NZ Shared Digital Health Record API
1.0.1 - release

NZ Shared Digital Health Record API, published by Health New Zealand. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/fhir-sdhr/ and changes regularly. See the Directory of published versions

## Resource Profile: SDHRObservation

Official URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/SDHRObservation | Version: 1.0.1
Active as of 2026-06-05 | Computable Name: SDHRObservation

A Shared Digital Health Record Observation.

Usages:

- Examples for this Profile: Observation/ObservationVitalSignsExample
- CapabilityStatements using this Profile: NZ Shared Digital Health Record API

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, value-or-dataabsentreason-required
meta | Σ | 1..1 | Meta | Metadata about the resource
source | Σ C | 1..1 | uri | Captures the source of the record - please see description for details Constraints: hpi-location-url-format
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to
tag | Σ | 0..* | Coding | Tag the resource with a code to indicate usability components of the resource Binding: ValueSet for SDHR Resource Tags (preferred)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClientLastUpdated |  | 1..1 | dateTime | Client Last Updated URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension
identifier | Σ | 1..* | Identifier | A local identifier MUST be added to this section. If used, system MUST be specified.
use | ?!Σ | 0..1 | code | The local identifier use SHOULD be set to secondary, where the SDHR resource id is considered the primary identifier. Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | Σ | 1..1 | uri | System for the local identifier. This MUST be consistent per PMS/Health Application Example General: http://www.acme.com/identifiers/patient Example Local Identifier System: https://fhir.example.co.nz
value | Σ | 1..1 | string | The actual local identifier value, e.g. ec2d6cad-1e19-46ee-accf-dc460a680710 Example General: 123456 Example Local Identifier Value: ec2d6cad-1e19-46ee-accf-dc460a680710
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code | Σ | 1..1 | CodeableConcept | Observation code. Note that when the observation is an individual observation (singular) LOINC should be used. If, however, the Observation is a grouping (e.g. vital-signs) the code can be from SNOMED CT e.g. `122869004`. See https://fhir-ig.digital.health.nz/sdhr/Observation-ObservationVitalSignsExample.html for example Binding: LOINCCodes (preferred)
subject | Σ | 1..1 | Reference(Patient) | National Health Identifier for the health consumer
reference | Σ C | 1..1 | string | Must be an absolute URL reference to the patient on the NHI system. See constraints for details. Constraints: nhi-url-format
type | Σ | 1..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Patient
effective[x] | Σ | 1..1 |  | Date and time/time-period the measurement was obtained
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Preferred - an HPI Practitioner URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Practitioner/11AAAA
bodySite |  | 0..1 | CodeableConcept | Code for the body site affected by the problem (if applicable) Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.tag | Base | preferred | ValueSet for SDHR Resource Tags | 📦1.0.1 | This IG
Observation.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hpi-location-url-format | error | Observation.meta.source | Reference must be an HPI Location URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Location/FZZ111-A | `matches('^https://api.hip.digital.health.nz/fhir/hpi/v1/Location/F[A-Za-z0-9]{2}[0-9]{3}-[A-Za-z0-9]$')`
nhi-url-format | error | Observation.subject.reference | Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA | `matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$')`
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()`
value-or-dataabsentreason-required | error | Observation | Observations must have a root or component value[x], or a root or component dataAbsentReason. | `value.exists() or component.value.exists() or dataAbsentReason.exists() or component.dataAbsentReason.exists()`

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: value-or-dataabsentreason-required
meta |  | 1..1 | Meta | Metadata about the resource
source | C | 1..1 | uri | Captures the source of the record - please see description for details Constraints: hpi-location-url-format
profile |  | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to
tag |  | 0..* | Coding | Tag the resource with a code to indicate usability components of the resource Binding: ValueSet for SDHR Resource Tags (preferred)
contained |  | 0..0 |  | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClientLastUpdated |  | 1..1 | dateTime | Client Last Updated URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension
modifierExtension |  | 0..0 |  | Extension
identifier |  | 1..* | Identifier | A local identifier MUST be added to this section. If used, system MUST be specified.
use |  | 0..1 | code | The local identifier use SHOULD be set to secondary, where the SDHR resource id is considered the primary identifier.
system |  | 1..1 | uri | System for the local identifier. This MUST be consistent per PMS/Health Application Example Local Identifier System: https://fhir.example.co.nz
value |  | 1..1 | string | The actual local identifier value, e.g. ec2d6cad-1e19-46ee-accf-dc460a680710 Example Local Identifier Value: ec2d6cad-1e19-46ee-accf-dc460a680710
code |  | 1..1 | CodeableConcept | Observation code. Note that when the observation is an individual observation (singular) LOINC should be used. If, however, the Observation is a grouping (e.g. vital-signs) the code can be from SNOMED CT e.g. `122869004`. See https://fhir-ig.digital.health.nz/sdhr/Observation-ObservationVitalSignsExample.html for example Binding: LOINCCodes (preferred)
coding |  |  |  |
userSelected |  | 0..1 | boolean | Indicates that the value has been selected by a system user
subject |  | 1..1 | Reference(Patient) | National Health Identifier for the health consumer
reference | C | 1..1 | string | Must be an absolute URL reference to the patient on the NHI system. See constraints for details. Constraints: nhi-url-format
type |  | 1..1 | uri | Type the reference refers to (e.g. "Patient") Required Pattern: Patient
effective[x] |  | 1..1 | dateTime, Period, Timing, instant | Date and time/time-period the measurement was obtained
performer |  | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Preferred - an HPI Practitioner URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Practitioner/11AAAA
bodySite |  | 0..1 | CodeableConcept | Code for the body site affected by the problem (if applicable)
component |  |  |  |
code |  | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred)
coding |  |  |  |
userSelected |  | 0..1 | boolean | Indicates that the value has been selected by a system user
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.tag | Base | preferred | ValueSet for SDHR Resource Tags | 📦1.0.1 | This IG
Observation.code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.component.​code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
hpi-location-url-format | error | Observation.meta.source | Reference must be an HPI Location URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Location/FZZ111-A | `matches('^https://api.hip.digital.health.nz/fhir/hpi/v1/Location/F[A-Za-z0-9]{2}[0-9]{3}-[A-Za-z0-9]$')`
nhi-url-format | error | Observation.subject.reference | Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA | `matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$')`
value-or-dataabsentreason-required | error | Observation | Observations must have a root or component value[x], or a root or component dataAbsentReason. | `value.exists() or component.value.exists() or dataAbsentReason.exists() or component.dataAbsentReason.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, value-or-dataabsentreason-required
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 1..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ C | 1..1 | uri | Captures the source of the record - please see description for details Constraints: hpi-location-url-format
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tag the resource with a code to indicate usability components of the resource Binding: ValueSet for SDHR Resource Tags (preferred)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClientLastUpdated |  | 1..1 | dateTime | Client Last Updated URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension
identifier | Σ | 1..* | Identifier | A local identifier MUST be added to this section. If used, system MUST be specified.
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 | The local identifier use SHOULD be set to secondary, where the SDHR resource id is considered the primary identifier. 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 | Σ | 1..1 | uri | System for the local identifier. This MUST be consistent per PMS/Health Application Example General: http://www.acme.com/identifiers/patient Example Local Identifier System: https://fhir.example.co.nz
value | Σ | 1..1 | string | The actual local identifier value, e.g. ec2d6cad-1e19-46ee-accf-dc460a680710 Example General: 123456 Example Local Identifier Value: ec2d6cad-1e19-46ee-accf-dc460a680710
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 | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | Σ | 1..1 | CodeableConcept | Observation code. Note that when the observation is an individual observation (singular) LOINC should be used. If, however, the Observation is a grouping (e.g. vital-signs) the code can be from SNOMED CT e.g. `122869004`. See https://fhir-ig.digital.health.nz/sdhr/Observation-ObservationVitalSignsExample.html for example Binding: LOINCCodes (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system
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 | Indicates that the value has been selected by a system user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(Patient) | National Health Identifier for the health consumer
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Must be an absolute URL reference to the patient on the NHI system. See constraints for details. Constraints: nhi-url-format
type | Σ | 1..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Patient
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
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 | 1..1 |  | Date and time/time-period the measurement was obtained
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Preferred - an HPI Practitioner URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Practitioner/11AAAA
value[x] | Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | 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 | Code for the body site affected by the problem (if applicable) 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.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
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 (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system
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 | Indicates that the value has been selected by a system user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Observation.meta.tag | Base | preferred | ValueSet for SDHR Resource Tags | 📦1.0.1 | This IG
Observation.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 | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hpi-location-url-format | error | Observation.meta.source | Reference must be an HPI Location URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Location/FZZ111-A | `matches('^https://api.hip.digital.health.nz/fhir/hpi/v1/Location/F[A-Za-z0-9]{2}[0-9]{3}-[A-Za-z0-9]$')`
nhi-url-format | error | Observation.subject.reference | Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA | `matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$')`
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()`
value-or-dataabsentreason-required | error | Observation | Observations must have a root or component value[x], or a root or component dataAbsentReason. | `value.exists() or component.value.exists() or dataAbsentReason.exists() or component.dataAbsentReason.exists()`

This structure is derived from Observation

Summary

Mandatory: 12 elements
Prohibited: 2 elements

Extensions

This structure refers to these extensions:

- https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, value-or-dataabsentreason-required
meta | Σ | 1..1 | Meta | Metadata about the resource
source | Σ C | 1..1 | uri | Captures the source of the record - please see description for details Constraints: hpi-location-url-format
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to
tag | Σ | 0..* | Coding | Tag the resource with a code to indicate usability components of the resource Binding: ValueSet for SDHR Resource Tags (preferred)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClientLastUpdated |  | 1..1 | dateTime | Client Last Updated URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension
identifier | Σ | 1..* | Identifier | A local identifier MUST be added to this section. If used, system MUST be specified.
use | ?!Σ | 0..1 | code | The local identifier use SHOULD be set to secondary, where the SDHR resource id is considered the primary identifier. Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | Σ | 1..1 | uri | System for the local identifier. This MUST be consistent per PMS/Health Application Example General: http://www.acme.com/identifiers/patient Example Local Identifier System: https://fhir.example.co.nz
value | Σ | 1..1 | string | The actual local identifier value, e.g. ec2d6cad-1e19-46ee-accf-dc460a680710 Example General: 123456 Example Local Identifier Value: ec2d6cad-1e19-46ee-accf-dc460a680710
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code | Σ | 1..1 | CodeableConcept | Observation code. Note that when the observation is an individual observation (singular) LOINC should be used. If, however, the Observation is a grouping (e.g. vital-signs) the code can be from SNOMED CT e.g. `122869004`. See https://fhir-ig.digital.health.nz/sdhr/Observation-ObservationVitalSignsExample.html for example Binding: LOINCCodes (preferred)
subject | Σ | 1..1 | Reference(Patient) | National Health Identifier for the health consumer
reference | Σ C | 1..1 | string | Must be an absolute URL reference to the patient on the NHI system. See constraints for details. Constraints: nhi-url-format
type | Σ | 1..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Patient
effective[x] | Σ | 1..1 |  | Date and time/time-period the measurement was obtained
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Preferred - an HPI Practitioner URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Practitioner/11AAAA
bodySite |  | 0..1 | CodeableConcept | Code for the body site affected by the problem (if applicable) Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.tag | Base | preferred | ValueSet for SDHR Resource Tags | 📦1.0.1 | This IG
Observation.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hpi-location-url-format | error | Observation.meta.source | Reference must be an HPI Location URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Location/FZZ111-A | `matches('^https://api.hip.digital.health.nz/fhir/hpi/v1/Location/F[A-Za-z0-9]{2}[0-9]{3}-[A-Za-z0-9]$')`
nhi-url-format | error | Observation.subject.reference | Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA | `matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$')`
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()`
value-or-dataabsentreason-required | error | Observation | Observations must have a root or component value[x], or a root or component dataAbsentReason. | `value.exists() or component.value.exists() or dataAbsentReason.exists() or component.dataAbsentReason.exists()`

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: value-or-dataabsentreason-required
meta |  | 1..1 | Meta | Metadata about the resource
source | C | 1..1 | uri | Captures the source of the record - please see description for details Constraints: hpi-location-url-format
profile |  | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to
tag |  | 0..* | Coding | Tag the resource with a code to indicate usability components of the resource Binding: ValueSet for SDHR Resource Tags (preferred)
contained |  | 0..0 |  | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClientLastUpdated |  | 1..1 | dateTime | Client Last Updated URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension
modifierExtension |  | 0..0 |  | Extension
identifier |  | 1..* | Identifier | A local identifier MUST be added to this section. If used, system MUST be specified.
use |  | 0..1 | code | The local identifier use SHOULD be set to secondary, where the SDHR resource id is considered the primary identifier.
system |  | 1..1 | uri | System for the local identifier. This MUST be consistent per PMS/Health Application Example Local Identifier System: https://fhir.example.co.nz
value |  | 1..1 | string | The actual local identifier value, e.g. ec2d6cad-1e19-46ee-accf-dc460a680710 Example Local Identifier Value: ec2d6cad-1e19-46ee-accf-dc460a680710
code |  | 1..1 | CodeableConcept | Observation code. Note that when the observation is an individual observation (singular) LOINC should be used. If, however, the Observation is a grouping (e.g. vital-signs) the code can be from SNOMED CT e.g. `122869004`. See https://fhir-ig.digital.health.nz/sdhr/Observation-ObservationVitalSignsExample.html for example Binding: LOINCCodes (preferred)
coding |  |  |  |
userSelected |  | 0..1 | boolean | Indicates that the value has been selected by a system user
subject |  | 1..1 | Reference(Patient) | National Health Identifier for the health consumer
reference | C | 1..1 | string | Must be an absolute URL reference to the patient on the NHI system. See constraints for details. Constraints: nhi-url-format
type |  | 1..1 | uri | Type the reference refers to (e.g. "Patient") Required Pattern: Patient
effective[x] |  | 1..1 | dateTime, Period, Timing, instant | Date and time/time-period the measurement was obtained
performer |  | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Preferred - an HPI Practitioner URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Practitioner/11AAAA
bodySite |  | 0..1 | CodeableConcept | Code for the body site affected by the problem (if applicable)
component |  |  |  |
code |  | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (preferred)
coding |  |  |  |
userSelected |  | 0..1 | boolean | Indicates that the value has been selected by a system user
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.tag | Base | preferred | ValueSet for SDHR Resource Tags | 📦1.0.1 | This IG
Observation.code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.component.​code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
hpi-location-url-format | error | Observation.meta.source | Reference must be an HPI Location URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Location/FZZ111-A | `matches('^https://api.hip.digital.health.nz/fhir/hpi/v1/Location/F[A-Za-z0-9]{2}[0-9]{3}-[A-Za-z0-9]$')`
nhi-url-format | error | Observation.subject.reference | Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA | `matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$')`
value-or-dataabsentreason-required | error | Observation | Observations must have a root or component value[x], or a root or component dataAbsentReason. | `value.exists() or component.value.exists() or dataAbsentReason.exists() or component.dataAbsentReason.exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, value-or-dataabsentreason-required
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 1..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ C | 1..1 | uri | Captures the source of the record - please see description for details Constraints: hpi-location-url-format
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tag the resource with a code to indicate usability components of the resource Binding: ValueSet for SDHR Resource Tags (preferred)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClientLastUpdated |  | 1..1 | dateTime | Client Last Updated URL: https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension
identifier | Σ | 1..* | Identifier | A local identifier MUST be added to this section. If used, system MUST be specified.
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 | The local identifier use SHOULD be set to secondary, where the SDHR resource id is considered the primary identifier. 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 | Σ | 1..1 | uri | System for the local identifier. This MUST be consistent per PMS/Health Application Example General: http://www.acme.com/identifiers/patient Example Local Identifier System: https://fhir.example.co.nz
value | Σ | 1..1 | string | The actual local identifier value, e.g. ec2d6cad-1e19-46ee-accf-dc460a680710 Example General: 123456 Example Local Identifier Value: ec2d6cad-1e19-46ee-accf-dc460a680710
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 | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | Σ | 1..1 | CodeableConcept | Observation code. Note that when the observation is an individual observation (singular) LOINC should be used. If, however, the Observation is a grouping (e.g. vital-signs) the code can be from SNOMED CT e.g. `122869004`. See https://fhir-ig.digital.health.nz/sdhr/Observation-ObservationVitalSignsExample.html for example Binding: LOINCCodes (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system
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 | Indicates that the value has been selected by a system user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(Patient) | National Health Identifier for the health consumer
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Must be an absolute URL reference to the patient on the NHI system. See constraints for details. Constraints: nhi-url-format
type | Σ | 1..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Patient
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
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 | 1..1 |  | Date and time/time-period the measurement was obtained
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Preferred - an HPI Practitioner URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Practitioner/11AAAA
value[x] | Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | 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 | Code for the body site affected by the problem (if applicable) 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.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
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 (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system
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 | Indicates that the value has been selected by a system user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Observation.meta.tag | Base | preferred | ValueSet for SDHR Resource Tags | 📦1.0.1 | This IG
Observation.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 | ObservationStatus | 📍4.0.1 | FHIR Std.
Observation.category | Base | preferred | Observation Category Codes | 📍4.0.1 | FHIR Std.
Observation.code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Observation.method | Base | example | Observation Methods | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​type | Base | preferred | Observation Reference Range Meaning Codes | 📍4.0.1 | FHIR Std.
Observation.referenceRange.​appliesTo | Base | example | Observation Reference Range Applies To Codes | 📍4.0.1 | FHIR Std.
Observation.component.​code | Base | preferred | LOINC Codes | 📦4.0.1 | FHIR Std.
Observation.component.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Observation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hpi-location-url-format | error | Observation.meta.source | Reference must be an HPI Location URL with format https://api.hip.digital.health.nz/fhir/hpi/v1/Location/FZZ111-A | `matches('^https://api.hip.digital.health.nz/fhir/hpi/v1/Location/F[A-Za-z0-9]{2}[0-9]{3}-[A-Za-z0-9]$')`
nhi-url-format | error | Observation.subject.reference | Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA | `matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$')`
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()`
value-or-dataabsentreason-required | error | Observation | Observations must have a root or component value[x], or a root or component dataAbsentReason. | `value.exists() or component.value.exists() or dataAbsentReason.exists() or component.dataAbsentReason.exists()`

This structure is derived from Observation

Summary

Mandatory: 12 elements
Prohibited: 2 elements

Extensions

This structure refers to these extensions:

- https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/hnz-sdhr-client-last-updated-extension

Other representations of profile: CSV, Excel, Schematron