SMART Base Clinical, published by WHO. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-base-clinical/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• XML
• JSON
• TTL

Resource Profile: WHO SMART Guidelines Observation Not Done

The WHO SMART Guidelines Observation Not Done profile defines conformance requirements and exchange expectations for Observation resources used to communicate that a particular observation (or class of observations) was not performed in WHO Smart Guidelines content.

Usage:

• Refer to this Resource Profile: WHO SMART Guidelines CarePlan

Formal Views of Profile Content

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

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

This structure is derived from CPGObservation

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	CPGObservation	Measurements and simple assertions ond-1: To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided
identifier	S	1..*	Identifier	Business Identifier for observation
use	S	1..1	code	usual | official | temp | secondary | old (If known)
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
status	S	1..1	code	registered | preliminary | final | amended + Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation
code	SC	1..1	CodeableConcept	Type of observation (code / type)
Slices for extension				Content/Rules for all slices
notDoneValueSet	SC	1..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
subject	S	1..1	Reference(WHO SMART Guidelines Patient)	Who and/or what the observation is about
encounter	S	0..1	Reference(WHO SMART Guidelines Encounter)	Healthcare event during which this observation is made
issued	S	1..1	instant	Date/Time this version was made available
performer		0..*	Reference(WHO SMART Guidelines Practitioner | WHO SMART Guidelines PractitionerRole | WHO SMART Guidelines Patient | WHO SMART Guidelines RelatedPerson)	Who is responsible for the observation
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
ond-1	error	Observation	To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	CPGObservation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ond-1: To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
pertinent	S	0..*	Reference()	CPG Pertinent Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinent
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Business Identifier for observation
use	?!SΣ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
basedOn	SΣ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Slices for extension		1..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
notDoneValueSet	SC	1..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
subject	SΣ	1..1	Reference(WHO SMART Guidelines Patient)	Who and/or what the observation is about
encounter	SΣ	0..1	Reference(WHO SMART Guidelines Encounter)	Healthcare event during which this observation is made
issued	SΣ	1..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(WHO SMART Guidelines Practitioner | WHO SMART Guidelines PractitionerRole | WHO SMART Guidelines Patient | WHO SMART Guidelines RelatedPerson)	Who is responsible for the observation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	Fixed Value: cancelled http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ond-1	error	Observation	To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	CPGObservation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ond-1: To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
pertinent	S	0..*	Reference()	CPG Pertinent Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinent
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Business Identifier for observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!SΣ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn	SΣ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
notDoneValueSet	SC	1..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(WHO SMART Guidelines Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	SΣ	0..1	Reference(WHO SMART Guidelines Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	SΣ	1..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(WHO SMART Guidelines Practitioner | WHO SMART Guidelines PractitionerRole | WHO SMART Guidelines Patient | WHO SMART Guidelines RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	Fixed Value: cancelled http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ond-1	error	Observation	To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

This structure is derived from CPGObservation

Summary

Mandatory: 9 elements
Must-Support: 11 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• WHO SMART Guidelines Patient (http://smart.who.int/base-clinical/StructureDefinition/sg-patient)
• WHO SMART Guidelines Encounter (http://smart.who.int/base-clinical/StructureDefinition/sg-encounter)
• WHO SMART Guidelines Practitioner (http://smart.who.int/base-clinical/StructureDefinition/sg-practitioner)
• WHO SMART Guidelines PractitionerRole (http://smart.who.int/base-clinical/StructureDefinition/sg-practitionerrole)
• WHO SMART Guidelines RelatedPerson (http://smart.who.int/base-clinical/StructureDefinition/sg-relatedperson)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet

Differential View

This structure is derived from CPGObservation

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	CPGObservation	Measurements and simple assertions ond-1: To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided
identifier	S	1..*	Identifier	Business Identifier for observation
use	S	1..1	code	usual | official | temp | secondary | old (If known)
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
status	S	1..1	code	registered | preliminary | final | amended + Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation
code	SC	1..1	CodeableConcept	Type of observation (code / type)
Slices for extension				Content/Rules for all slices
notDoneValueSet	SC	1..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
subject	S	1..1	Reference(WHO SMART Guidelines Patient)	Who and/or what the observation is about
encounter	S	0..1	Reference(WHO SMART Guidelines Encounter)	Healthcare event during which this observation is made
issued	S	1..1	instant	Date/Time this version was made available
performer		0..*	Reference(WHO SMART Guidelines Practitioner | WHO SMART Guidelines PractitionerRole | WHO SMART Guidelines Patient | WHO SMART Guidelines RelatedPerson)	Who is responsible for the observation
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
ond-1	error	Observation	To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	CPGObservation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ond-1: To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
pertinent	S	0..*	Reference()	CPG Pertinent Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinent
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Business Identifier for observation
use	?!SΣ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
basedOn	SΣ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Slices for extension		1..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
notDoneValueSet	SC	1..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
subject	SΣ	1..1	Reference(WHO SMART Guidelines Patient)	Who and/or what the observation is about
encounter	SΣ	0..1	Reference(WHO SMART Guidelines Encounter)	Healthcare event during which this observation is made
issued	SΣ	1..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(WHO SMART Guidelines Practitioner | WHO SMART Guidelines PractitionerRole | WHO SMART Guidelines Patient | WHO SMART Guidelines RelatedPerson)	Who is responsible for the observation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.status	required	Fixed Value: cancelled http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ond-1	error	Observation	To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	SC	0..*	CPGObservation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present ond-1: To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
instantiatesCaseFeature	S	0..1	canonical(CPG Case Feature Definition)	CPG Instantiates Case Feature Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
caseFeatureType	S	0..1	code	CPG Case Feature Type Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType Binding: CPG Case Feature Type Value Set (required): Whether the case feature is asserted or inferred
caseFeaturePertinence	S	0..1	code	CPG Case Feature Pertinence Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence Binding: CPG Case Feature Pertinence Value Set (required): Describes the pertinence of a case feature
pertinent	S	0..*	Reference()	CPG Pertinent Extension URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pertinent
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Business Identifier for observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!SΣ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
basedOn	SΣ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
notDoneValueSet	SC	1..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(WHO SMART Guidelines Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	SΣ	0..1	Reference(WHO SMART Guidelines Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	SΣ	1..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(WHO SMART Guidelines Practitioner | WHO SMART Guidelines PractitionerRole | WHO SMART Guidelines Patient | WHO SMART Guidelines RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.status	required	Fixed Value: cancelled http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ond-1	error	Observation	To indicate what observation was not performed, either at least one coding in the code element or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

This structure is derived from CPGObservation

Summary

Mandatory: 9 elements
Must-Support: 11 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• WHO SMART Guidelines Patient (http://smart.who.int/base-clinical/StructureDefinition/sg-patient)
• WHO SMART Guidelines Encounter (http://smart.who.int/base-clinical/StructureDefinition/sg-encounter)
• WHO SMART Guidelines Practitioner (http://smart.who.int/base-clinical/StructureDefinition/sg-practitioner)
• WHO SMART Guidelines PractitionerRole (http://smart.who.int/base-clinical/StructureDefinition/sg-practitionerrole)
• WHO SMART Guidelines RelatedPerson (http://smart.who.int/base-clinical/StructureDefinition/sg-relatedperson)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet

Other representations of profile: CSV, Excel, Schematron