referencia entre sí. Un flujo soportado por esta IG es que las respuestas a los cuestionarios resultan en observaciones que pueden ser usadas como evidencia para condiciones que pueden llevar a metas, solicitudes de servicios y procedimientos. Sin embargo, también son posibles caminos alternativos.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A unique identifier assigned to this observation.

Allows observations to be distinguished and referenced.

Estado de la observación

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Limitado adicionalmente a valores que son relevantes para los SDOH.

A code that classifies the general type of observation being made.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos de alto nivel para la categoría de una observación

Para identificar que una respuesta de detección de una observación SDOH se deriva de una cuestionario SDOH, se requieren los códigos "social-history" y "survey".

A code that classifies the general type of observation being made.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos de alto nivel para la categoría de una observación

Se utiliza para filtrar observaciones de la historia social.

A code that classifies the general type of observation being made.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos de alto nivel para la categoría de una observación

Se utiliza para filtrar observaciones derivadas de una encuesta/cuestionario.

Una categoría de SDOH asignada a la observación.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos para categorías de SDOH de alto nivel.

Los códigos de este value set pueden usarse para asignar una o más categorías de SDOH (por ejemplo,inseguridad alimentaria, inseguridad en el transporte,etc.) a una observación.Se recomienda que se utilicen los códigos de categorías de SDOH para facilitar la búsqueda de observaciones de SDOH.

Describes what was observed. Sometimes this is called the observation "name".

All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Códigos que identifican nombres de observaciones simples.

Conocer qué tipo de observación se está realizando es esencial para entender la observación.

La guía de implementación restringe las observaciones de cuestionarios/encuestas a LOINC para mover a la industria hacia el uso de paneles/encuestas LOINC (estructura que no están disponibles en otros sistemas de terminología) con el fin de estandarizar la codificación de los instrumentos de evaluación de riesgos relacionados con los SDOH.

The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

La cardinalidad es 1..1

Observations have no value if you don't know who or what they're about.

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

For some observations it may be important to know the link between an observation and a particular encounter.

El tiempo o período de tiempo en el que se afirma que el valor observado es verdadero.Para sujetos biológicos, por ejemplo, pacientes humanos, esto se llama generalmente el "tiempo fisiológicamente relevante".

Al menos una fecha debe estar presente a menos que esta observación sea un informe histórico.

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

Who was responsible for asserting the observed value as "true".

Algunas preguntas en un cuestionario de detección de SDOH no son respondidas directamente (por ejemplo, afirmadas) por la persona que completa el cuestionario.En cambio,la respuesta a algunas preguntas (por ejemplo,el signo vital de hambre 88124-3 "riesgo de inseguridad alimentaria") puede derivarse de las respuestas a una o más otras preguntas.Para una respuesta de detección de observación que es derivada, en lugar de respondida directamente, no se debe especificar el Observation.performer.

The information determined as a result of making the observation, if the information has a simple value.

Una observación existe para tener un valor, aunque podría no tenerlo si está en error, si representa un grupo de observaciones, o si una razón para su omisión está capturada por Observation.dataAbsentReason.

Una observación existe para tener un valor,aunque podría no tenerlo si está en error, si representa un grupo de observaciones, o si una razón para su omisión está capturada por Observation.dataAbsentReason.

The information determined as a result of making the observation, if the information has a simple value.

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Esté es el conjunto completo de códigos UCUM.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

The information determined as a result of making the observation, if the information has a simple value.

El conjunto de códigos permitidos será determinado por Observation.code.Se utilizaría un CodeableConcept con solo un texto en lugar de una cadena si el campo normalmente se codifica, o si el tipo asociado con Observation.code define un valor codificado.

Esté value set incluye todos los códigos LOINC.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Provides a reason why the expected value in the element Observation.value[x] is missing.

Los valores "nulos" o excepcionales pueden ser representados de dos maneras en las observaciones FHIR. Una forma es incluirlos simplemente en el conjunto de valores y representar las excepciones en el valor.La otra forma es usar el elemento de valor para observaciones reales y utilizar el elemento explícito dataAbsentReason para registrar valores excepcionales.Para una pregunta LOINC dada, si la lista de respuestas LOINC incluye conceptos como "desconocido" o "no disponible", deben usarse para Observation.value.Cuando estos conceptos no son parte del conjunto de valores para Observation.value.Cuando estos conceptos no son parte del conjunto de valores para Observation.value, se puede utilizar Observation.dataAbsentReason si es necesario y apropiado.

Codes specifying why the result (Observation.value[x]) is missing.

For many results it is necessary to handle exceptional values in measurements.

Interpretación del valor de la observación

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Códigos de identificción para la interpretación de la observación

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Comments about the observation or the results.

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Need to be able to provide free text additional information.

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Codes describing anatomical locations. May include laterality.

The specimen that was used when this observation was made.

Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

Referencia las observaciones hijas de una observación de agrupamiento.

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

Este es el conjunto de observaciones hijas que se espera que sean soportadas por las implementaciones de SDOH.

Se pueden enviar otros tipos de observaciones o recursos, pero los sistemas SDOH no están obligados a prestarles atención.

Proporciona contexto a las observaciones hijas sobre "en qué instrumento/panel se recopiló esta información", lo cual es crítico en situaciones donde las observaciones hijas no tienen relaciones derivedFrom con un QuestionnaireResponse.

El recurso objetivo representa un QuestionnaireResponse u otra observación de la cual se infirió o calculó el valor de esta observación.

Todas las opciones de referencia que se enumeran en este elemento pueden representar observaciones clínicas y otras mediciones que pueden ser la fuente de un valor derivado.

Los tipos de recursos "derivedFrom" que deben ser soportados por las implementaciones que se ajustan a esta IG.

Se permiten objetivos de derivación adicionales (según lo admitido por el recurso de observación subyacente), pero no se espera que los implementadores de esta IG les presten atención.

Permite la trazabilidad (y el contexto) para las observaciones derivadas de un QuestionnaireResponse y también establece vínculos para observaciones que fueron calculadas o inferidas basándose en otras observaciones (por ejemplo,para puntajes calculados).

Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

For a discussion on the ways Observations can be assembled in groups together see Notes below.

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Describes what was observed. Sometimes this is called the observation "code".

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Códigos de identficación simple para el nombre de una observación

Knowing what kind of observation is being made is essential to understanding the observation.

The information determined as a result of making the observation, if the information has a simple value.

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Interpretación del valor del componente de la observación

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Códigos de identificción para la interpretación de la observación

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Para observaciones derivadas de encuestas (cuestionarios de detección de SDOH.)

Se utiliza para observaciones simples, como el estado educativo, observaciones sobre la inseguridad alimentaria, etc. Este perfil permite la representación de observaciones de los Determinantes Sociales de la Salud (SDOH) basadas en las respuestas a cuestionarios de detección de SDOH (que también pueden ser representadas utilizando SDC QuestionnaireResponse).

Muchos de los perfiles de SDOHCC hacen referencia entre sí. Un flujo soportado por esta IG es que las respuestas a los cuestionarios resultan en observaciones que pueden ser usadas como evidencia para condiciones que pueden llevar a metas, solicitudes de servicios y procedimientos. Sin embargo, también son posibles caminos alternativos.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A unique identifier assigned to this observation.

Allows observations to be distinguished and referenced.

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

Estado de la observación

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Limitado adicionalmente a valores que son relevantes para los SDOH.

A code that classifies the general type of observation being made.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos de alto nivel para la categoría de una observación

Para identificar que una respuesta de detección de una observación SDOH se deriva de una cuestionario SDOH, se requieren los códigos "social-history" y "survey".

A code that classifies the general type of observation being made.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos de alto nivel para la categoría de una observación

Se utiliza para filtrar observaciones de la historia social.

A code that classifies the general type of observation being made.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos de alto nivel para la categoría de una observación

Se utiliza para filtrar observaciones derivadas de una encuesta/cuestionario.

Una categoría de SDOH asignada a la observación.

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Códigos para categorías de SDOH de alto nivel.

Los códigos de este value set pueden usarse para asignar una o más categorías de SDOH (por ejemplo,inseguridad alimentaria, inseguridad en el transporte,etc.) a una observación.Se recomienda que se utilicen los códigos de categorías de SDOH para facilitar la búsqueda de observaciones de SDOH.

Describes what was observed. Sometimes this is called the observation "name".

All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Códigos que identifican nombres de observaciones simples.

Conocer qué tipo de observación se está realizando es esencial para entender la observación.

La guía de implementación restringe las observaciones de cuestionarios/encuestas a LOINC para mover a la industria hacia el uso de paneles/encuestas LOINC (estructura que no están disponibles en otros sistemas de terminología) con el fin de estandarizar la codificación de los instrumentos de evaluación de riesgos relacionados con los SDOH.

The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

La cardinalidad es 1..1

Observations have no value if you don't know who or what they're about.

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

For some observations it may be important to know the link between an observation and a particular encounter.

El tiempo o período de tiempo en el que se afirma que el valor observado es verdadero.Para sujetos biológicos, por ejemplo, pacientes humanos, esto se llama generalmente el "tiempo fisiológicamente relevante".

Al menos una fecha debe estar presente a menos que esta observación sea un informe histórico.

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

Who was responsible for asserting the observed value as "true".

Algunas preguntas en un cuestionario de detección de SDOH no son respondidas directamente (por ejemplo, afirmadas) por la persona que completa el cuestionario.En cambio,la respuesta a algunas preguntas (por ejemplo,el signo vital de hambre 88124-3 "riesgo de inseguridad alimentaria") puede derivarse de las respuestas a una o más otras preguntas.Para una respuesta de detección de observación que es derivada, en lugar de respondida directamente, no se debe especificar el Observation.performer.

The information determined as a result of making the observation, if the information has a simple value.

Una observación existe para tener un valor, aunque podría no tenerlo si está en error, si representa un grupo de observaciones, o si una razón para su omisión está capturada por Observation.dataAbsentReason.

Una observación existe para tener un valor,aunque podría no tenerlo si está en error, si representa un grupo de observaciones, o si una razón para su omisión está capturada por Observation.dataAbsentReason.

The information determined as a result of making the observation, if the information has a simple value.

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Esté es el conjunto completo de códigos UCUM.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

The information determined as a result of making the observation, if the information has a simple value.

El conjunto de códigos permitidos será determinado por Observation.code.Se utilizaría un CodeableConcept con solo un texto en lugar de una cadena si el campo normalmente se codifica, o si el tipo asociado con Observation.code define un valor codificado.

Esté value set incluye todos los códigos LOINC.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Provides a reason why the expected value in the element Observation.value[x] is missing.

Los valores "nulos" o excepcionales pueden ser representados de dos maneras en las observaciones FHIR. Una forma es incluirlos simplemente en el conjunto de valores y representar las excepciones en el valor.La otra forma es usar el elemento de valor para observaciones reales y utilizar el elemento explícito dataAbsentReason para registrar valores excepcionales.Para una pregunta LOINC dada, si la lista de respuestas LOINC incluye conceptos como "desconocido" o "no disponible", deben usarse para Observation.value.Cuando estos conceptos no son parte del conjunto de valores para Observation.value.Cuando estos conceptos no son parte del conjunto de valores para Observation.value, se puede utilizar Observation.dataAbsentReason si es necesario y apropiado.

Codes specifying why the result (Observation.value[x]) is missing.

For many results it is necessary to handle exceptional values in measurements.

Interpretación del valor de la observación

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Códigos de identificción para la interpretación de la observación

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Comments about the observation or the results.

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Need to be able to provide free text additional information.

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Codes describing anatomical locations. May include laterality.

Indicates the mechanism used to perform the observation.

Only used if not implicit in code for Observation.code.

Methods for simple observations.

In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

The specimen that was used when this observation was made.

Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

The device used to generate the observation data.

Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

Code for the meaning of a reference range.

Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

Codes identifying the population the reference range applies to.

Need to be able to identify the target population for proper interpretation.

The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

Some analytes vary greatly over age.

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

Referencia las observaciones hijas de una observación de agrupamiento.

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

Este es el conjunto de observaciones hijas que se espera que sean soportadas por las implementaciones de SDOH.

Se pueden enviar otros tipos de observaciones o recursos, pero los sistemas SDOH no están obligados a prestarles atención.

Proporciona contexto a las observaciones hijas sobre "en qué instrumento/panel se recopiló esta información", lo cual es crítico en situaciones donde las observaciones hijas no tienen relaciones derivedFrom con un QuestionnaireResponse.

El recurso objetivo representa un QuestionnaireResponse u otra observación de la cual se infirió o calculó el valor de esta observación.

Todas las opciones de referencia que se enumeran en este elemento pueden representar observaciones clínicas y otras mediciones que pueden ser la fuente de un valor derivado.

Los tipos de recursos "derivedFrom" que deben ser soportados por las implementaciones que se ajustan a esta IG.

Se permiten objetivos de derivación adicionales (según lo admitido por el recurso de observación subyacente), pero no se espera que los implementadores de esta IG les presten atención.

Permite la trazabilidad (y el contexto) para las observaciones derivadas de un QuestionnaireResponse y también establece vínculos para observaciones que fueron calculadas o inferidas basándose en otras observaciones (por ejemplo,para puntajes calculados).

Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

For a discussion on the ways Observations can be assembled in groups together see Notes below.

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Describes what was observed. Sometimes this is called the observation "code".

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Códigos de identficación simple para el nombre de una observación

Knowing what kind of observation is being made is essential to understanding the observation.

The information determined as a result of making the observation, if the information has a simple value.

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Codes specifying why the result (Observation.value[x]) is missing.

For many results it is necessary to handle exceptional values in measurements.

Interpretación del valor del componente de la observación

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Códigos de identificción para la interpretación de la observación

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Guidance on how to interpret the value by comparison to a normal or recommended range.

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.