Scope and usage

The Danish Core Observation profile is intended to represent observations for a variety of cases including:

• laboratory data
• results of using clinical assessment tools such as APGAR
• observations obtained in clinical assesments such as abdominal tenderness
• general health status such as pregnancy
• social history and anamnesis (Please be aware, an Observation must only include more than one code, if each code is true for the observation that actually happened, and not several observation as a result of an investigation. In this case, the ClinicalImpression resource should be used.)

Note: The profile DkCoreBasicObservation is made to ensure a common structure of measurable and often used observations, such as vital signs, height and weight. When sharing these basic observations, DkCoreBasicObservation profile is recommended to use.

Codes

In a Observation resource, codes from CodeSystems are used to describe what is observed in the elements Observation.code.coding and Observation.component.code.coding. In these elements, multiple CodeSystems are specified to ensure similar use of relevant CodeSystems in a Danish context. Some observations may need to be grouped together to document critical observations, e.g. systolic and diastolic bloodpressure, which can be supported by the element Observation.component. Click here for more information about Observation Grouping.

Multiple CodeSystems are added to the elements Observation.code.coding and Observation.component.code.coding, to ensure similar use of relevant CodeSystems in a Danish context. In addition, locally defined codes may be added. HL7 Denmark recommend adding these in a new slice using a system, that clearly states from where the code originate.

Two or more Observation.code.coding may be assigned in the same Observation.code, if each coding is true for the observation that actually happened. An example is HeartRate.Poul.1974654, where a LOINC, IEEE and NPU coding is used to describe the heart rate. Only one of the codings can be user selected, described by the element userSelected = true. An example is ElsePainVRS, where the value[x] includes two codings with one of them being userSelected. If the codings and units does not represent the same meaning, one instance of an Observation can be derived from another, as described in section Observation derived from other Observation.

None of the specified CodeSystems are required since each use case may call for different codes to represent the observations. The specified CodeSystems are included based on the standard catalogue from the Danish Health Data Agency, and Danish practice. In the following, some overall recommendations about the use of the code systems are provided:

• NPU codes are the preferred first choice when communicating observations from the laboratory area. NPU contains few codes outside the laboratory area. NPU is recommended to use in the standard catalogue from the Danish Health Data Agency.
• LOINC codes are generally not recommended, for clinical areas that NPU covers, because they are overlapping without being modelled in exactly the same way. For clinical areas not covered by NPU, LOINC can be used. LOINC is an international code system, and is the first choice for many FHIR-observations around the world. This also means that Observation standard-profiles often use LOINC codes, and that interoperability use cases using equipment/wearables intended for markets intentionally, very well may have build-in LOINC codes. LOINC is not recommended to use by the Danish Health Data Agency, but is included to support interoperability across countries in projects such as European Helath Data Space (EHDS).
• IEEE codes are the internal codes of many devices see https://www.iso.org/standard/37890.html. If an original observation from a device is represented, HL7-DK recommends using its original layout including the IEEE codes. Read more in IHE Personal Connected Health https://wiki.ihe.net/index.php/Personal_Connected_Health. IEEE is recommended to use in the standard catalogue from the Danish Health Data Agency.
• SKS does have a few observation codes in use, most are found in the 'R' Hierarchy - see e.g. https://medinfo.dk/sks/brows.php. HL7-DK does not recommend the use of SKS codes from the 'ZZ' hierarchy as FHIR observation-codes as they are codes for procedures. SKS is recommended to use in the standard catalogue from the Danish Health Data Agency.
• MedCom codes are Danish codes, that are not part of SKS, but have been necessary in Danish interoperability projects through time. They are sometimes referred to as kiap-codes or MCS codes. They can be found here: https://medcom.dk/standarder/koder/laboratorieomraadet/ or here: https://kiap.dk/kiap/praksis/services/koder/iupackoder.php. MedCom codes are not recommended to use by the Danish Health Data Agency, but are included as they are often used in MedComs standards.
• SNOMED CT codes are accepted in Denmark. SNOMED CT codes are relevant, for areas that NPU does not cover. Additionally, SNOMED CT is often used as a reference terminology, to give a common language of retrieval for data that have originally been defined or coded in some other way. If SNOMED CT is used as a reference terminology, it is often relevant to provide a SNOMED CT code, in addition to the original coding. This is also acceptable if the SNOMED CT concept is less granular than the original code, if each code is true for the observation that happened. SNOMED CT is stated to be usefull in the standard catalogue from the Danish Health Data Agency.

Subjects and performers

The primary use of this profile is to describe an observation performed on a patient. The patient must be represented using the DkCorePatient profile. However, it is still possible to select Observation.subject to be a Group, Device or Location. This is chosen to enable different uses of the profile e.g. a device calibration result is an observation of the device, not of the person that usually uses the device.

The performer of the observation may be different kinds of actors depending on the use case. The performer may be represented using DkCorePractitioner, DkCoreOrganization, DkCorePatient, PractitionerRole, CareTeam or DkCoreRelatedPerson.

Quality of the Observation

If known, information about the method used for the observation can be included, in the element Observation.method, as this might affect the interpretation of the observation. In DkCoreObservation profile, a slice is added which includes an extensible ValueSet of commonly used SNOMED CT methods; Estimation technique, Measurement technique, and Reported. If a different method is used the ValueSet may be extended with SNOMED CT codes, or a new slice may be added.

If a known device is used to collect the observation, and information about the device is exchanged, the instance of the Device or DeviceMetric resource can be included in the same Bundle as the Observation instance. An example of usage is Poul's home blood pressure measurement, where a Bundle includes both information about devices use to make the observations about the blood pressure.

Units

If the unit of measure is known, it shall be included in the Observation instance. It is assumed, that in most situations these units can be represented with UCUM. For this reason, UCUM is included as system in the element Observation.valueQuantity.system. However, special cases may arise where the unit is not represented by UCUM. In such case, the unit shall be included in the element Observation.valueQuantity.unit as a string. This Observation profile has implemented a rule known as a FHIR invariant that check that this condition holds true. The invariant is called dk-core-observation-mandatory-units, and ensures that when a valueQuantity.value is specified, a unit and/or code shall be present.

All NPU-codes include a unit internally in the observation-code. All the other code systems mentioned here, as well as the FHIR Observation resource, assume that the unit is provided in a separate attribute. Consequently, it is important to provide the same unit in valueQuantity.code and/or valueQuantity.unit, as provided in the NPU code. If consistency is not maintained, interpretation is impossible. No explicit rules to support the use of NPU consistently are implemented in this profile, so this should be considered before implementation.

Observation derived from other Observation

An Observation can refer to another, possibly contained Observation from which it is derived. This can be used in cases where the measuring Device provides the measured value in, for instance, another unit or precision than used in a particular exchange context.

An example is an oxygen saturation measured as a fraction in, say, the NPU code system. Exchanging the measurement as a vital signs Observation with oxygen saturation given as percent, the original NPU-based measurement can be contained and referenced using Observation.derivedFrom. The example can be found in John's oxygen saturation measurement.

Calculated values

[TBD]

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

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions dk-core-observation-mandatory-units: If value is specified then unit and/or code must be specified
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC		0..1	Coding	LOINC code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system
coding:SNOMEDCT		0..1	Coding	SNOMED CT code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system
coding:NPU		0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
code		1..1	code	Symbol in syntax defined by the system
coding:IEEE		0..1	Coding	IEEE code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
code		1..1	code	Symbol in syntax defined by the system
coding:MedCom		0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
system		1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
code		1..1	code	Symbol in syntax defined by the system
coding:SKS		0..1	Coding	SKS code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
code		1..1	code	Symbol in syntax defined by the system
subject		1..1	Reference(Danish Core Patient Profile | Group | Location | Device)	Who and/or what the observation is about
performer		0..*	Reference(Danish Core Practitioner Profile | Danish Core Organization Profile | Danish Core Patient Profile | PractitionerRole | CareTeam | Danish Core Related Person Profile)	Who is responsible for the observation
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment, Reference(MolecularSequence)	Actual result Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Actual result
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
method
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:SCTCode		0..1	Coding	Code defined by a terminology system Binding: TechniqesSCTCodes (example)
system		1..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
device		0..1	Reference(Device | DeviceMetric)	The device used for the measurement. It is recommended that when information about the device is sent, it is contained in the same Bundle as the Observation the device measured.
component
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC		0..1	Coding	LOINC code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system
coding:SNOMEDCT		0..1	Coding	SNOMED CT code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system
coding:NPU		0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
code		1..1	code	Symbol in syntax defined by the system
coding:IEEE		0..1	Coding	IEEE code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
code		1..1	code	Symbol in syntax defined by the system
coding:MedCom		0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
system		1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
code		1..1	code	Symbol in syntax defined by the system
coding:SKS		0..1	Coding	SKS code for the observation.
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
code		1..1	code	Symbol in syntax defined by the system
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment, Reference(MolecularSequence)	Actual component result Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Actual component result
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.method.coding:SCTCode	example	TechniqesSCTCodes http://hl7.dk/fhir/core/ValueSet/TechniqesSCTCodes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dk-core-observation-mandatory-units	error	Observation	If value is specified then unit and/or code must be specified : value.ofType(Quantity).value.exists() implies value.ofType(Quantity).unit.exists() or value.ofType(Quantity).code.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present dk-core-observation-mandatory-units: If value is specified then unit and/or code must be specified
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	ΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC	Σ	0..1	Coding	LOINC code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:SNOMEDCT	Σ	0..1	Coding	SNOMED CT code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:NPU	Σ	0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:IEEE	Σ	0..1	Coding	IEEE code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:MedCom	Σ	0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:SKS	Σ	0..1	Coding	SKS code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
code	ΣC	1..1	code	Symbol in syntax defined by the system
subject	Σ	1..1	Reference(Danish Core Patient Profile | Group | Location | Device)	Who and/or what the observation is about
performer	Σ	0..*	Reference(Danish Core Practitioner Profile | Danish Core Organization Profile | Danish Core Patient Profile | PractitionerRole | CareTeam | Danish Core Related Person Profile)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
comparator	?!Σ	0..1	code	< | <= | >= | > | ad - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
device		0..1	Reference(Device | DeviceMetric)	The device used for the measurement. It is recommended that when information about the device is sent, it is contained in the same Bundle as the Observation the device measured.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|5.0.0 from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dk-core-observation-mandatory-units	error	Observation	If value is specified then unit and/or code must be specified : value.ofType(Quantity).value.exists() implies value.ofType(Quantity).unit.exists() or value.ofType(Quantity).code.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present dk-core-observation-mandatory-units: If value is specified then unit and/or code must be specified
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
instantiates[x]	Σ	0..1	canonical(ObservationDefinition), Reference(ObservationDefinition)	Instantiates FHIR ObservationDefinition
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
triggeredBy		0..*	BackboneElement	Triggering observation(s)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
observation	Σ	1..1	Reference(Observation)	Triggering observation
type	Σ	1..1	code	reflex | repeat | re-run Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
reason		0..1	string	Reason that the observation was triggered
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	ΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC	Σ	0..1	Coding	LOINC code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SNOMEDCT	Σ	0..1	Coding	SNOMED CT code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:NPU	Σ	0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:IEEE	Σ	0..1	Coding	IEEE code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:MedCom	Σ	0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SKS	Σ	0..1	Coding	SKS code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Danish Core Patient Profile | Group | Location | Device)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Danish Core Practitioner Profile | Danish Core Organization Profile | Danish Core Patient Profile | PractitionerRole | CareTeam | Danish Core Related Person Profile)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > | ad - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	ΣC	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	C	0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
bodyStructure	C	0..1	Reference(BodyStructure)	Observed body structure
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:SCTCode	Σ	0..1	Coding	Code defined by a terminology system Binding: TechniqesSCTCodes (example)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	0..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
specimen	C	0..1	Reference(Specimen | Group)	Specimen used for this observation obs-9: If Observation.specimen is a reference to Group, the group can only have specimens
device		0..1	Reference(Device | DeviceMetric)	The device used for the measurement. It is recommended that when information about the device is sent, it is contained in the same Bundle as the Observation the device measured.
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
normalValue		0..1	CodeableConcept	Normal value, if relevant Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	C	0..1	markdown	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy)	Related resource from which the observation is made
component	ΣC	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC	Σ	0..1	Coding	LOINC code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SNOMEDCT	Σ	0..1	Coding	SNOMED CT code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:NPU	Σ	0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:IEEE	Σ	0..1	Coding	IEEE code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:MedCom	Σ	0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SKS	Σ	0..1	Coding	SKS code for the observation.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
Slices for value[x]	Σ	0..1		Actual component result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	Σ	0..1	Quantity	Actual component result
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > | ad - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	ΣC	0..1	code	Coded form of the unit
dataAbsentReason		0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
Observation.triggeredBy.type	required	TriggeredBytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype|5.0.0 from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|5.0.0 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.method.coding:SCTCode	example	TechniqesSCTCodes http://hl7.dk/fhir/core/ValueSet/TechniqesSCTCodes from this IG
Observation.referenceRange.normalValue	extensible	ObservationReferenceRangeNormalValueCodes http://hl7.org/fhir/ValueSet/observation-referencerange-normalvalue from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dk-core-observation-mandatory-units	error	Observation	If value is specified then unit and/or code must be specified : value.ofType(Quantity).value.exists() implies value.ofType(Quantity).unit.exists() or value.ofType(Quantity).code.exists()

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions dk-core-observation-mandatory-units: If value is specified then unit and/or code must be specified
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC		0..1	Coding	LOINC code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system
coding:SNOMEDCT		0..1	Coding	SNOMED CT code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system
coding:NPU		0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
code		1..1	code	Symbol in syntax defined by the system
coding:IEEE		0..1	Coding	IEEE code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
code		1..1	code	Symbol in syntax defined by the system
coding:MedCom		0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
system		1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
code		1..1	code	Symbol in syntax defined by the system
coding:SKS		0..1	Coding	SKS code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
code		1..1	code	Symbol in syntax defined by the system
subject		1..1	Reference(Danish Core Patient Profile | Group | Location | Device)	Who and/or what the observation is about
performer		0..*	Reference(Danish Core Practitioner Profile | Danish Core Organization Profile | Danish Core Patient Profile | PractitionerRole | CareTeam | Danish Core Related Person Profile)	Who is responsible for the observation
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment, Reference(MolecularSequence)	Actual result Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Actual result
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
method
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:SCTCode		0..1	Coding	Code defined by a terminology system Binding: TechniqesSCTCodes (example)
system		1..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
device		0..1	Reference(Device | DeviceMetric)	The device used for the measurement. It is recommended that when information about the device is sent, it is contained in the same Bundle as the Observation the device measured.
component
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC		0..1	Coding	LOINC code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system
coding:SNOMEDCT		0..1	Coding	SNOMED CT code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system
coding:NPU		0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
code		1..1	code	Symbol in syntax defined by the system
coding:IEEE		0..1	Coding	IEEE code for the observation
system		1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
code		1..1	code	Symbol in syntax defined by the system
coding:MedCom		0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
system		1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
code		1..1	code	Symbol in syntax defined by the system
coding:SKS		0..1	Coding	SKS code for the observation.
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
code		1..1	code	Symbol in syntax defined by the system
Slices for value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment, Reference(MolecularSequence)	Actual component result Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	Quantity	Actual component result
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.method.coding:SCTCode	example	TechniqesSCTCodes http://hl7.dk/fhir/core/ValueSet/TechniqesSCTCodes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dk-core-observation-mandatory-units	error	Observation	If value is specified then unit and/or code must be specified : value.ofType(Quantity).value.exists() implies value.ofType(Quantity).unit.exists() or value.ofType(Quantity).code.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present dk-core-observation-mandatory-units: If value is specified then unit and/or code must be specified
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	ΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC	Σ	0..1	Coding	LOINC code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:SNOMEDCT	Σ	0..1	Coding	SNOMED CT code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:NPU	Σ	0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:IEEE	Σ	0..1	Coding	IEEE code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:MedCom	Σ	0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
code	ΣC	1..1	code	Symbol in syntax defined by the system
coding:SKS	Σ	0..1	Coding	SKS code for the observation
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
code	ΣC	1..1	code	Symbol in syntax defined by the system
subject	Σ	1..1	Reference(Danish Core Patient Profile | Group | Location | Device)	Who and/or what the observation is about
performer	Σ	0..*	Reference(Danish Core Practitioner Profile | Danish Core Organization Profile | Danish Core Patient Profile | PractitionerRole | CareTeam | Danish Core Related Person Profile)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
comparator	?!Σ	0..1	code	< | <= | >= | > | ad - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
device		0..1	Reference(Device | DeviceMetric)	The device used for the measurement. It is recommended that when information about the device is sent, it is contained in the same Bundle as the Observation the device measured.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|5.0.0 from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dk-core-observation-mandatory-units	error	Observation	If value is specified then unit and/or code must be specified : value.ofType(Quantity).value.exists() implies value.ofType(Quantity).unit.exists() or value.ofType(Quantity).code.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present dk-core-observation-mandatory-units: If value is specified then unit and/or code must be specified
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
instantiates[x]	Σ	0..1	canonical(ObservationDefinition), Reference(ObservationDefinition)	Instantiates FHIR ObservationDefinition
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
triggeredBy		0..*	BackboneElement	Triggering observation(s)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
observation	Σ	1..1	Reference(Observation)	Triggering observation
type	Σ	1..1	code	reflex | repeat | re-run Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
reason		0..1	string	Reason that the observation was triggered
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	ΣC	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC	Σ	0..1	Coding	LOINC code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SNOMEDCT	Σ	0..1	Coding	SNOMED CT code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:NPU	Σ	0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:IEEE	Σ	0..1	Coding	IEEE code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:MedCom	Σ	0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SKS	Σ	0..1	Coding	SKS code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Danish Core Patient Profile | Group | Location | Device)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Danish Core Practitioner Profile | Danish Core Organization Profile | Danish Core Patient Profile | PractitionerRole | CareTeam | Danish Core Related Person Profile)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > | ad - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	ΣC	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite	C	0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
bodyStructure	C	0..1	Reference(BodyStructure)	Observed body structure
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:SCTCode	Σ	0..1	Coding	Code defined by a terminology system Binding: TechniqesSCTCodes (example)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	0..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
specimen	C	0..1	Reference(Specimen | Group)	Specimen used for this observation obs-9: If Observation.specimen is a reference to Group, the group can only have specimens
device		0..1	Reference(Device | DeviceMetric)	The device used for the measurement. It is recommended that when information about the device is sent, it is contained in the same Bundle as the Observation the device measured.
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
normalValue		0..1	CodeableConcept	Normal value, if relevant Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	C	0..1	markdown	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy)	Related resource from which the observation is made
component	ΣC	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LOINC	Σ	0..1	Coding	LOINC code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SNOMEDCT	Σ	0..1	Coding	SNOMED CT code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:NPU	Σ	0..1	Coding	NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.1
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:IEEE	Σ	0..1	Coding	IEEE code for the observation
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:iso:std:iso:11073:10101
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:MedCom	Σ	0..1	Coding	MedCom code for the observation. MedCom codes are administred by the MedCom.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:SKS	Σ	0..1	Coding	SKS code for the observation.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.2.208.176.2.4
version	Σ	0..1	string	Version of the system - if relevant
code	ΣC	1..1	code	Symbol in syntax defined by the system
display	ΣC	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
Slices for value[x]	Σ	0..1		Actual component result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
valueAttachment			Attachment
valueReference			Reference(MolecularSequence)
value[x]:valueQuantity	Σ	0..1	Quantity	Actual component result
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > | ad - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	ΣC	0..1	code	Coded form of the unit
dataAbsentReason		0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
Observation.triggeredBy.type	required	TriggeredBytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype|5.0.0 from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|5.0.0 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.method.coding:SCTCode	example	TechniqesSCTCodes http://hl7.dk/fhir/core/ValueSet/TechniqesSCTCodes from this IG
Observation.referenceRange.normalValue	extensible	ObservationReferenceRangeNormalValueCodes http://hl7.org/fhir/ValueSet/observation-referencerange-normalvalue from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0 from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dk-core-observation-mandatory-units	error	Observation	If value is specified then unit and/or code must be specified : value.ofType(Quantity).value.exists() implies value.ofType(Quantity).unit.exists() or value.ofType(Quantity).code.exists()

This structure is derived from Observation

Summary

Mandatory: 1 element(25 nested mandatory elements)
Fixed: 12 elements

Structures

This structure refers to these other structures:

• Danish Core Patient Profile (http://hl7.dk/fhir/core/StructureDefinition/dk-core-patient)
• Danish Core Practitioner Profile (http://hl7.dk/fhir/core/StructureDefinition/dk-core-practitioner)
• Danish Core Organization Profile (http://hl7.dk/fhir/core/StructureDefinition/dk-core-organization)
• Danish Core Related Person Profile (http://hl7.dk/fhir/core/StructureDefinition/dk-core-related-person)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.value[x]
• The element 1 is sliced based on the value of Observation.method.coding
• The element 1 is sliced based on the value of Observation.component.code.coding
• The element 1 is sliced based on the value of Observation.component.value[x]