DK MedCom Notes
0.1.0 - draft Denmark flag

DK MedCom Notes, published by MedCom. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/medcomdk/dk-medcom-notes/ and changes regularly. See the Directory of published versions

Resource Profile: MedComNotesObservation

Official URL: http://medcomfhir.dk/ig/notes/StructureDefinition/medcom-notes-observation Version: 0.1.0
Draft as of 2026-02-02 Computable Name: MedComNotesObservation

Observation profile intended to be used in MedCom's Notes standard.

MedCom Notes Observation

This page describes how the MedComNotesObservation profile is intended to be used within the MedCom Notes standard.

This profile specifies how the Observation represents the note from the general practitioner using a dedicated extension. It also specifies how other information must be applied, such as the metadata related to the attachment, as well as coding and references to the patient and performing organization or practitioner. Read more about this in the following paragrafs.

Consultation Note

This Observation contains a FHIR extension designed to hold the note. The note must be encoded in Base64 and the mimetype must be xhtml+xml to describe the content. The valueAttachment element is implemented as an extension as the base value[x] element does not support the Attachment type in FHIR R4. The extension also captures essential metadata for the attachment; the MIME type and the title.

The note is represented in the Observation resource in extension:valueAttachment, as described above. This also means that the note content is base64-encoded. The formatting of the content follows the same conventions as defined in the MedCom FNUX standard. This means that line breaks, bold, italics, underline, and monospaced text are supported, and these may be combined.

Title

It is possible for practitioners authoring the notes to include a self-written title for the note. The title is profiled as mandatory and SHALL be populated in extension:valueAttachment.value.title.

Although it is not mandatory for practitioners to provide a title in their clinical system, a value MUST be provided in extension:valueAttachment.value.title. If no title is entered in the clinical system, a generic description of the content MUST be used instead, e.g. "Journalnotat".

Notes date and time

The effectiveDateTime element is a mandatory element used to represent the date and time the note was created and SHALL be provided as a dateTime.

Required LOINC coding

The element code describes what was observed. This code is for Shared Notes fixed to code.coding:LOINC.code: 11488-4 system: http://loinc.org display: Consult Note.

Author

A reference to the author of the note is included in the element performer. If information about the healthcare professional and his/her role is available this should be included in the profiles MedComDocumentPractitioner and MedComDocumentPractitionerRole, respectively. If only information about the authoring organization is available, this must be included.

Resource references

This Observation references the Patient resource through the subject element and the author Organization, Practitioner, or PractitionerRole through the performer element.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* MedComDocumentObservation Measurements and simple assertions
Constraints: obs-6, obs-7, dk-core-observation-mandatory-units
... id SOΣ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 1..1 Narrative The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... status S 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required): The status of a resource narrative.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
.... extension:valueAttachment S 1..1 (Complex) Observation value as attachment.
URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url S 1..1 uri "http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension"
..... value[x] S 1..1 Attachment Value of extension
...... contentType SOΣ 1..1 code MIME type of the note
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
Fixed Value: application/xhtml+xml
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... data S 1..1 base64Binary Base64-encoded content of the note (Da: journalnotatet)
...... title SOΣ 1..1 string Either the title of the note written by the responsible or a generic title e.g. 'Journalnotat'.
Example General: Official Corporate Logo
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Globally unique, stable identifier for this resource. The same identifier SHALL be used when this resource is recreated from the same source data.
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string The value that is unique
Example General: 123456
... status ?!SOΣ 1..1 code Status MUST be final.
Binding: MedComCoreObservationStatus (required)
Required Pattern: final
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:LOINC SΣ 1..1 Coding LOINC code for the observation
...... system SOΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... code SOΣ 1..1 code Symbol in syntax defined by the system
Fixed Value: 11488-4
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... display SOΣ 1..1 string Representation defined by the system
Fixed Value: Consult note
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
..... 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 Σ 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: http://npu-terminology.org
...... code Σ 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 Σ 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 Σ 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 Σ 1..1 code Symbol in syntax defined by the system
... subject SOΣ 1..1 Reference(MedComDocumentPatient) {b} Who and/or what the observation is about
... effective[x] SOΣC 1..1 dateTime Date and time the note was created (Da: Oprettelsestidspunkt for notatet)
Constraints: medcom-datetime-has-time-offset-zulu
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... performer SOΣ 1..1 Reference(MedComDocumentOrganization | MedComDocumentPractitioner | MedComDocumentPractitionerRole) 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
.... value[x]:valueQuantity ΣC 0..1 Quantity Actual result
..... comparator ?!Σ 0..1 code < | <= | >= | > - 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.text.status Base required NarrativeStatus 📍4.0.1 FHIR Std.
Observation.extension:valueAttachment.​value[x].contentType Base required MimeType 📍4.0.1 FHIR Std.
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.status Base required MedComCoreObservationStatus 📦1.8.2 DK MedCom Terminology v2.0
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
medcom-datetime-has-time-offset-zulu error Observation.effective[x] dateTime must include date, time, and time zone. $this.toString().matches('^[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[12][0-9]|3[01])T([01][0-9]|2[0-3]):[0-5][0-9]:[0-5][0-9]([.][0-9]+)?(Z|[+-][0-9]{2}:[0-9]{2})$')
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
txt-1 error Observation.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error Observation.text.div The narrative SHALL have some non-whitespace content htmlChecks()

This structure is derived from MedComDocumentObservation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* MedComDocumentObservation Measurements and simple assertions
... extension 1..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:valueAttachment S 1..1 MedComObservationValueAttachmentExtension Observation value as attachment.
..... url S 1..1 uri identifies the meaning of the extension
..... value[x] S 1..1 Attachment Value of extension
...... contentType SO 1..1 code MIME type of the note
Fixed Value: application/xhtml+xml
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... data S 1..1 base64Binary Base64-encoded content of the note (Da: journalnotatet)
...... title SO 1..1 string Either the title of the note written by the responsible or a generic title e.g. 'Journalnotat'.
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... status 1..1 code Status MUST be final.
Required Pattern: final
.... coding 1..* Coding Code defined by a terminology system
.... Slices for coding Content/Rules for all slices
..... coding:LOINC S 1..1 Coding LOINC code for the observation
...... system SO 1..1 uri Identity of the terminology system
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... code SO 1..1 code Symbol in syntax defined by the system
Fixed Value: 11488-4
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... display SO 1..1 string Representation defined by the system
Fixed Value: Consult note
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... effective[x] SOC 1..1 dateTime Date and time the note was created (Da: Oprettelsestidspunkt for notatet)
Constraints: medcom-datetime-has-time-offset-zulu
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... performer 1..1 Reference(MedComDocumentOrganization | MedComDocumentPractitioner | MedComDocumentPractitionerRole) Who is responsible for the observation

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
medcom-datetime-has-time-offset-zulu error Observation.effective[x] dateTime must include date, time, and time zone. $this.toString().matches('^[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[12][0-9]|3[01])T([01][0-9]|2[0-3]):[0-5][0-9]:[0-5][0-9]([.][0-9]+)?(Z|[+-][0-9]{2}:[0-9]{2})$')
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* MedComDocumentObservation Measurements and simple assertions
Constraints: obs-6, obs-7, dk-core-observation-mandatory-units
... id SOΣ 1..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text S 1..1 Narrative The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required): The status of a resource narrative.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:valueAttachment S 1..1 (Complex) Observation value as attachment.
URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url S 1..1 uri "http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension"
..... value[x] S 1..1 Attachment Value of extension
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... contentType SOΣ 1..1 code MIME type of the note
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
Fixed Value: application/xhtml+xml
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... language Σ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
...... data S 1..1 base64Binary Base64-encoded content of the note (Da: journalnotatet)
...... url Σ 0..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
...... size Σ 0..1 unsignedInt Number of bytes of content (if url provided)
...... hash Σ 0..1 base64Binary Hash of the data (sha-1, base64ed)
...... title SOΣ 1..1 string Either the title of the note written by the responsible or a generic title e.g. 'Journalnotat'.
Example General: Official Corporate Logo
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... creation Σ 0..1 dateTime Date attachment was first created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Globally unique, stable identifier for this resource. The same identifier SHALL be used when this resource is recreated from the same source data.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SOΣ 1..1 code Status MUST be final.
Binding: MedComCoreObservationStatus (required)
Required Pattern: final
... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:LOINC SΣ 1..1 Coding LOINC code for the observation
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SOΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... version Σ 0..1 string Version of the system - if relevant
...... code SOΣ 1..1 code Symbol in syntax defined by the system
Fixed Value: 11488-4
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... display SOΣ 1..1 string Representation defined by the system
Fixed Value: Consult note
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... 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 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:NPU Σ 0..1 Coding NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://npu-terminology.org
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:IEEE Σ 0..1 Coding IEEE code for the observation
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:MedCom Σ 0..1 Coding MedCom code for the observation. MedCom codes are administred by the MedCom.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:SKS Σ 0..1 Coding SKS code for the observation
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.208.176.2.4
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SOΣ 1..1 Reference(MedComDocumentPatient) {b} 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] SOΣC 1..1 dateTime Date and time the note was created (Da: Oprettelsestidspunkt for notatet)
Constraints: medcom-datetime-has-time-offset-zulu
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... issued Σ 0..1 instant Date/Time this version was made available
... performer SOΣ 1..1 Reference(MedComDocumentOrganization | MedComDocumentPractitioner | MedComDocumentPractitionerRole) 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
.... value[x]:valueQuantity ΣC 0..1 Quantity Actual result
..... id 0..1 string 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 < | <= | >= | > - 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 Σ 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 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:SCTCode Σ 0..1 Coding Code defined by a terminology system
Binding: DK TechniquesSCTCodes (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://snomed.info/sct|http://snomed.info/sct/554471000005108
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... 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
Constraints: obs-3
.... 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(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 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 Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... 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 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:SNOMEDCT Σ 0..1 Coding SNOMED CT code for the observation
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:NPU Σ 0..1 Coding NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://npu-terminology.org
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:IEEE Σ 0..1 Coding IEEE code for the observation
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:MedCom Σ 0..1 Coding MedCom code for the observation. MedCom codes are administred by the MedCom.
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:SKS Σ 0..1 Coding SKS code for the observation.
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.208.176.2.4
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... 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
..... value[x]:valueQuantity Σ 0..1 Quantity Actual component result
...... id 0..1 string 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 < | <= | >= | > - 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 Σ 0..1 code Coded form of the unit
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.text.status Base required NarrativeStatus 📍4.0.1 FHIR Std.
Observation.extension:valueAttachment.​value[x].contentType Base required MimeType 📍4.0.1 FHIR Std.
Observation.extension:valueAttachment.​value[x].language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.identifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Observation.status Base required MedComCoreObservationStatus 📦1.8.2 DK MedCom Terminology v2.0
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.method.coding:SCTCode Base example DK TechniquesSCTCodes 📦3.5.0 HL7 FHIR Implementation Guide: DK Core v3.5
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
medcom-datetime-has-time-offset-zulu error Observation.effective[x] dateTime must include date, time, and time zone. $this.toString().matches('^[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[12][0-9]|3[01])T([01][0-9]|2[0-3]):[0-5][0-9]:[0-5][0-9]([.][0-9]+)?(Z|[+-][0-9]{2}:[0-9]{2})$')
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
txt-1 error Observation.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error Observation.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* MedComDocumentObservation Measurements and simple assertions
Constraints: obs-6, obs-7, dk-core-observation-mandatory-units
... id SOΣ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 1..1 Narrative The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... status S 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required): The status of a resource narrative.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
.... extension:valueAttachment S 1..1 (Complex) Observation value as attachment.
URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url S 1..1 uri "http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension"
..... value[x] S 1..1 Attachment Value of extension
...... contentType SOΣ 1..1 code MIME type of the note
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
Fixed Value: application/xhtml+xml
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... data S 1..1 base64Binary Base64-encoded content of the note (Da: journalnotatet)
...... title SOΣ 1..1 string Either the title of the note written by the responsible or a generic title e.g. 'Journalnotat'.
Example General: Official Corporate Logo
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Globally unique, stable identifier for this resource. The same identifier SHALL be used when this resource is recreated from the same source data.
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string The value that is unique
Example General: 123456
... status ?!SOΣ 1..1 code Status MUST be final.
Binding: MedComCoreObservationStatus (required)
Required Pattern: final
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:LOINC SΣ 1..1 Coding LOINC code for the observation
...... system SOΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... code SOΣ 1..1 code Symbol in syntax defined by the system
Fixed Value: 11488-4
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... display SOΣ 1..1 string Representation defined by the system
Fixed Value: Consult note
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
..... 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 Σ 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: http://npu-terminology.org
...... code Σ 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 Σ 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 Σ 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 Σ 1..1 code Symbol in syntax defined by the system
... subject SOΣ 1..1 Reference(MedComDocumentPatient) {b} Who and/or what the observation is about
... effective[x] SOΣC 1..1 dateTime Date and time the note was created (Da: Oprettelsestidspunkt for notatet)
Constraints: medcom-datetime-has-time-offset-zulu
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... performer SOΣ 1..1 Reference(MedComDocumentOrganization | MedComDocumentPractitioner | MedComDocumentPractitionerRole) 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
.... value[x]:valueQuantity ΣC 0..1 Quantity Actual result
..... comparator ?!Σ 0..1 code < | <= | >= | > - 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.text.status Base required NarrativeStatus 📍4.0.1 FHIR Std.
Observation.extension:valueAttachment.​value[x].contentType Base required MimeType 📍4.0.1 FHIR Std.
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.status Base required MedComCoreObservationStatus 📦1.8.2 DK MedCom Terminology v2.0
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
medcom-datetime-has-time-offset-zulu error Observation.effective[x] dateTime must include date, time, and time zone. $this.toString().matches('^[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[12][0-9]|3[01])T([01][0-9]|2[0-3]):[0-5][0-9]:[0-5][0-9]([.][0-9]+)?(Z|[+-][0-9]{2}:[0-9]{2})$')
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
txt-1 error Observation.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error Observation.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Differential View

This structure is derived from MedComDocumentObservation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* MedComDocumentObservation Measurements and simple assertions
... extension 1..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:valueAttachment S 1..1 MedComObservationValueAttachmentExtension Observation value as attachment.
..... url S 1..1 uri identifies the meaning of the extension
..... value[x] S 1..1 Attachment Value of extension
...... contentType SO 1..1 code MIME type of the note
Fixed Value: application/xhtml+xml
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... data S 1..1 base64Binary Base64-encoded content of the note (Da: journalnotatet)
...... title SO 1..1 string Either the title of the note written by the responsible or a generic title e.g. 'Journalnotat'.
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... status 1..1 code Status MUST be final.
Required Pattern: final
.... coding 1..* Coding Code defined by a terminology system
.... Slices for coding Content/Rules for all slices
..... coding:LOINC S 1..1 Coding LOINC code for the observation
...... system SO 1..1 uri Identity of the terminology system
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... code SO 1..1 code Symbol in syntax defined by the system
Fixed Value: 11488-4
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... display SO 1..1 string Representation defined by the system
Fixed Value: Consult note
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... effective[x] SOC 1..1 dateTime Date and time the note was created (Da: Oprettelsestidspunkt for notatet)
Constraints: medcom-datetime-has-time-offset-zulu
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... performer 1..1 Reference(MedComDocumentOrganization | MedComDocumentPractitioner | MedComDocumentPractitionerRole) Who is responsible for the observation

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
medcom-datetime-has-time-offset-zulu error Observation.effective[x] dateTime must include date, time, and time zone. $this.toString().matches('^[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[12][0-9]|3[01])T([01][0-9]|2[0-3]):[0-5][0-9]:[0-5][0-9]([.][0-9]+)?(Z|[+-][0-9]{2}:[0-9]{2})$')

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* MedComDocumentObservation Measurements and simple assertions
Constraints: obs-6, obs-7, dk-core-observation-mandatory-units
... id SOΣ 1..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text S 1..1 Narrative The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required): The status of a resource narrative.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:valueAttachment S 1..1 (Complex) Observation value as attachment.
URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url S 1..1 uri "http://medcomfhir.dk/ig/core/StructureDefinition/medcom-observation-value-attachment-extension"
..... value[x] S 1..1 Attachment Value of extension
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... contentType SOΣ 1..1 code MIME type of the note
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.
Fixed Value: application/xhtml+xml
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... language Σ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
...... data S 1..1 base64Binary Base64-encoded content of the note (Da: journalnotatet)
...... url Σ 0..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
...... size Σ 0..1 unsignedInt Number of bytes of content (if url provided)
...... hash Σ 0..1 base64Binary Hash of the data (sha-1, base64ed)
...... title SOΣ 1..1 string Either the title of the note written by the responsible or a generic title e.g. 'Journalnotat'.
Example General: Official Corporate Logo
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... creation Σ 0..1 dateTime Date attachment was first created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 1..1 Identifier Globally unique, stable identifier for this resource. The same identifier SHALL be used when this resource is recreated from the same source data.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SOΣ 1..1 code Status MUST be final.
Binding: MedComCoreObservationStatus (required)
Required Pattern: final
... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:LOINC SΣ 1..1 Coding LOINC code for the observation
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SOΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... version Σ 0..1 string Version of the system - if relevant
...... code SOΣ 1..1 code Symbol in syntax defined by the system
Fixed Value: 11488-4
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... display SOΣ 1..1 string Representation defined by the system
Fixed Value: Consult note
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
...... 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 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:NPU Σ 0..1 Coding NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://npu-terminology.org
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:IEEE Σ 0..1 Coding IEEE code for the observation
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:MedCom Σ 0..1 Coding MedCom code for the observation. MedCom codes are administred by the MedCom.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:SKS Σ 0..1 Coding SKS code for the observation
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.208.176.2.4
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SOΣ 1..1 Reference(MedComDocumentPatient) {b} 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] SOΣC 1..1 dateTime Date and time the note was created (Da: Oprettelsestidspunkt for notatet)
Constraints: medcom-datetime-has-time-offset-zulu
ObligationsActor
SHALL:in-narrative Producer of FHIR resources
... issued Σ 0..1 instant Date/Time this version was made available
... performer SOΣ 1..1 Reference(MedComDocumentOrganization | MedComDocumentPractitioner | MedComDocumentPractitionerRole) 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
.... value[x]:valueQuantity ΣC 0..1 Quantity Actual result
..... id 0..1 string 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 < | <= | >= | > - 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 Σ 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 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:SCTCode Σ 0..1 Coding Code defined by a terminology system
Binding: DK TechniquesSCTCodes (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://snomed.info/sct|http://snomed.info/sct/554471000005108
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... 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
Constraints: obs-3
.... 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(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 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 Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... 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 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:SNOMEDCT Σ 0..1 Coding SNOMED CT code for the observation
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:NPU Σ 0..1 Coding NPU code for the observation. NPU codes are administred by the Danish Health Data Authority.
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://npu-terminology.org
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:IEEE Σ 0..1 Coding IEEE code for the observation
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:MedCom Σ 0..1 Coding MedCom code for the observation. MedCom codes are administred by the MedCom.
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-observation-codes
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:SKS Σ 0..1 Coding SKS code for the observation.
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.208.176.2.4
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... 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
..... value[x]:valueQuantity Σ 0..1 Quantity Actual component result
...... id 0..1 string 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 < | <= | >= | > - 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 Σ 0..1 code Coded form of the unit
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.text.status Base required NarrativeStatus 📍4.0.1 FHIR Std.
Observation.extension:valueAttachment.​value[x].contentType Base required MimeType 📍4.0.1 FHIR Std.
Observation.extension:valueAttachment.​value[x].language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Observation.identifier.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
Observation.status Base required MedComCoreObservationStatus 📦1.8.2 DK MedCom Terminology v2.0
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.method.coding:SCTCode Base example DK TechniquesSCTCodes 📦3.5.0 HL7 FHIR Implementation Guide: DK Core v3.5
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
medcom-datetime-has-time-offset-zulu error Observation.effective[x] dateTime must include date, time, and time zone. $this.toString().matches('^[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[12][0-9]|3[01])T([01][0-9]|2[0-3]):[0-5][0-9]:[0-5][0-9]([.][0-9]+)?(Z|[+-][0-9]{2}:[0-9]{2})$')
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
txt-1 error Observation.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error Observation.text.div The narrative SHALL have some non-whitespace content htmlChecks()

 

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