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

Left: | US Core Observation ADI Documentation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-adi-documentation)
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-adi-documentation' 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: 'USCoreObservationADIDocumentationProfile' vs 'USCoreObservationAccommodationProfile'
Information | StructureDefinition.title | Values for title differ: 'US Core Observation ADI Documentation Profile' vs 'US Core Observation Patient Accommodation Profile'
Information | StructureDefinition.date | Values for date differ: '2024-09-13' vs '2026-05-13'
Information | StructureDefinition.short | Values for short differ: 'US Core Observation ADI Presence Profile' vs 'US Core Observation Patient Accommodation Profile'
Information | StructureDefinition.short | Values for short differ: 'Extension' vs 'Additional content defined by implementations'
Information | StructureDefinition.definition | Values for definition differ: 'An Extension' vs 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.'
Information | StructureDefinition.short | Values for short differ: 'Observation ADI Documentation code' vs 'Patient accommodation code'
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.'
Warning | Observation.effective[x] | Elements differ in definition for mustSupport: 'false' vs 'true'
Information | StructureDefinition.short | Values for short differ: 'Date/Time this observation was made available' vs 'Date/Time this version was made available'
Warning | Observation.issued | Elements differ in definition for mustSupport: 'true' vs 'false'
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'

### 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 |
date | 2024-09-13 | 2026-05-13 | Values Differ
description | The US Core Observation Advance Directive Information (ADI) Documentation Profile inherits from the FHIR [Observation](https://hl7.org/fhir/R4/observation.html) resource; refer to it for scope and usage definitions. This profile and the [US Core Observation ADI DocumentationReference Profile](StructureDefinition-us-core-adi-documentreference.html) meet the [U.S. Core Data for Interoperability (USCDI)](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi) *Advance Directive Observation* Data Element requirements. It is used to communicate whether a person has advance directive information (ADI) and, if one or more documents exist, their location. Examples of advance healthcare directive documents include physician order for life sustaining treatment (POLST), do not resuscitate order (DNR), and medical power of attorney. To communicate the type of advance directive document, the author, the verifier, and other properties, see the US Core ADI DocumentReference Profile. This profile sets minimum expectations for the Observation resource to record, search, and fetch findings about the presence of a patient's advance directives. 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. | 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 |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreObservationADIDocumentationProfile | USCoreObservationAccommodationProfile | Values Differ
publisher | HL7 International / Cross-Group Projects |
purpose |  |
status | active |
title | US Core Observation ADI Documentation Profile | US Core Observation Patient Accommodation Profile | Values Differ
type | Observation |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-adi-documentation | 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 | US Core Observation ADI Presence Profile | 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 |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |  | 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 | 0..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by value:$this Binding: ?? (preferred): FHIR and US Core codes for high level observation categories. | S | 0..* | CodeableConcept | Classification of type of observation Slice: Unordered, Open by value:$this Binding: ?? (preferred): FHIR and US Core codes for high level observation categories. |
code | S Σ | 1..1 | CodeableConcept | Observation ADI Documentation code Binding: ?? (example): Codes identifying names of simple observations. Required Pattern: {"coding":[{"system":"http://loinc.org","code":"45473-6"}]} | 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)) | 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 | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made |
effective[x] | Σ | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation | S Σ | 0..1 | dateTime S, Period, Timing, instant | Clinically relevant time/time-period for observation | Elements differ in definition for mustSupport: 'false' vs 'true'
issued | S Σ | 0..1 | instant | Date/Time this observation was made available | Σ | 0..1 | instant | Date/Time this version was made available | Elements differ in definition for mustSupport: 'true' vs 'false'
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 | CodeableConcept | Actual result Binding: ?? (required): Answer Set with Yes No and Unknowns | S Σ C | 0..1 | string S, CodeableConcept S | Actual result |
dataAbsentReason | 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. |
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