HL7 BE Laboratory WG Implementation Guide
1.0.1 - STU

HL7 BE Laboratory WG Implementation Guide, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/lab/ and changes regularly. See the Directory of published versions

## Resource Profile: BeObservationLaboratory

Official URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-observation-laboratory | Version: 1.0.1
Draft as of 2021-11-08 | Maturity Level: 1 | Computable Name: BeObservationLaboratory

Belgian profile for an observation in a laboratory report

Usages:

- Refer to this Profile: BeLaboratoryReport and BeObservationLaboratory
- Examples for this Profile: Observation/obsCreat, Observation/obsDynamic0, Observation/obsDynamic1, Observation/obsDynamic2... Show 6 more, Observation/obsDynamicHead, Observation/obsKetonen, Observation/obsMagnesium, Observation/obsUrineIonen, Observation/obsUrineScreening and Observation/obsUrobili

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..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language | S | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S 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 | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | BeObservationCodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code | Σ | 1..1 | code | Symbol in syntax defined by the system
coding:SNOMED-CT | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 0..1 | Reference(Group | Device | Location | Patient core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BePatient.
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | S Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 0..* | Reference(CareTeam | RelatedPerson | Patient core BE profile | Organisation core BE profile | Practitioner role core BE profile | Practitioner core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeOrganization or BePractitioner
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note | S | 0..* | BeCodedAnnotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen | S | 0..1 | Reference(BeSpecimenLaboratory) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Comment |  | 0..* | BeCodedAnnotation | Comment extension for ReferenceRange URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
hasMember | S Σ | 0..* | Reference(QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeObservationLaboratory
derivedFrom | S Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this can be BeObservationLaboratory or Media
Slices for component | S Σ | 0..* | BackboneElement | Component results Slice: Unordered, Open by value:code.coding.code
component:All Slices |  |  |  | Content/Rules for all slices
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.
component:relativeTimeQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a time interval but needs one to qualify the code.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 1..1 | Quantity | UCUM
component:substanceAmountQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a substance amount but needs one to qualify the code
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 1..1 | Quantity | UCUM
component:productNameQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a product name but needs one to qualify the code
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 1..1 |  | Actual component result
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
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.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
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 | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
language | S | 0..1 | code | Language of the resource content
text |  |  |  |
status |  | 1..1 | code | generated | extensions | additional | empty Required Pattern: empty
identifier | S | 0..* | Identifier | Business Identifier for observation
basedOn |  | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf |  | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | S | 1..1 | code | registered | preliminary | final | amended +
category | S | 0..* | CodeableConcept | Classification of type of observation
code | S | 1..1 | BeObservationCodeableConcept | Type of observation (code / type)
coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
subject | S | 0..1 | Reference(Group | Device | Location | Patient core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BePatient.
effective[x] | S | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation
issued | S | 0..1 | instant | Date/Time this version was made available
performer | S | 0..* | Reference(CareTeam | RelatedPerson | Patient core BE profile | Organisation core BE profile | Practitioner role core BE profile | Practitioner core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeOrganization or BePractitioner
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result
dataAbsentReason | S | 0..1 | CodeableConcept | Why the result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc.
note | S | 0..* | BeCodedAnnotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part
method | S | 0..1 | CodeableConcept | How it was done
specimen | S | 0..1 | Reference(BeSpecimenLaboratory) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | S | 0..* | BackboneElement | Provides guide for interpretation
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Comment |  | 0..* | BeCodedAnnotation | Comment extension for ReferenceRange URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment
hasMember | S | 0..* | Reference(QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeObservationLaboratory
derivedFrom | S | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this can be BeObservationLaboratory or Media
Slices for component | S | 0..* | BackboneElement | Component results Slice: Unordered, Open by value:code.coding.code
component:relativeTimeQualifier |  | 0..1 | BackboneElement | If a testing code does not include a time interval but needs one to qualify the code.
code |  |  |  |
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118578006
display |  | 1..1 | string | Representation defined by the system Fixed Value: Relative time
value[x] |  | 1..1 | Quantity | UCUM
component:substanceAmountQualifier |  | 0..1 | BackboneElement | If a testing code does not include a substance amount but needs one to qualify the code
code |  |  |  |
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118555000
display |  | 1..1 | string | Representation defined by the system Fixed Value: Substance amount
value[x] |  | 1..1 | Quantity | UCUM
component:productNameQualifier |  | 0..1 | BackboneElement | If a testing code does not include a product name but needs one to qualify the code
code |  |  |  |
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 774167006
display |  | 1..1 | string | Representation defined by the system Fixed Value: Product name
value[x] |  | 1..1 |  | Actual component result
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
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 | S | 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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status |  | 1..1 | code | generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative. Required Pattern: empty
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S 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 | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | BeObservationCodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:SNOMED-CT | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 0..1 | Reference(Group | Device | Location | Patient core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BePatient.
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
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | S Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 0..* | Reference(CareTeam | RelatedPerson | Patient core BE profile | Organisation core BE profile | Practitioner role core BE profile | Practitioner core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeOrganization or BePractitioner
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note | S | 0..* | BeCodedAnnotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen | S | 0..1 | Reference(BeSpecimenLaboratory) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Comment |  | 0..* | BeCodedAnnotation | Comment extension for ReferenceRange URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | 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 | S Σ | 0..* | Reference(QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeObservationLaboratory
derivedFrom | S Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this can be BeObservationLaboratory or Media
Slices for component | S Σ | 0..* | BackboneElement | Component results Slice: Unordered, Open by value:code.coding.code
component:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:relativeTimeQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a time interval but needs one to qualify the code.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118578006
display | Σ | 1..1 | string | Representation defined by the system Fixed Value: Relative time
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 1..1 | Quantity | UCUM
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
component:substanceAmountQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a substance amount but needs one to qualify the code
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118555000
display | Σ | 1..1 | string | Representation defined by the system Fixed Value: Substance amount
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 1..1 | Quantity | UCUM
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
component:productNameQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a product name but needs one to qualify the code
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 774167006
display | Σ | 1..1 | string | Representation defined by the system Fixed Value: Product name
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 1..1 |  | Actual component result
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
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.text.status | Base | required | NarrativeStatus | 📍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.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
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 | example | Observation Methods | 📍4.0.1 | FHIR Std.
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.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text | `low.exists() or high.exists() or text.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
txt-1 | error | Observation.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes | `htmlChecks()`
txt-2 | error | Observation.text.div | The narrative SHALL have some non-whitespace content | `htmlChecks()`

This structure is derived from Observation

Summary

Mandatory: 0 element(12 nested mandatory elements)
Must-Support: 20 elements
Fixed: 9 elements

Structures

This structure refers to these other structures:

- BeObservationCodeableConcept (https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-observationcodeableconcept)
- Patient core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient)
- Organisation core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization)
- Practitioner role core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole)
- Practitioner core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner)
- Coded Annotation (https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/coded-annotation)
- BeSpecimenLaboratory (https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-specimen-laboratory)
- BeObservationLaboratory (https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-observation-laboratory)

Extensions

This structure refers to these extensions:

- https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.code.coding
- The element 1 is sliced based on the value of Observation.component

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language | S | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S 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 | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | BeObservationCodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code | Σ | 1..1 | code | Symbol in syntax defined by the system
coding:SNOMED-CT | Σ | 0..* | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 0..1 | Reference(Group | Device | Location | Patient core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BePatient.
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | S Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 0..* | Reference(CareTeam | RelatedPerson | Patient core BE profile | Organisation core BE profile | Practitioner role core BE profile | Practitioner core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeOrganization or BePractitioner
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note | S | 0..* | BeCodedAnnotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen | S | 0..1 | Reference(BeSpecimenLaboratory) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Comment |  | 0..* | BeCodedAnnotation | Comment extension for ReferenceRange URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
hasMember | S Σ | 0..* | Reference(QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeObservationLaboratory
derivedFrom | S Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this can be BeObservationLaboratory or Media
Slices for component | S Σ | 0..* | BackboneElement | Component results Slice: Unordered, Open by value:code.coding.code
component:All Slices |  |  |  | Content/Rules for all slices
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.
component:relativeTimeQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a time interval but needs one to qualify the code.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 1..1 | Quantity | UCUM
component:substanceAmountQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a substance amount but needs one to qualify the code
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 1..1 | Quantity | UCUM
component:productNameQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a product name but needs one to qualify the code
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 1..1 |  | Actual component result
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
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.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
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 | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
language | S | 0..1 | code | Language of the resource content
text |  |  |  |
status |  | 1..1 | code | generated | extensions | additional | empty Required Pattern: empty
identifier | S | 0..* | Identifier | Business Identifier for observation
basedOn |  | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf |  | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | S | 1..1 | code | registered | preliminary | final | amended +
category | S | 0..* | CodeableConcept | Classification of type of observation
code | S | 1..1 | BeObservationCodeableConcept | Type of observation (code / type)
coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
subject | S | 0..1 | Reference(Group | Device | Location | Patient core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BePatient.
effective[x] | S | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation
issued | S | 0..1 | instant | Date/Time this version was made available
performer | S | 0..* | Reference(CareTeam | RelatedPerson | Patient core BE profile | Organisation core BE profile | Practitioner role core BE profile | Practitioner core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeOrganization or BePractitioner
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result
dataAbsentReason | S | 0..1 | CodeableConcept | Why the result is missing
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc.
note | S | 0..* | BeCodedAnnotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part
method | S | 0..1 | CodeableConcept | How it was done
specimen | S | 0..1 | Reference(BeSpecimenLaboratory) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | S | 0..* | BackboneElement | Provides guide for interpretation
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Comment |  | 0..* | BeCodedAnnotation | Comment extension for ReferenceRange URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment
hasMember | S | 0..* | Reference(QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeObservationLaboratory
derivedFrom | S | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this can be BeObservationLaboratory or Media
Slices for component | S | 0..* | BackboneElement | Component results Slice: Unordered, Open by value:code.coding.code
component:relativeTimeQualifier |  | 0..1 | BackboneElement | If a testing code does not include a time interval but needs one to qualify the code.
code |  |  |  |
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118578006
display |  | 1..1 | string | Representation defined by the system Fixed Value: Relative time
value[x] |  | 1..1 | Quantity | UCUM
component:substanceAmountQualifier |  | 0..1 | BackboneElement | If a testing code does not include a substance amount but needs one to qualify the code
code |  |  |  |
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118555000
display |  | 1..1 | string | Representation defined by the system Fixed Value: Substance amount
value[x] |  | 1..1 | Quantity | UCUM
component:productNameQualifier |  | 0..1 | BackboneElement | If a testing code does not include a product name but needs one to qualify the code
code |  |  |  |
coding |  |  |  |
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 774167006
display |  | 1..1 | string | Representation defined by the system Fixed Value: Product name
value[x] |  | 1..1 |  | Actual component result
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7
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 | S | 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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status |  | 1..1 | code | generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative. Required Pattern: empty
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S 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 | ?!S Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category | S | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | BeObservationCodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:SNOMED-CT | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 0..1 | Reference(Group | Device | Location | Patient core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BePatient.
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
effective[x] | S Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | S Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 0..* | Reference(CareTeam | RelatedPerson | Patient core BE profile | Organisation core BE profile | Practitioner role core BE profile | Practitioner core BE profile) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeOrganization or BePractitioner
value[x] | S Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | S C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation | S | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note | S | 0..* | BeCodedAnnotation | Comments about the observation
bodySite | S | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method | S | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen | S | 0..1 | Reference(BeSpecimenLaboratory) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | S C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Comment |  | 0..* | BeCodedAnnotation | Comment extension for ReferenceRange URL: https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | 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 | S Σ | 0..* | Reference(QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this is BeObservationLaboratory
derivedFrom | S Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | BeObservationLaboratory) | In the initial iteration of the Belgium lab project: when sending to eHealthBox, this can be BeObservationLaboratory or Media
Slices for component | S Σ | 0..* | BackboneElement | Component results Slice: Unordered, Open by value:code.coding.code
component:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:relativeTimeQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a time interval but needs one to qualify the code.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118578006
display | Σ | 1..1 | string | Representation defined by the system Fixed Value: Relative time
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 1..1 | Quantity | UCUM
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
component:substanceAmountQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a substance amount but needs one to qualify the code
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 118555000
display | Σ | 1..1 | string | Representation defined by the system Fixed Value: Substance amount
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 1..1 | Quantity | UCUM
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
component:productNameQualifier | Σ | 0..1 | BackboneElement | If a testing code does not include a product name but needs one to qualify the code
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 774167006
display | Σ | 1..1 | string | Representation defined by the system Fixed Value: Product name
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 1..1 |  | Actual component result
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
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.text.status | Base | required | NarrativeStatus | 📍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.code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
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 | example | Observation Methods | 📍4.0.1 | FHIR Std.
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.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:relativeTimeQualifier.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:substanceAmountQualifier.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:productNameQualifier.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text | `low.exists() or high.exists() or text.exists()`
obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present | `dataAbsentReason.empty() or value.empty()`
obs-7 | error | Observation | If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present | `value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`
txt-1 | error | Observation.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes | `htmlChecks()`
txt-2 | error | Observation.text.div | The narrative SHALL have some non-whitespace content | `htmlChecks()`

This structure is derived from Observation

Summary

Mandatory: 0 element(12 nested mandatory elements)
Must-Support: 20 elements
Fixed: 9 elements

Structures

This structure refers to these other structures:

- BeObservationCodeableConcept (https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-observationcodeableconcept)
- Patient core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient)
- Organisation core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization)
- Practitioner role core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole)
- Practitioner core BE profile (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner)
- Coded Annotation (https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/coded-annotation)
- BeSpecimenLaboratory (https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-specimen-laboratory)
- BeObservationLaboratory (https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-observation-laboratory)

Extensions

This structure refers to these extensions:

- https://www.ehealth.fgov.be/standards/fhir/lab/StructureDefinition/be-ext-referencerange-comment

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.code.coding
- The element 1 is sliced based on the value of Observation.component

Maturity: 1

Other representations of profile: CSV, Excel, Schematron