HL7 FHIR Implementation Guide Laboratory Report
0.2.0 - trial-use

HL7 FHIR Implementation Guide Laboratory Report, published by HL7 Italia. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-it/lab-report/ and changes regularly. See the Directory of published versions

## Resource Profile: ObservationDocRefertoLabIt - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 1

Definitions for the observation-doc-it-lab resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition | This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and references the atomic results of the study as "has-member" child observations Measurements and simple assertions made about a patient, device or other subject.
Short | Observation Referto di LaboratorioMeasurements and simple assertions
Comments | Represents either a lab simple observation or the group of observations produced by a laboratory study. Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Vital Signs, Measurement, Results, Tests
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (`dataAbsentReason.empty() or value.empty()`) 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 (`value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`) eu-lab-1: If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component" (`(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()`) eu-lab-2: If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason" (`component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()`) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty()) 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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
2. Observation.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Observation.extension:supportingInfo
Slice Name | supportingInfo
Definition | Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use `Observation.hasMember` instead of supportingInformation for representing the members of an Observation panel.
Short | Other information that may be relevant to this event.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Supporting info) (Extension Type: Reference(Resource))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Observation.extension:triggeredBy-r5
Slice Name | triggeredBy-r5
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Observation.triggeredBy for Version 5.0) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
8. Observation.extension:triggeredBy-r5.extension:observation
Slice Name | observation
Definition | An Extension
Short | Triggering observation.Additional content defined by implementations
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Observation.extension:triggeredBy-r5.extension:observation.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Observation.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
12. Observation.extension:triggeredBy-r5.extension:observation.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `observation`
14. Observation.extension:triggeredBy-r5.extension:observation.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Reference(Observation), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Observation.extension:triggeredBy-r5.extension:type
Slice Name | type
Definition | An Extension
Short | The type of triggerAdditional content defined by implementations
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Observation.extension:triggeredBy-r5.extension:type.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Observation.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
20. Observation.extension:triggeredBy-r5.extension:type.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `type`
22. Observation.extension:triggeredBy-r5.extension:type.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Observation.extension:triggeredBy-r5.extension:reason
Slice Name | reason
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. Observation.extension:triggeredBy-r5.extension:reason.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Observation.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
28. Observation.extension:triggeredBy-r5.extension:reason.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `reason`
30. Observation.extension:triggeredBy-r5.extension:reason.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Observation.extension:triggeredBy-r5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy`
34. Observation.extension:triggeredBy-r5.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..01
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Observation.extension:certifiedRefMaterialCodeable
Slice Name | certifiedRefMaterialCodeable
Definition | This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using a CodeableConcept. This extension should be used when the unit is UCUM [IU].
Short | Certified Reference Material: CodeableConcept
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Certified Reference Material: CodeableConcept) (Extension Type: CodeableConcept)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
38. Observation.extension:certifiedRefMaterialIdentifer
Slice Name | certifiedRefMaterialIdentifer
Definition | This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using an Identifier. This extension should be used when the unit is UCUM [IU].
Short | Certified Reference Material: Identifier
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Certified Reference Material: Identifier) (Extension Type: Identifier)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
40. Observation.extension:labTestKit
Slice Name | labTestKit
Definition | This extension links this observation with the laboratory test kit used for this test. Usually only one laboratory test kit is referred
Short | Device Laboratory Test Kit
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Device Laboratory Test Kit) (Extension Type: Reference(Device))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. Observation.extension:value-r5
Slice Name | value-r5
Definition | Optional Extension Element - found in all resources.
Short | only for result of type Attachment
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. Observation.extension:value-r5.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Observation.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. Observation.extension:value-r5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]`
48. Observation.extension:value-r5.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Attachment, date, Meta, Address, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Observation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Observation.status
Definition | The status of the result value.
Short | Descrizione attributo: Stato dell'osservazione. Possibili valori: registered | preliminary | final | amended +registered | preliminary | final | amended +
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from Observation status code http://hl7.org/fhir/ValueSet/observation-status|4.0.1 (required to `http://hl7.it/fhir/lab-report/ValueSet/valueset-status-obs-it` )
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to track the status of individual results. Some results are finalized before the whole report is finalized.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Observation.category
Definition | La categoria di osservazione può definire la classificazione tramite diversi livelli di dettaglio, a partire da laboratory. A code that classifies the general type of observation being made.
Short | Codice che classifica il tipo di osservazione.Classification of type of observation
Comments | "laboratory" includes laboratory medicine and pathology In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 10..*
Binding | The codes SHOULD be taken from ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/observation-category` ) Codes for high level observation categories.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
56. Observation.category:laboratory
Slice Name | laboratory
Definition | A code that classifies the general type of observation being made.
Short | Indica genericamente che si riferisce ad un esame di LaboratorioClassification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 10..1*
Binding | The codes SHOULD be taken from ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/observation-category` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Observation.category:studyType
Slice Name | studyType
Definition | A code that classifies the general type of observation being made.
Short | Classificazione per tipo di studioClassification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 0..*
Binding | The codes SHALL be taken from The codes SHOULD be taken from Laboratory Study Types http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Observation.category:specialty
Slice Name | specialty
Definition | A code that classifies the general type of observation being made.
Short | Classificazione per specialitàClassification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 0..*
Binding | The codes SHALL be taken from The codes SHOULD be taken from Laboratory Specialty http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Observation.code
Definition | Describes what was observed. Sometimes this is called the observation "name". In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations Describes what was observed. Sometimes this is called the observation "name".
Short | Tipo di osservazione tramite codice.Type of observation (code / type)
Comments | In the context of this Observation-laboratory-uv-ips profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided. All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from For example codes, see Tipo Osservazione http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (preferred to `http://hl7.it/fhir/lab-report/ValueSet/risultato-osservazione` )
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Name
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Observation.subject
Definition | The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
Short | Soggetto della rilevazione clinica.Who and/or what the observation is about
Comments | One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.
Control | 10..1
Type | Reference(Patient - Lab Report, Patient, Group, Device, Location)
Is Modifier | false
Summary | true
Requirements | Observations have no value if you don't know who or what they're about.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Observation.subject.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 10..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Observation.effective[x]
Definition | The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
Short | Clinically relevant time/time-period for observation
Comments | At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.
Control | 10..1
Type | Choice of: dateTime, Period, Timing, instant
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Knowing when an observation was deemed true is important to its relevance as well as determining trends.
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Observation.effective[x].extension:data-absent-reason
Slice Name | data-absent-reason
Definition | Provides a reason why the effectiveTime is missing.
Short | effective[x] absence reason
Control | 0..1
Type | Extension(Data Absent Reason) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Observation.performer
Definition | Who was responsible for asserting the observed value as "true".
Short | Soggetto responsabile dell'osservazione.Who is responsible for the observation
Control | 10..*
Type | Reference(Practitioner - Lab Report, PractitionerRole - Lab Report, Organization - Lab Report, CareTeam, RelatedPerson, Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
Is Modifier | false
Summary | true
Requirements | May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Observation.performer.extension:performerFunction
Slice Name | performerFunction
Definition | Distinguishes the type of involvement of the performer in the event. For example, 'author', 'verifier' or 'responsible party'.
Short | Type of performance
Control | 0..*
Type | Extension(Performer function) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. Observation.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Risultato dell'osservazione.Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.value[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
78. Observation.value[x]:valueQuantity
Slice Name | valueQuantity
Definition | A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM. The information determined as a result of making the observation, if the information has a simple value.
Short | Risultato misurabile tramite una quantità.Actual result
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: ele-1, obs-7
Type | Quantity(Quantity - Lab Report), dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
80. Observation.value[x]:valueCodeableConcept
Slice Name | valueCodeableConcept
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. The information determined as a result of making the observation, if the information has a simple value.
Short | Concept - reference to a terminology or just textActual result
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: ele-1, obs-7
Binding | The codes SHOULD be taken from For codes, see Risultato osservazione codificato (preferred to `http://hl7.it/fhir/lab-report/ValueSet/valueset-valuecodeableconcept-obs-it` )
Type | CodeableConcept(Codeable Concept (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Observation.value[x]:valueString
Slice Name | valueString
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | string, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Observation.value[x]:valueRange
Slice Name | valueRange
Definition | A set of ordered Quantities defined by a low and high limit. The information determined as a result of making the observation, if the information has a simple value.
Short | Set of values bounded by low and highActual result
Comments | The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: ele-1, obs-7
Type | Range(Range (IPS)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) rng-2: If present, low SHALL have a lower value than high (`low.empty() or high.empty() or (low <= high)`)
86. Observation.value[x]:valueRatio
Slice Name | valueRatio
Definition | A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM. The information determined as a result of making the observation, if the information has a simple value.
Short | A measured ratio using UCUMActual result
Comments | The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: ele-1, obs-7
Type | Ratio(Ratio (Eu Lab)), dateTime, boolean, string, SampledData, Quantity, Period, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present (`(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`)
88. Observation.value[x]:valueTime
Slice Name | valueTime
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | time, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Observation.value[x]:valueDateTime
Slice Name | valueDateTime
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Observation.value[x]:valuePeriod
Slice Name | valuePeriod
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Period, dateTime, boolean, string, SampledData, Quantity, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
2. Observation.status
Binding | The codes SHALL be taken from Observation status code (required to `http://hl7.it/fhir/lab-report/ValueSet/valueset-status-obs-it` )

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition | This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and references the atomic results of the study as "has-member" child observations
Short | Observation Referto di Laboratorio
Comments | Represents either a lab simple observation or the group of observations produced by a laboratory study.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Vital Signs, Measurement, Results, Tests
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (`dataAbsentReason.empty() or value.empty()`) 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 (`value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`) eu-lab-1: If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided: "value", "dataAbsentReason", "hasMember" or "component" (`(status in ('registered'|'cancelled')) or value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists()`) eu-lab-2: If observation has components and observation status is other then "registered" or "cancelled", at least one of these Observation.component elements shall be provided: "value" or "dataAbsentReason" (`component.exists() implies (status in ('registered'|'cancelled')) or component.value.exists() or component.dataAbsentReason.exists()`)
2. Observation.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Observation.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Observation.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Observation.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Observation.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Observation.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Observation.extension
Definition | The laboratory test kit used for this test.
Short | Laboratory Test Kit
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Observation.extension:supportingInfo
Slice Name | supportingInfo
Definition | Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use `Observation.hasMember` instead of supportingInformation for representing the members of an Observation panel.
Short | Other information that may be relevant to this event.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Supporting info) (Extension Type: Reference(Resource))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Observation.extension:triggeredBy-r5
Slice Name | triggeredBy-r5
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Observation.triggeredBy for Version 5.0) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. Observation.extension:triggeredBy-r5.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
22. Observation.extension:triggeredBy-r5.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. Observation.extension:triggeredBy-r5.extension:observation
Slice Name | observation
Definition | An Extension
Short | Triggering observation.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Observation.extension:triggeredBy-r5.extension:observation.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
28. Observation.extension:triggeredBy-r5.extension:observation.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
30. Observation.extension:triggeredBy-r5.extension:observation.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `observation`
32. Observation.extension:triggeredBy-r5.extension:observation.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Reference(Observation)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. Observation.extension:triggeredBy-r5.extension:type
Slice Name | type
Definition | An Extension
Short | The type of trigger
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
36. Observation.extension:triggeredBy-r5.extension:type.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
38. Observation.extension:triggeredBy-r5.extension:type.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
40. Observation.extension:triggeredBy-r5.extension:type.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `type`
42. Observation.extension:triggeredBy-r5.extension:type.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | code
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Observation.extension:triggeredBy-r5.extension:reason
Slice Name | reason
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
46. Observation.extension:triggeredBy-r5.extension:reason.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
48. Observation.extension:triggeredBy-r5.extension:reason.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. Observation.extension:triggeredBy-r5.extension:reason.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `reason`
52. Observation.extension:triggeredBy-r5.extension:reason.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Observation.extension:triggeredBy-r5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy`
56. Observation.extension:triggeredBy-r5.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..0
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Observation.extension:certifiedRefMaterialCodeable
Slice Name | certifiedRefMaterialCodeable
Definition | This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using a CodeableConcept. This extension should be used when the unit is UCUM [IU].
Short | Certified Reference Material: CodeableConcept
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Certified Reference Material: CodeableConcept) (Extension Type: CodeableConcept)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
60. Observation.extension:certifiedRefMaterialIdentifer
Slice Name | certifiedRefMaterialIdentifer
Definition | This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using an Identifier. This extension should be used when the unit is UCUM [IU].
Short | Certified Reference Material: Identifier
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Certified Reference Material: Identifier) (Extension Type: Identifier)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
62. Observation.extension:labTestKit
Slice Name | labTestKit
Definition | This extension links this observation with the laboratory test kit used for this test. Usually only one laboratory test kit is referred
Short | Device Laboratory Test Kit
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Device Laboratory Test Kit) (Extension Type: Reference(Device))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
64. Observation.extension:value-r5
Slice Name | value-r5
Definition | Optional Extension Element - found in all resources.
Short | only for result of type Attachment
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
66. Observation.extension:value-r5.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
68. Observation.extension:value-r5.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
70. Observation.extension:value-r5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]`
72. Observation.extension:value-r5.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Observation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
76. Observation.identifier
Definition | A unique identifier assigned to this observation.
Short | Business Identifier for observation
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows observations to be distinguished and referenced.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Observation.basedOn
Definition | A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.
Short | Fulfills plan, proposal or order
Control | 0..*
Type | Reference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
Is Modifier | false
Summary | true
Requirements | Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.
Alternate Names | Fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Observation.partOf
Definition | A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.
Short | Part of referenced event
Comments | To link an Observation to an Encounter use `encounter`. See the Notes below for guidance on referencing another Observation.
Control | 0..*
Type | Reference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)
Is Modifier | false
Summary | true
Alternate Names | Container
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Observation.status
Definition | The status of the result value.
Short | Descrizione attributo: Stato dell'osservazione. Possibili valori: registered | preliminary | final | amended +
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from Observation status code (required to `http://hl7.it/fhir/lab-report/ValueSet/valueset-status-obs-it` )
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to track the status of individual results. Some results are finalized before the whole report is finalized.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Observation.category
Definition | La categoria di osservazione può definire la classificazione tramite diversi livelli di dettaglio, a partire da laboratory.
Short | Codice che classifica il tipo di osservazione.
Comments | "laboratory" includes laboratory medicine and pathology
Control | 1..*
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to `http://hl7.org/fhir/ValueSet/observation-category` ) Codes for high level observation categories.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
86. Observation.category:laboratory
Slice Name | laboratory
Definition | A code that classifies the general type of observation being made.
Short | Indica genericamente che si riferisce ad un esame di Laboratorio
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 1..1
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to `http://hl7.org/fhir/ValueSet/observation-category` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Observation.category:studyType
Slice Name | studyType
Definition | A code that classifies the general type of observation being made.
Short | Classificazione per tipo di studio
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 0..*
Binding | The codes SHALL be taken from Laboratory Study Types (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. Observation.category:specialty
Slice Name | specialty
Definition | A code that classifies the general type of observation being made.
Short | Classificazione per specialità
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 0..*
Binding | The codes SHALL be taken from Laboratory Specialty (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. Observation.code
Definition | Describes what was observed. Sometimes this is called the observation "name". In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations
Short | Tipo di osservazione tramite codice.
Comments | In the context of this Observation-laboratory-uv-ips profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from Tipo Osservazione (preferred to `http://hl7.it/fhir/lab-report/ValueSet/risultato-osservazione` )
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Name
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Observation.subject
Definition | The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
Short | Soggetto della rilevazione clinica.
Comments | One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.
Control | 1..1
Type | Reference(Patient - Lab Report)
Is Modifier | false
Summary | true
Requirements | Observations have no value if you don't know who or what they're about.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Observation.subject.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
98. Observation.subject.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.subject.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
100. Observation.subject.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 1..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Observation.subject.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Observation.subject.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Observation.subject.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Observation.focus
Definition | The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.
Short | What the observation is about, when it is not about the subject of record
Comments | Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use `specimen` if a reference to a specimen is required. If a code is required instead of a resource use either `bodysite` for bodysites or the standard extension focusCode.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. Observation.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
Short | Contesto in cui è stata prodotta l'osservazione.
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Control | 0..1
Type | Reference(Encounter - Lab Report)
Is Modifier | false
Summary | true
Requirements | For some observations it may be important to know the link between an observation and a particular encounter.
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. Observation.effective[x]
Definition | The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
Short | Clinically relevant time/time-period for observation
Comments | At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.
Control | 1..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Knowing when an observation was deemed true is important to its relevance as well as determining trends.
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Observation.effective[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
116. Observation.effective[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.effective[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
118. Observation.effective[x].extension:data-absent-reason
Slice Name | data-absent-reason
Definition | Provides a reason why the effectiveTime is missing.
Short | effective[x] absence reason
Control | 0..1
Type | Extension(Data Absent Reason) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. Observation.issued
Definition | The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
Short | Date/Time this result was made available
Comments | For Observations that don’t require review and verification, it may be the same as the `lastUpdated` time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Observation.performer
Definition | Who was responsible for asserting the observed value as "true".
Short | Soggetto responsabile dell'osservazione.
Control | 1..*
Type | Reference(Practitioner - Lab Report, PractitionerRole - Lab Report, Organization - Lab Report, CareTeam, RelatedPerson)
Is Modifier | false
Summary | true
Requirements | May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Observation.performer.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
126. Observation.performer.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.performer.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
128. Observation.performer.extension:performerFunction
Slice Name | performerFunction
Definition | Distinguishes the type of involvement of the performer in the event. For example, 'author', 'verifier' or 'responsible party'.
Short | Type of performance
Control | 0..*
Type | Extension(Performer function) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
130. Observation.performer.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Observation.performer.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. Observation.performer.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Observation.performer.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Observation.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Risultato dell'osservazione.
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.value[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
140. Observation.value[x]:valueQuantity
Slice Name | valueQuantity
Definition | A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.
Short | Risultato misurabile tramite una quantità.
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Quantity(Quantity - Lab Report)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
142. Observation.value[x]:valueCodeableConcept
Slice Name | valueCodeableConcept
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | Concept - reference to a terminology or just text
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from Risultato osservazione codificato (preferred to `http://hl7.it/fhir/lab-report/ValueSet/valueset-valuecodeableconcept-obs-it` )
Type | CodeableConcept(Codeable Concept (IPS))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. Observation.value[x]:valueString
Slice Name | valueString
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. Observation.value[x]:valueRange
Slice Name | valueRange
Definition | A set of ordered Quantities defined by a low and high limit.
Short | Set of values bounded by low and high
Comments | The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Range(Range (IPS))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) rng-2: If present, low SHALL have a lower value than high (`low.empty() or high.empty() or (low <= high)`)
148. Observation.value[x]:valueRatio
Slice Name | valueRatio
Definition | A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM.
Short | A measured ratio using UCUM
Comments | The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Ratio(Ratio (Eu Lab))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present (`(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`)
150. Observation.value[x]:valueTime
Slice Name | valueTime
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. Observation.value[x]:valueDateTime
Slice Name | valueDateTime
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Observation.value[x]:valuePeriod
Slice Name | valuePeriod
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Observation.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.value[x] is missing.
Short | Provides a reason why the expected value is missing.
Comments | Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Observation.interpretation
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | Interpretazione del risultato (Alto, Basso, Normale, ecc.)
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation` ) Codes identifying interpretations of observations.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Observation.note
Definition | Comments about the observation or the results.
Short | Comments about the observation
Comments | May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Requirements | Need to be able to provide free text additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. Observation.bodySite
Definition | Indicates the site on the subject's body where the observation was made (i.e. the target site).
Short | Sito corporeo dell'osservazione.
Comments | Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.
Control | 0..1
Binding | For example codes, see SNOMEDCTBodyStructures (example to `http://hl7.org/fhir/ValueSet/body-site` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. Observation.method
Definition | Laboratory technigue that has been used
Short | Metodo di rilevazione dell'osservazione.
Comments | Laboratory technique (method of measurement) are integral parts of the test specification of some laboratory test coding systems (e.g. NPU), in LOINC hovewer measurement principle is not always present in the test definition. In some cases however knowledge of the used measurment techique is important for proper interpretation of the test result. That's why it is important to explicitly include informaiton about measurement method is such cases.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from ObservationMethods (preferred to `http://hl7.org/fhir/ValueSet/observation-methods` )
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Requirements | In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. Observation.specimen
Definition | The specimen that was used when this observation was made.
Short | Reference al campione su cui si basa l'osservazione.
Comments | When the specimen is applicable and known it shall be documented
Control | 0..1
Type | Reference(Specimen - Lab Report)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Observation.device
Definition | The device used to generate the observation data.
Short | Dispositivo utilizzato per ottenere l'osservazione.
Comments | Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.
Control | 0..1
Type | Reference(Device - Lab Report, DeviceMetric)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
170. Observation.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.
Short | Range di riferimento per la caratterizzazione dell'osservazione sulla base di un criterio. Esempio: Range di normalità per uomo adulto.
Comments | Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) obs-3: Must have at least a low or a high or text (`low.exists() or high.exists() or text.exists()`)
172. Observation.referenceRange.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
174. Observation.referenceRange.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
176. Observation.referenceRange.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
178. Observation.referenceRange.low
Definition | The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).
Short | Limite inferiore del range di riferimento, se rilevante.
Control | 0..1 This element is affected by the following invariants: obs-3
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
180. Observation.referenceRange.high
Definition | The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).
Short | Limite superiore del range di riferimento, se rilevante.
Control | 0..1 This element is affected by the following invariants: obs-3
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. Observation.referenceRange.type
Definition | Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.
Short | Contesto del range di riferimento. Esempio: Un intervallo atteso in un individuo prima della pubertà.
Comments | This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.
Control | 0..1
Binding | The codes SHOULD be taken from ObservationReferenceRangeMeaningCodes (preferred to `http://hl7.org/fhir/ValueSet/referencerange-meaning` ) Code for the meaning of a reference range.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. Observation.referenceRange.appliesTo
Definition | Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple `appliesTo` are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.
Short | Categoria della popolazione a cui si applica il range di riferimento.
Comments | This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.
Control | 0..*
Binding | For example codes, see ObservationReferenceRangeAppliesToCodes (example to `http://hl7.org/fhir/ValueSet/referencerange-appliesto` ) Codes identifying the population the reference range applies to.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need to be able to identify the target population for proper interpretation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. Observation.referenceRange.age
Definition | The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.
Short | Età a cui si applica, se rilevante.
Control | 0..1
Type | Range
Is Modifier | false
Summary | false
Requirements | Some analytes vary greatly over age.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Observation.referenceRange.text
Definition | Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".
Short | Note testuali.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Observation.hasMember
Definition | A reference to another Observation profiled by Observation-results-laboratory-uv-ips. The target observation (for instance an individual test member of a panel) is considered as a sub-observation of the current one, which plays the role of a grouper.
Short | Osservazioni correlate alla risorsa.
Comments | This element is used in the context of international patient summary when there is a need to group a collection of observations, because they belong to the same panel, or because they share a common interpretation comment, or a common media attachment (illustrative image or graph). In these cases, the current observation is the grouper, and its set of sub-observations are related observations using the type "has-member". For a discussion on the ways Observations can be assembled in groups together see Observation Grouping.
Control | 0..*
Type | Reference(Observation - Lab Report)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. Observation.derivedFrom
Definition | The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.
Short | Reference dell'osservazione da cui deriva questo valore di osservazione. Ad esempio, un gap anionico calcolato o una misurazione fetale basata su un'immagine ecografica.
Comments | All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.
Control | 0..*
Type | Reference(Observation - Lab Report, Media - Lab Report)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Observation.component
Definition | Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
Short | Laboratory result
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Observation.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
198. Observation.component.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
200. Observation.component.extension:value-r5
Slice Name | value-r5
Definition | Optional Extension Element - found in all resources.
Short | only for result of type Attachment
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Observation.value[x] for Version 5.0) (Extension Type: Choice of: Attachment, Reference(MolecularSequence))
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
202. Observation.component.extension:value-r5.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
204. Observation.component.extension:value-r5.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
206. Observation.component.extension:value-r5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value[x]`
208. Observation.component.extension:value-r5.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. Observation.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
212. Observation.component.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | Concept - reference to a terminology or just text
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from Results Laboratory Observation - IPS (preferred to `http://hl7.org/fhir/uv/ips/ValueSet/results-laboratory-observations-uv-ips` )
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
214. Observation.component.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.component.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
216. Observation.component.value[x]:valueString
Slice Name | valueString
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Observation.component.value[x]:valueRange
Slice Name | valueRange
Definition | A set of ordered Quantities defined by a low and high limit.
Short | Set of values bounded by low and high
Comments | The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Range(Range (IPS))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) rng-2: If present, low SHALL have a lower value than high (`low.empty() or high.empty() or (low <= high)`)
220. Observation.component.value[x]:valueRatio
Slice Name | valueRatio
Definition | A measured ratio (or a ratio that can potentially be measured) and uncertainty of the measurement. This profile imposes that the code system for units be UCUM.
Short | A measured ratio using UCUM
Comments | The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Ratio(Ratio (Eu Lab))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present (`(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`)
222. Observation.component.value[x]:valueTime
Slice Name | valueTime
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. Observation.component.value[x]:valueDateTime
Slice Name | valueDateTime
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. Observation.component.value[x]:valuePeriod
Slice Name | valuePeriod
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. Observation.component.value[x]:valueQuantity
Slice Name | valueQuantity
Definition | A measured amount (or an amount that can potentially be measured) and uncertainty of the measurement. Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. This profile imposes that the code system for units be UCUM.
Short | A measured amount using UCUM
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Quantity(Quantity (Eu Lab))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
230. Observation.component.value[x]:valueCodeableConcept
Slice Name | valueCodeableConcept
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | Concept - reference to a terminology or just text
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from Results Coded Values Laboratory - IPS (preferred to `http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-uv-ips` )
Type | CodeableConcept(Codeable Concept (IPS))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. Observation.component.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Observation.component.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Observation.component.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)