## Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result vs http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-accommodation

Left: | US Core Observation Clinical Result Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result)
Right: | US Core Observation Patient Accommodation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-accommodation)

### Messages

Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result' vs 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-accommodation'
Error | StructureDefinition.version | Values for version differ: '9.0.0' vs '0.1.0'
Information | StructureDefinition.name | Values for name differ: 'USCoreObservationClinicalResultProfile' vs 'USCoreObservationAccommodationProfile'
Information | StructureDefinition.title | Values for title differ: 'US Core Observation Clinical Result Profile' vs 'US Core Observation Patient Accommodation Profile'
Information | StructureDefinition.date | Values for date differ: '2023-10-17' vs '2026-05-13'
Information | StructureDefinition.short | Values for short differ: 'Measurements and simple assertions' vs 'US Core Observation Patient Accommodation Profile'
Information | Observation.category | Element minimum cardinalities differ: '1' vs '0'
Information | Observation.category | Example/preferred bindings differ at Observation.category using binding from USCoreObservationClinicalResultProfile
Information | StructureDefinition.short | Values for short differ: 'Clinical Test or Procedure Name' vs 'Patient accommodation code'
Information | StructureDefinition.definition | Values for definition differ: 'The name of the clinical test or procedure performed on a patient. A LOINC **SHALL** be used if the concept is present in LOINC.' vs 'Describes what was observed. Sometimes this is called the observation 'name'.'
Information | StructureDefinition.comment | Values for comment differ: 'The typical patterns for codes are: 1) a LOINC code either as a translation from a 'local' code or as a primary code, or 2) a local code only if no suitable LOINC exists, or 3) both the local and the LOINC translation. Systems SHALL be capable of sending the local code if one exists. When using LOINC , Use either the SHORTNAME or LONG_COMMON_NAME field for the display.' vs '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
Information | StructureDefinition.short | Values for short differ: 'Encounter associated with Observation' vs 'Healthcare event during which this observation is made'
Warning | Observation.encounter | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | StructureDefinition.definition | Values for definition differ: 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'. This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.' vs 'The time or time-period the observed value is asserted as being true.'
Information | StructureDefinition.short | Values for short differ: 'Who is responsible for the observation' vs '𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who is responsible for the observation'
Warning | Observation.performer | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | StructureDefinition.short | Values for short differ: 'Result Value' vs 'Actual result'
Information | StructureDefinition.definition | Values for definition differ: 'The clinical test or procedure result value. If a numeric value, valueQuantity.code **SHALL** be selected from [UCUM](http://unitsofmeasure.org). A FHIR [UCUM Codes value set](http://hl7.org/fhir/STU3/valueset-ucum-units.html) that defines all UCUM codes is in the FHIR specification.' vs 'The information determined as a result of making the observation, if the information has a simple value.'
Warning | Observation.dataAbsentReason | Elements differ in definition for mustSupport: 'true' vs 'false'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/Observation |
copyright |  | Used by permission of HL7 International, all rights reserved Creative Commons License | Added the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date | 2023-10-17 | 2026-05-13 | Values Differ
description | The US Core Observation Clinical Result Profile is based upon the core FHIR Observation Resource and, along with the US Core DiagnosticReport Profile, meets the US Core Data for Interoperability (USCDI) requirements for *Diagnostic Imaging* and *Clinical Tests* Data Classes. This profile sets minimum expectations for the Observation resource to record and search non-laboratory clinical test results (e.g., radiology and other clinical observations generated from procedures). An example would be when a gastroenterologist reports the size of a polyp observed during a colonoscopy. This profile is the basis for the US Core Laboratory Result Observation Profile, which defines additional data elements to record and search laboratory test results. The US Core Observation Clinical Result Profile sets minimum expectations to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases. | The US Core Observation 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. | Values Differ
experimental |  | false | Added the item 'false'
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreObservationClinicalResultProfile | USCoreObservationAccommodationProfile | Values Differ
publisher | HL7 International / Cross-Group Projects |
purpose |  |
status | active |
title | US Core Observation Clinical Result Profile | US Core Observation Patient Accommodation Profile | Values Differ
type | Observation |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result | http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-accommodation | Values Differ
version | 9.0.0 | 0.1.0 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: us-core-2 | C | 0..* | Observation | US Core Observation Patient Accommodation Profile |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | 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 |  | 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 |  | 0..* | Resource | Contained, inline Resources |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | Σ | 0..* | Identifier | Business Identifier for observation | Σ | 0..* | Identifier | Business Identifier for observation |
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | 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 | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event |
status | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation. | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation. |
Slices for category | S | 1..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by value:$this Binding: ?? (preferred): Codes for high level observation categories. | S | 0..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by value:$this Binding: ?? (preferred): FHIR and US Core codes for high level observation categories. | Element minimum cardinalities differ: '1' vs '0' Example/preferred bindings differ at Observation.category using binding from USCoreObservationClinicalResultProfile
code | S Σ | 1..1 | CodeableConcept | Clinical Test or Procedure Name Binding: ?? (extensible) | S Σ | 1..1 | CodeableConcept | Patient accommodation code Binding: ?? (example): Codes identifying names of simple observations. Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/us/core/CodeSystem/us-core-category","code":"accommodation"}]} |
subject | S Σ | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot) S | Group | US Core Device Profile | US Core Location Profile) | Who and/or what the observation is about | S Σ | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who and/or what the observation is about |
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record |
encounter | S Σ | 0..1 | Reference(US Core Encounter Profile) | Encounter associated with Observation | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | Elements differ in definition for mustSupport: 'true' vs 'false'
effective[x] | S Σ C | 0..1 | dateTime S, Period, Timing, instant | Clinically relevant time/time-period for observation Constraints: us-core-1 | S Σ | 0..1 | dateTime S, Period, Timing, instant | Clinically relevant time/time-period for observation |
issued | Σ | 0..1 | instant | Date/Time this version was made available | Σ | 0..1 | instant | Date/Time this version was made available |
performer | S Σ | 0..* | Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) | Who is responsible for the observation | Σ | 0..* | Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who is responsible for the observation | Elements differ in definition for mustSupport: 'true' vs 'false'
value[x] | S Σ C | 0..1 | Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Result Value Constraints: us-core-3 | S Σ C | 0..1 | string S, CodeableConcept S | Actual result |
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing. | C | 0..1 | CodeableConcept | Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing. | Elements differ in definition for mustSupport: 'true' vs 'false'
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations. |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations. |
note |  | 0..* | Annotation | Comments about the observation |  | 0..* | Annotation | Comments about the observation |
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality. |  | 0..1 | CodeableConcept | Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality. |
method |  | 0..1 | CodeableConcept | How it was done Binding: ?? (example): Methods for simple observations. |  | 0..1 | CodeableConcept | How it was done Binding: ?? (example): Methods for simple observations. |
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation |  | 0..1 | Reference(Specimen) | Specimen used for this observation |
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device |
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation | C | 0..* | BackboneElement | Provides guide for interpretation |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
low | C | 0..1 | ?? | Low Range, if relevant | C | 0..1 | ?? | Low Range, if relevant |
high | C | 0..1 | ?? | High Range, if relevant | C | 0..1 | ?? | High Range, if relevant |
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range. |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range. |
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to. |  | 0..* | CodeableConcept | Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to. |
age |  | 0..1 | Range | Applicable age range, if relevant |  | 0..1 | Range | Applicable age range, if relevant |
text |  | 0..1 | string | Text based reference range in an observation |  | 0..1 | string | Text based reference range in an observation |
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group |
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from |
component | Σ | 0..* | BackboneElement | Component results | Σ | 0..* | BackboneElement | Component results |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations. | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations. |
value[x] | Σ | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result | Σ | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing. | C | 0..1 | CodeableConcept | Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations. |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations. |
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result |
Documentation for this format