## USCorePatientAccommodationProfile — US Core Patient Accommodation Profile

The US Core Patient Accommodation Profile inherits from the FHIR [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) *Accommodation Data Element of the Patient Demographics/Information Data Class*. It sets minimum expectations for the Observation resource to record, search, and fetch information about modifications, tools, technologies, and other supports necessary to enable a patient to access care. Examples include, but are not limited to, sign language interpreters, wheelchair accessibility requirements, and sensory accommodation. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

- **URL:** `http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient-accommodation`
- **Version:** 0.1.0
- **Status:** active
- **Kind:** resource
- **Type:** `Observation`
- **Base Definition:** `http://hl7.org/fhir/StructureDefinition/Observation`
- **Derivation:** constraint


### Elements (differential)

| Element | Must Support | Add'l USCDI | Cardinality | Type | Description |
|---|:---:|:---:|---|---|---|
| `Observation` |  |  | 0..* |  | **US Core Observation Patient Accommodation Profile**<br/>Measurements and simple assertions made about a patient, device or other subject. |
| <span style="padding-left: 1.5em;">↳</span>`status` | ✅ |  | 1..1 | `code` | **registered \| preliminary \| final \| amended +**<br/>The status of the result value.<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/ValueSet/observation-status\|4.0.1` (required) — Codes providing the status of an observation.</span> |
| <span style="padding-left: 1.5em;">↳</span>`category` | ✅ |  | 0..* | `CodeableConcept` | **Classification of  type of observation**<br/>A code that classifies the general type of observation being made.<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category` (preferred) — FHIR and US Core codes for high level observation categories.</span><br/><span style="font-size: 0.85em;">**Slicing:** discriminator `value@$this` — rules: open</span> |
| <span style="padding-left: 1.5em;">↳</span>`category`<br/><span style="font-size: 0.85em;">slice: `us-core`</span> | ✅ |  | 0..1 | `CodeableConcept` | **Classification of  type of observation**<br/>A code that classifies the general type of observation being made.<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category` (preferred) — FHIR and US Core codes for high level observation categories.</span><br/><span style="font-size: 0.85em;">**Pattern (CodeableConcept):** `http://hl7.org/fhir/us/core/CodeSystem/us-core-category#accommodation`</span> |
| <span style="padding-left: 1.5em;">↳</span>`code` | ✅ |  | 1..1 | `CodeableConcept` | **Patient accommodation code (SHAM CODE)**<br/>Describes what was observed. Sometimes this is called the observation "name".<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/ValueSet/observation-codes\|4.0.1` (example) — Codes identifying names of simple observations.</span><br/><span style="font-size: 0.85em;">**Pattern (CodeableConcept):** `http://loinc.org#55555-5`</span> |
| <span style="padding-left: 1.5em;">↳</span>`subject` | ✅ |  | 1..1 | `Reference`<br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</span> | **Who and/or what the observation is about**<br/>The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation. |
| <span style="padding-left: 1.5em;">↳</span>`effective[x]` | ✅ |  | 0..1 | `dateTime`<br/>`Period`<br/>`Timing`<br/>`instant` | **Clinically relevant time/time-period for observation**<br/>The time or time-period the observed value is asserted as being true. |
| <span style="padding-left: 1.5em;">↳</span>`performer` |  | ✅ | 0..* | `Reference`<br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/StructureDefinition/PractitionerRole</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson</span> | **Who is responsible for the observation**<br/>Who was responsible for asserting the observed value as "true". |
| <span style="padding-left: 1.5em;">↳</span>`value[x]` | ✅ |  | 0..1 | `string`<br/>`CodeableConcept`<br/>`Quantity`<br/>`boolean`<br/>`integer`<br/>`Range`<br/>`Ratio`<br/>`SampledData`<br/>`time`<br/>`dateTime`<br/>`Period` | **Actual result**<br/>The information determined as a result of making the observation, if the information has a simple value. |