IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/idea4rc/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: Observation: Comorbidities

This profile constrains the Observation resource to represent Comorbidities for the purpose of the IDEA4RC project. This profiles is adapted from the mCode FHIR Implementation Guide

Usage:

• Examples for this Resource Profile: Observation/observation-id-23

Formal Views of Profile Content

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

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

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comorbidConditionPresent		0..*	(Complex)	Related Condition Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
comorbidConditionAbsent		0..*	(Complex)	Related Condition Absent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
value[x]		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
code		1..1	CodeableConcept	Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75618-9
display		1..1	string	Representation defined by the system Fixed Value: Comorbid condition
subject		1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
value[x]		0..1		Comorbidity score or risk index
valueQuantity			Quantity
valueInteger			integer
bodySite		0..0
method		0..1	CodeableConcept	Comorbidity framework used.
specimen		0..0
device		0..0
hasMember		0..0
component		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.extension:comorbidConditionAbsent.value[x]	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comorbidConditionPresent		0..*	(Complex)	Related Condition Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
comorbidConditionAbsent		0..*	(Complex)	Related Condition Absent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75618-9
display		1..1	string	Representation defined by the system Fixed Value: Comorbid condition
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
value[x]	ΣC	0..1		Comorbidity score or risk index
valueQuantity			Quantity
valueInteger			integer
method		0..1	CodeableConcept	Comorbidity framework used. Binding: ObservationMethods (example): Methods for simple observations.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.extension:comorbidConditionAbsent.value[x]	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 75618-9("Comorbid condition") http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comorbidConditionPresent		0..*	(Complex)	Related Condition Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
comorbidConditionAbsent		0..*	(Complex)	Related Condition Absent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75618-9
display		1..1	string	Representation defined by the system Fixed Value: Comorbid condition
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient: IDEA4RC)	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
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1		Comorbidity score or risk index
valueQuantity			Quantity
valueInteger			integer
dataAbsentReason	C	0..1	CodeableConcept	Why the 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.
note		0..*	Annotation	Comments about the observation
method		0..1	CodeableConcept	Comorbidity framework used. Binding: ObservationMethods (example): Methods for simple observations.
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.extension:comorbidConditionAbsent.value[x]	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 75618-9("Comorbid condition") http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from Observation

Summary

Mandatory: 1 element(1 nested mandatory element)
Prohibited: 5 elements

Structures

This structure refers to these other structures:

• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comorbidConditionPresent		0..*	(Complex)	Related Condition Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
comorbidConditionAbsent		0..*	(Complex)	Related Condition Absent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
value[x]		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
code		1..1	CodeableConcept	Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75618-9
display		1..1	string	Representation defined by the system Fixed Value: Comorbid condition
subject		1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
value[x]		0..1		Comorbidity score or risk index
valueQuantity			Quantity
valueInteger			integer
bodySite		0..0
method		0..1	CodeableConcept	Comorbidity framework used.
specimen		0..0
device		0..0
hasMember		0..0
component		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.extension:comorbidConditionAbsent.value[x]	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comorbidConditionPresent		0..*	(Complex)	Related Condition Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
comorbidConditionAbsent		0..*	(Complex)	Related Condition Absent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75618-9
display		1..1	string	Representation defined by the system Fixed Value: Comorbid condition
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
value[x]	ΣC	0..1		Comorbidity score or risk index
valueQuantity			Quantity
valueInteger			integer
method		0..1	CodeableConcept	Comorbidity framework used. Binding: ObservationMethods (example): Methods for simple observations.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.extension:comorbidConditionAbsent.value[x]	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 75618-9("Comorbid condition") http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
comorbidConditionPresent		0..*	(Complex)	Related Condition Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
comorbidConditionAbsent		0..*	(Complex)	Related Condition Absent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Comorbidities: Athena (required) Additional Bindings Purpose Comorbidities: SNOMED Required
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75618-9
display		1..1	string	Representation defined by the system Fixed Value: Comorbid condition
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient: IDEA4RC)	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
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1		Comorbidity score or risk index
valueQuantity			Quantity
valueInteger			integer
dataAbsentReason	C	0..1	CodeableConcept	Why the 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.
note		0..*	Annotation	Comments about the observation
method		0..1	CodeableConcept	Comorbidity framework used. Binding: ObservationMethods (example): Methods for simple observations.
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.extension:comorbidConditionAbsent.value[x]	required	VsComorbiditiesAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/comorbidities-athena-eu-i4rc from this IG
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 75618-9("Comorbid condition") http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from Observation

Summary

Mandatory: 1 element(1 nested mandatory element)
Prohibited: 5 elements

Structures

This structure refers to these other structures:

• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent

Slices

This structure defines the following Slices:

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

Other representations of profile: CSV, Excel, Schematron