CH ELM (R4), published by Federal Office of Public Health FOPH. This guide is not an authorized publication; it is the continuous build for version 1.12.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/ch-elm/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• XML
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Resource Profile: CH ELM Observation Results: Laboratory

This CH ELM base profile constrains the Observation resource for the purpose of laboratory test reports.

Usages:

• Derived from this Profile: CH ELM Observation Results for HIV Recency Testing (strict), CH ELM Observation Results for Genotyping, CH ELM Observation Results for Microbiology studies (set) and CH ELM Observation Results for Microbial susceptibility tests
• Use this Profile: CH ELM Document: Laboratory Report
• Refer to this Profile: CH ELM DiagnosticReport: Laboratory Report

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, eu-lab-1, eu-lab-2, ch-elm-expecting-specimen-specification, ch-elm-patient-name-representation-initial-loinc, ch-elm-patient-name-representation-initial-snomedct, ch-elm-patient-name-representation-initial-or-vctcode-loinc, ch-elm-patient-name-representation-initial-or-vctcode-snomedct, ch-elm-patient-name-representation-hiv-code-loinc, ch-elm-patient-name-representation-hiv-code-snomedct
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		0..*	Extension	Triggering observation.
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
code	Σ	1..1	ChElmCodeableConcept	Type of observation (code / type) Binding: CH ELM Results Laboratory Observation Complete (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation Constraints: ch-elm-dateTime
Slices for extension				Content/Rules for all slices
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueString			string
valueRatio			Ratio
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueString	ΣC	0..1	string	String if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Ratio if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Quantity if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueCodeableConcept	ΣC	0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
value[x]:valueBoolean	ΣC	0..1	boolean	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
dataAbsentReason	C	0..1	CodeableConcept	see also 'Guidance - Laboratory Result' Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	ChElmCodeableConcept	see also 'Guidance - Laboratory Result' Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:laboratory	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.category:specialty	Base	required	Laboratory Specialty	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.code	Base	extensible	CH ELM Results Laboratory Observation Complete	📦1.12.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	CH ELM Results Coded Values Laboratory	📦1.12.0	This IG
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required.	$this.toString().length() >= 10
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs	code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-patient-name-representation-hiv-code-loinc	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-hiv-code-snomedct	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-initial-loinc	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
ch-elm-patient-name-representation-initial-or-vctcode-loinc	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-or-vctcode-snomedct	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-snomedct	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
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())
eu-lab-1	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
eu-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()
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()

This structure is derived from ChLabObservationResultsLaboratory

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory This profile also imposes the profile Observation Results: laboratory Constraints: ch-elm-expecting-specimen-specification, ch-elm-patient-name-representation-initial-loinc, ch-elm-patient-name-representation-initial-snomedct, ch-elm-patient-name-representation-initial-or-vctcode-loinc, ch-elm-patient-name-representation-initial-or-vctcode-snomedct, ch-elm-patient-name-representation-hiv-code-loinc, ch-elm-patient-name-representation-hiv-code-snomedct
status		1..1	code	Status of this observation (e.g. preliminary, final,...) Required Pattern: final
code		1..1	ChElmCodeableConcept	Type of observation (code / type) Binding: CH ELM Results Laboratory Observation Complete (extensible)
subject		1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
Slices for effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	C	1..1	dateTime	Clinically relevant time/time-period for observation Constraints: ch-elm-dateTime
performer		1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]				Content/Rules for all slices
value[x]:valueString		0..1	string	String if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueRatio		0..1	RatioEuLab	Ratio if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueQuantity		0..1	QuantityEuLab	Quantity if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
dataAbsentReason		0..1	CodeableConcept	see also 'Guidance - Laboratory Result'
interpretation		0..1	ChElmCodeableConcept	see also 'Guidance - Laboratory Result'
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.code	Base	extensible	CH ELM Results Laboratory Observation Complete	📦1.12.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	CH ELM Results Coded Values Laboratory	📦1.12.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required.	$this.toString().length() >= 10
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs	code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-patient-name-representation-hiv-code-loinc	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-hiv-code-snomedct	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-initial-loinc	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
ch-elm-patient-name-representation-initial-or-vctcode-loinc	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-or-vctcode-snomedct	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-snomedct	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, eu-lab-1, eu-lab-2, ch-elm-expecting-specimen-specification, ch-elm-patient-name-representation-initial-loinc, ch-elm-patient-name-representation-initial-snomedct, ch-elm-patient-name-representation-initial-or-vctcode-loinc, ch-elm-patient-name-representation-initial-or-vctcode-snomedct, ch-elm-patient-name-representation-hiv-code-loinc, ch-elm-patient-name-representation-hiv-code-snomedct
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:observation		0..*	Extension	Triggering observation.
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
code	Σ	1..1	ChElmCodeableConcept	Type of observation (code / type) Binding: CH ELM Results Laboratory Observation Complete (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation Constraints: ch-elm-dateTime
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
issued	Σ	0..1	instant	Date/Time this result was made available
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueString			string
valueRatio			Ratio
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueString	ΣC	0..1	string	String if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Ratio if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Quantity if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueCodeableConcept	ΣC	0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
value[x]:valueBoolean	ΣC	0..1	boolean	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
dataAbsentReason	C	0..1	CodeableConcept	see also 'Guidance - Laboratory Result' Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	ChElmCodeableConcept	see also 'Guidance - Laboratory Result' 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: Laboratory Techniques (preferred)
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	Measuring instrument
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
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(CH LAB-Report Observation Results: Laboratory Report)	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	Laboratory result
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
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.
Slices for value[x]	Σ	0..1		Actual component result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueString	Σ	0..1	string	Actual component result
value[x]:valueBoolean	Σ	0..1	boolean	Actual component result
value[x]:valueRange	Σ	0..1	RangeIPS	Actual component result
value[x]:valueRatio	Σ	0..1	RatioEuLab	Actual component result
value[x]:valueTime	Σ	0..1	time	Actual component result
value[x]:valueDateTime	Σ	0..1	dateTime	Actual component result
value[x]:valuePeriod	Σ	0..1	Period	Actual component result
value[x]:valueQuantity	Σ	0..1	QuantityEuLab	Actual component result
value[x]:valueCodeableConcept	Σ	0..1	CodeableConceptIPS	Actual component result Binding: Results Coded Values Laboratory - IPS (preferred)
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	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:laboratory	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.category:specialty	Base	required	Laboratory Specialty	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.code	Base	extensible	CH ELM Results Laboratory Observation Complete	📦1.12.0	This IG
Observation.subject.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.performer.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	preferred	CH ELM Results Coded Values Laboratory	📦1.12.0	This IG
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	preferred	Laboratory Techniques	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📦4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📦4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📦4.0.1	FHIR Std.
Observation.component.​value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required.	$this.toString().length() >= 10
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs	code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-patient-name-representation-hiv-code-loinc	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-hiv-code-snomedct	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-initial-loinc	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
ch-elm-patient-name-representation-initial-or-vctcode-loinc	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-or-vctcode-snomedct	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-snomedct	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
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())
eu-lab-1	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
eu-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()
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()

This structure is derived from ChLabObservationResultsLaboratory

Summary

Mandatory: 2 elements

Structures

This structure refers to these other structures:

• CH ELM CodeableConcept (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-codeableconcept)
• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Lab (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab)
• Ratio (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Ratio-eu-lab)
• Quantity (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Quantity-eu-lab)
• CH ELM Specimen: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.effective[x]

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, eu-lab-1, eu-lab-2, ch-elm-expecting-specimen-specification, ch-elm-patient-name-representation-initial-loinc, ch-elm-patient-name-representation-initial-snomedct, ch-elm-patient-name-representation-initial-or-vctcode-loinc, ch-elm-patient-name-representation-initial-or-vctcode-snomedct, ch-elm-patient-name-representation-hiv-code-loinc, ch-elm-patient-name-representation-hiv-code-snomedct
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		0..*	Extension	Triggering observation.
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
code	Σ	1..1	ChElmCodeableConcept	Type of observation (code / type) Binding: CH ELM Results Laboratory Observation Complete (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation Constraints: ch-elm-dateTime
Slices for extension				Content/Rules for all slices
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueString			string
valueRatio			Ratio
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueString	ΣC	0..1	string	String if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Ratio if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Quantity if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueCodeableConcept	ΣC	0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
value[x]:valueBoolean	ΣC	0..1	boolean	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
dataAbsentReason	C	0..1	CodeableConcept	see also 'Guidance - Laboratory Result' Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	ChElmCodeableConcept	see also 'Guidance - Laboratory Result' Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:laboratory	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.category:specialty	Base	required	Laboratory Specialty	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.code	Base	extensible	CH ELM Results Laboratory Observation Complete	📦1.12.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	CH ELM Results Coded Values Laboratory	📦1.12.0	This IG
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required.	$this.toString().length() >= 10
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs	code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-patient-name-representation-hiv-code-loinc	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-hiv-code-snomedct	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-initial-loinc	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
ch-elm-patient-name-representation-initial-or-vctcode-loinc	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-or-vctcode-snomedct	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-snomedct	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
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())
eu-lab-1	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
eu-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()
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()

Differential View

This structure is derived from ChLabObservationResultsLaboratory

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory This profile also imposes the profile Observation Results: laboratory Constraints: ch-elm-expecting-specimen-specification, ch-elm-patient-name-representation-initial-loinc, ch-elm-patient-name-representation-initial-snomedct, ch-elm-patient-name-representation-initial-or-vctcode-loinc, ch-elm-patient-name-representation-initial-or-vctcode-snomedct, ch-elm-patient-name-representation-hiv-code-loinc, ch-elm-patient-name-representation-hiv-code-snomedct
status		1..1	code	Status of this observation (e.g. preliminary, final,...) Required Pattern: final
code		1..1	ChElmCodeableConcept	Type of observation (code / type) Binding: CH ELM Results Laboratory Observation Complete (extensible)
subject		1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
Slices for effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	C	1..1	dateTime	Clinically relevant time/time-period for observation Constraints: ch-elm-dateTime
performer		1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
Slices for value[x]				Content/Rules for all slices
value[x]:valueString		0..1	string	String if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueRatio		0..1	RatioEuLab	Ratio if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueQuantity		0..1	QuantityEuLab	Quantity if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueCodeableConcept		0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
dataAbsentReason		0..1	CodeableConcept	see also 'Guidance - Laboratory Result'
interpretation		0..1	ChElmCodeableConcept	see also 'Guidance - Laboratory Result'
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.code	Base	extensible	CH ELM Results Laboratory Observation Complete	📦1.12.0	This IG
Observation.value[x]:valueCodeableConcept	Base	preferred	CH ELM Results Coded Values Laboratory	📦1.12.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required.	$this.toString().length() >= 10
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs	code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-patient-name-representation-hiv-code-loinc	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-hiv-code-snomedct	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-initial-loinc	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
ch-elm-patient-name-representation-initial-or-vctcode-loinc	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-or-vctcode-snomedct	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-snomedct	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	ChLabObservationResultsLaboratory	CH ELM Observation Results: Laboratory This profile also imposes the profile Observation Results: laboratory Constraints: obs-6, obs-7, eu-lab-1, eu-lab-2, ch-elm-expecting-specimen-specification, ch-elm-patient-name-representation-initial-loinc, ch-elm-patient-name-representation-initial-snomedct, ch-elm-patient-name-representation-initial-or-vctcode-loinc, ch-elm-patient-name-representation-initial-or-vctcode-snomedct, ch-elm-patient-name-representation-hiv-code-loinc, ch-elm-patient-name-representation-hiv-code-snomedct
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Laboratory Test Kit Slice: Unordered, Open by value:url
extension:supportingInfo		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:triggeredBy-r5		0..*	(Complex)	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:observation		0..*	Extension	Triggering observation.
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Value of extension
extension:type		0..*	Extension	The type of trigger
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	Value of extension
extension:reason		0..*	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:certifiedRefMaterialCodeable		0..*	CodeableConcept	Certified Reference Material: CodeableConcept URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialCodeable Binding: Laboratory Certified Reference Material (example)
extension:certifiedRefMaterialIdentifer		0..*	Identifier	Certified Reference Material: Identifier URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-certifiedRefMaterialIdentifer
extension:labTestKit		0..*	Reference(Device)	Device Laboratory Test Kit URL: http://hl7.eu/fhir/laboratory/StructureDefinition/observation-deviceLabTestKit
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	Status of this observation (e.g. preliminary, final,...) Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category		1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:laboratory		1..1	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:studyType		0..*	CodeableConcept	The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty		0..*	CodeableConcept	The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
code	Σ	1..1	ChElmCodeableConcept	Type of observation (code / type) Binding: CH ELM Results Laboratory Observation Complete (extensible)
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the observation is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
effective[x]:effectiveDateTime	ΣC	1..1	dateTime	Clinically relevant time/time-period for observation Constraints: ch-elm-dateTime
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason		0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
issued	Σ	0..1	instant	Date/Time this result was made available
performer	Σ	1..1	Reference(CH ELM Organization: Lab)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueString			string
valueRatio			Ratio
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueString	ΣC	0..1	string	String if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueRatio	ΣC	0..1	RatioEuLab	Ratio if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueQuantity	ΣC	0..1	QuantityEuLab	Quantity if required by leading code, see also 'Guidance - Laboratory Result'
value[x]:valueCodeableConcept	ΣC	0..1	ChElmCodeableConcept	Positive/Negative or code for an additional organism specification, see also 'Guidance - Laboratory Result' Binding: CH ELM Results Coded Values Laboratory (preferred)
value[x]:valueBoolean	ΣC	0..1	boolean	Actual result
value[x]:valueRange	ΣC	0..1	RangeIPS	Actual result
value[x]:valueTime	ΣC	0..1	time	Actual result
value[x]:valueDateTime	ΣC	0..1	dateTime	Actual result
value[x]:valuePeriod	ΣC	0..1	Period	Actual result
dataAbsentReason	C	0..1	CodeableConcept	see also 'Guidance - Laboratory Result' Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	ChElmCodeableConcept	see also 'Guidance - Laboratory Result' 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: Laboratory Techniques (preferred)
specimen		1..1	Reference(CH ELM Specimen: Laboratory)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	Measuring instrument
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
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(CH LAB-Report Observation Results: Laboratory Report)	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	Laboratory result
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value-r5		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D]]	only for result of type Attachment URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value%5Bx%5D
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]"
value[x]		1..1	Attachment	Value of extension
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.
Slices for value[x]	Σ	0..1		Actual component result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueString	Σ	0..1	string	Actual component result
value[x]:valueBoolean	Σ	0..1	boolean	Actual component result
value[x]:valueRange	Σ	0..1	RangeIPS	Actual component result
value[x]:valueRatio	Σ	0..1	RatioEuLab	Actual component result
value[x]:valueTime	Σ	0..1	time	Actual component result
value[x]:valueDateTime	Σ	0..1	dateTime	Actual component result
value[x]:valuePeriod	Σ	0..1	Period	Actual component result
value[x]:valueQuantity	Σ	0..1	QuantityEuLab	Actual component result
value[x]:valueCodeableConcept	Σ	0..1	CodeableConceptIPS	Actual component result Binding: Results Coded Values Laboratory - IPS (preferred)
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	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:laboratory	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:studyType	Base	required	Laboratory Study Types	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.category:specialty	Base	required	Laboratory Specialty	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.code	Base	extensible	CH ELM Results Laboratory Observation Complete	📦1.12.0	This IG
Observation.subject.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.performer.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	preferred	CH ELM Results Coded Values Laboratory	📦1.12.0	This IG
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	preferred	Laboratory Techniques	📦0.1.1	HL7 Europe Laboratory Report v0.1
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📦4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📦4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📦4.0.1	FHIR Std.
Observation.component.​value[x]:valueCodeableConcept	Base	preferred	Results Coded Values Laboratory - IPS	📦1.1.0	International Patient Summary Implementation Guide v1.1
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ch-elm-dateTime	error	Observation.effective[x]:effectiveDateTime	At least the format YYYY-MM-DD is required.	$this.toString().length() >= 10
ch-elm-expecting-specimen-specification	error	Observation	If Observation.code is a member of http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification, then Specimen.type must be a member of the mapped ValueSet in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs	code.memberOf('http://fhir.ch/ig/ch-elm/ValueSet/ch-elm-expecting-specimen-specification') implies (specimen.resolve().exists() and specimen.resolve().type.exists() and specimen.resolve().type.memberOf('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-expecting-specimen-specification-to-results-completion-vs'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code))
ch-elm-patient-name-representation-hiv-code-loinc	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-hiv-code-snomedct	error	Observation	If Observation.code is mapped to hiv-code in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient representation must follow profile resource profile: CH ELM Patient HIV	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'hiv-code' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientHIV')))
ch-elm-patient-name-representation-initial-loinc	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
ch-elm-patient-name-representation-initial-or-vctcode-loinc	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://loinc.org').element.where(code=%context.code.coding.where(system='http://loinc.org').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-or-vctcode-snomedct	error	Observation	If Observation.code is mapped to initials or vctcode in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name family and given must have one character or - in case of a VCT patient - must be masked and the following elements must not be provided: patient.telecom, patient.address.line.	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials-or-vctcode' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials') or subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientVCT')))
ch-elm-patient-name-representation-initial-snomedct	error	Observation	If Observation.code is mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given must have one character and the following elements must not be provided: patient.telecom, patient.address.line	'http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).empty() or ('http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation'.resolve().group.where(source='http://snomed.info/sct').element.where(code=%context.code.coding.where(system='http://snomed.info/sct').first().code).target.first().code = 'initials' implies (subject.resolve().conformsTo('http://fhir.ch/ig/ch-elm/StructureDefinition/ChElmPatientInitials')))
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())
eu-lab-1	error	Observation	If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component"	(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()
eu-lab-2	error	Observation	If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason"	component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()
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()

This structure is derived from ChLabObservationResultsLaboratory

Summary

Mandatory: 2 elements

Structures

This structure refers to these other structures:

• CH ELM CodeableConcept (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-codeableconcept)
• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Lab (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab)
• Ratio (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Ratio-eu-lab)
• Quantity (Eu Lab) (http://hl7.eu/fhir/laboratory/StructureDefinition/Quantity-eu-lab)
• CH ELM Specimen: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.effective[x]