- NHS North West Genomics v2.2.5

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

4. Observation.extension:bodyStructure

Slice Name bodyStructure

Definition

R5: Observation.bodyStructure (new:Reference(BodyStructure))

Short R5: Observed body structure (new)

Comments

Element Observation.bodyStructure has a context of Observation based on following the parent source element upwards and mapping to Observation. Element Observation.bodyStructure has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Only used if not implicit in code found in Observation.code or bodySite is used. In many systems, this may be represented as a related observation instead of an inline component.

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Extension UK Core Observation Body Structure) (Extension Type: Reference(BodyStructure))

Is Modifier false

Summary false

Requirements

EHDSObservation.anatomicLocation

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

6. Observation.extension:triggeredBy

Slice Name triggeredBy

Definition

R5: Observation.triggeredBy (new:BackboneElement)

Short R5: Triggering observation(s) (new)

Comments

Element Observation.triggeredBy has a context of Observation based on following the parent source element upwards and mapping to Observation. Element Observation.triggeredBy has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Extension UK Core Observation Triggered By) (Complex Extension)

Is Modifier false

8. Observation.extension:triggeredBy.extension

Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Short ExtensionAdditional content defined by implementations

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control 20..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

10. Observation.extension:triggeredBy.extension:observation

Slice Name observation

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Control 10..1*

Is Modifier false

Summary false

12. Observation.extension:triggeredBy.extension:observation.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.extension.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

14. Observation.extension:triggeredBy.extension:observation.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "observation"
}

<url value="observation"/>

16. Observation.extension:triggeredBy.extension:observation.value[x]

Definition

Reference to the triggering observation.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Triggering observationValue of extension

Control 10..1

Type Reference(Observation: Medical Test Result (EU core)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Requirements

EHDSObservation.triggeredBy[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

18. Observation.extension:triggeredBy.extension:type

Slice Name type

Definition

R5: Observation.triggeredBy.type (new:code)

Short R5: reflex | repeat | re-run (new)Additional content defined by implementations

Comments

Element Observation.triggeredBy.type is part of an existing definition because parent element Observation.triggeredBy requires a cross-version extension. Element Observation.triggeredBy.type has a context of Observation based on following the parent source element upwards and mapping to Observation. Element Observation.triggeredBy.type has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

Control 10..1*

Is Modifier false

Summary false

Requirements

20. Observation.extension:triggeredBy.extension:type.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "type"
}

<url value="type"/>

22. Observation.extension:triggeredBy.extension:type.value[x]

Definition

The type of trigger. Reflex | Repeat | Re-run.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short reflex | repeat | re-runValue of extension

Control 10..1

The codes SHALL be taken from For codes, see R5ObservationTriggeredbytypeForR4 (0.1.0)
(required to http://hl7.org/fhir/uv/xver/ValueSet/R5-observation-triggeredbytype-for-R4|0.1.0)

The type of TriggeredBy Observation.

Type code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

24. Observation.extension:triggeredBy.extension:reason

Slice Name reason

Definition

R5: Observation.triggeredBy.reason (new:string)

Short R5: Reason that the observation was triggered (new)Additional content defined by implementations

Comments

Element Observation.triggeredBy.reason is part of an existing definition because parent element Observation.triggeredBy requires a cross-version extension. Element Observation.triggeredBy.reason has a context of Observation based on following the parent source element upwards and mapping to Observation. Element Observation.triggeredBy.reason has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

Control 0..1*

Is Modifier false

Summary false

Requirements

26. Observation.extension:triggeredBy.extension:reason.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "reason"
}

<url value="reason"/>

28. Observation.extension:triggeredBy.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
}

<url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"/>

30. Observation.extension:triggeredBy.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..01

Type Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

32. Observation.extension:value-r5

Slice Name value-r5

Definition

When the result is a Diagram or Picture (Microbiology), then the Attachment data type should be used. In FHIR R4 this can be done by preadopting the R5 Observation.value[x] element using the cross-version extension.

Short only for Diagrams or Pictures

Comments

Element Observation.value[x] is mapped to FHIR R4 element Observation.value[x] as SourceIsBroaderThanTarget. The mappings for Observation.value[x] do not cover the following types: Attachment, Reference. The target context Observation.value[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Observation.

An observation may have:
1. a single value here
2. both a value and a set of related or component values
3. only a set of related or component values.
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
The usage of valueReference is restricted to the MolecularSequence resource when used as a definitional resource, not as a patient-specific finding. .
For additional guidance, see the Notes section below.

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: value additional types) (Extension Type: Choice of: Attachment, Reference(Cross-version Profile for R5.MolecularSequence for use in FHIR R4, MolecularSequence))

Is Modifier false

Summary false

34. Observation.extension:value-r5.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

36. Observation.extension:value-r5.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value"
}

<url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value"/>

38. Observation.extension:supportingInfo

Slice Name supportingInfo

Definition

Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use Observation.hasMember instead of supportingInformation for representing the members of an Observation panel.

Short Other information that may be relevant to this event.

Control 0..*

Type Extension(Supporting info) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

40. Observation.extension:labTestKit

Slice Name labTestKit

Definition

The laboratory test kit used for this test.

Short Laboratory Test Kit

Control 0..*

Type Extension(Device Laboratory Test Kit) (Extension Type: Reference(Device))

Is Modifier false

Summary false

42. Observation.extension:certifiedRefMaterialCodeable

Slice Name certifiedRefMaterialCodeable

Definition

This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using a CodeableConcept. This extension should be used when the unit is UCUM [IU].

Short Certified Reference Material: CodeableConcept

Control 0..*

Type Extension(Certified Reference Material: CodeableConcept) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

44. Observation.extension:certifiedRefMaterialIdentifer

Slice Name certifiedRefMaterialIdentifer

Definition

This extension links this observation with the certified reference material used for the calibration. The certified reference material is identified by using an Identifier. This extension should be used when the unit is UCUM [IU].

Short Certified Reference Material: Identifier

Control 0..*

Type Extension(Certified Reference Material: Identifier) (Extension Type: Identifier)

Is Modifier false

Summary false

46. Observation.extension:accredited

Slice Name accredited

Definition

Indicates that this laboratory test was/is accredited.

Short Accredited test

Control 0..1

Type Extension(Many: Laboratory Accredited) (Extension Type: boolean)

Is Modifier false

Summary false

48. Observation.extension:statusReason

Slice Name statusReason

Definition

Captures the reason for the current state of this observation, which is of interest whenever the result was withdrawn or revised.

Short Reason for the current status

Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "cancelled". The reason for performing the event at all is captured in reasonCode, not here. (distinct reason codes for different statuses can be enforced using invariants if they are universal bindings).

Control 0..1

Type Extension(Event status reason) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

50. Observation.modifierExtension

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Names extensions, user content

52. Observation.identifier

Definition

A unique identifier assigned to this observation.

Short Business Identifier for observation

Note This is a business identifier, not a resource identifier (see discussion)

Control 10..*

Identifier

Is Modifier false

Must Support true

Summary true

Requirements

EHDSObservation.header.identifier

Allows observations to be distinguished and referenced.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

54. Observation.status

Definition

The status of the result value.

Short Observation Status (HL7 v2 OBX-11)registered | preliminary | final | amended +

Comments

The statuses amended, corrected, cancelled and entered-in-error SHOULD be accompanied by the reason for that status, conveyed in the statusReason extension.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control 1..1

The codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

Codes providing the status of an observation.

Is Modifier true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

EHDSObservation.header.status

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

56. Observation.category

Definition

A code that classifies the general type of observation being made.

Short Classification of type of observation

Comments

"laboratory" includes laboratory medicine and pathology

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Control 10..*

The codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.category. The slices are Unordered and Open, and can be differentiated using the following discriminators:

pattern @ $this

58. Observation.category:laboratory

Slice Name laboratory

Definition

A code that classifies the general type of observation being made.

Short Classification of type of observation

Comments

Control 10..1*

The codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Pattern Value

{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "laboratory"
    }
  ]
}

<category>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
    <code value="laboratory"/>
  </coding>
</category>

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

60. Observation.category:studyType

Slice Name studyType

Definition

A code that classifies the general type of observation being made.

Short The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)Classification of type of observation

Comments

Control 0..*

Binding The codes SHALL be taken from The codes SHOULD be taken from Laboratory Study Typeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
(required to http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab)

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

62. Observation.category:specialty

Slice Name specialty

Definition

A code that classifies the general type of observation being made.

Short The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)Classification of type of observation

Comments

Control 0..*

Binding The codes SHALL be taken from The codes SHOULD be taken from Laboratory Specialtyhttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
(required to http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab)

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

64. Observation.category:geCategory

Slice Name geCategory

Definition

A code that classifies the general type of observation being made.

Short Classification of type of observation

Comments

Control 0..1*

The codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Pattern Value

{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "GE"
    }
  ]
}

<category>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
    <code value="GE"/>
  </coding>
</category>

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

66. Observation.code

Definition

Describes what was observed. Sometimes this is called the observation "name". In this profile this code represents either a simple laboratory test or a laboratory study with multiple child observations

Describes what was observed. Sometimes this is called the observation "name".

Short The type of observation (code / type). (HL7 v2 OBX-3)Type of observation (code / type)

Comments

In the context of this Observation-laboratory profile, when the observation plays the role of a grouper of member sub-observations, the code represent the group (for instance a panel code). In case no code is available, at least a text shall be provided.

All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Control 1..1

Binding The codes SHOULD be taken from For example codes, see Laboratory Codehttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
(preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab)

Is Modifier false

Summary true

Requirements

EHDSObservation.code

Knowing what kind of observation is being made is essential to understanding the observation.

Alternate Names Name

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

68. Observation.subject

Definition

The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

Short Who and/or what the observation is about

Comments

One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

Control 10..1

Type Reference(Patient, Patient, Group, Device, Location)

Is Modifier false

Summary true

Requirements

EHDSObservation.header.subject

Observations have no value if you don't know who or what they're about.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

70. Observation.subject.reference

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Short Literal reference, Relative, internal or absolute URL

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control 10..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

72. Observation.subject.identifier

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Short Logical reference, when literal reference is not known

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Type Identifier(NHS Identifier)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

74. Observation.encounter

Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

Short Healthcare event during which this observation is made

Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

Control 0..1

Type Reference(Encounter)

Is Modifier false

Must Support true

Summary true

Requirements

For some observations it may be important to know the link between an observation and a particular encounter.

Alternate Names Context

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

76. Observation.encounter.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Type Identifier(Correlation Identifier)

Is Modifier false

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:populate-if-known

SHALL:populate-if-known

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

78. Observation.effective[x]

Definition

The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

Short Clinically relevant time/time-period for observation (HL7 v2 OBX-14)

Comments

At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

Control 10..1

Type Choice of: dateTime, Period, Timing, instant

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Obligations

Obligations

Actor

SHOULD:populate-if-known

SHOULD:populate-if-known

SHOULD:populate-if-known

Summary true

Requirements

EHDSObservation.observationDate[x]

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

Alternate Names Occurrence

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

80. Observation.performer

Definition

Who was responsible for asserting the observed value as "true".

Short Who is responsible for the observation

Control 10..*

Type Reference(PractitionerRole, Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)

Is Modifier false

Summary true

Requirements

EHDSObservation.header.performer

May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

82. Observation.performer.extension:performerFunction

Slice Name performerFunction

Definition

Distinguishes the type of involvement of the performer in the event. For example, 'author', 'verifier' or 'responsible party'.

Short Type of performance

Comments

If a Practitioner(Role) is involved in multiple roles, the Practitioner(Role) has to be added multiple times.

Control 0..1

Type Extension(Performer function) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

Requirements

EHDSObservation.performer.function

84. Observation.value[x]

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result (HL7 v2 OBX-5)

Comments

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Control 0..1
This element is affected by the following invariants: obs-7

Type Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

EHDSObservation.result.value[x]

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.value[x]. The slices are Unordered and Closed, and can be differentiated using the following discriminators:

type @ $this

86. Observation.value[x]:valueQuantity

Slice Name valueQuantity

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Quantity(Quantity (Eu Lab)), dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

88. Observation.value[x]:valueQuantity.extension:uncertainty

Slice Name uncertainty

Definition

The primary measure of variance/uncertainty of the value (the square root of the sum of the squares of the differences between all data points and the mean).

Short Standard Deviation (same units as the quantity)

Comments

standardDeviation has the same units as the quantity. It is used to normalize the data for computing the distribution function. Applications that cannot deal with probability distributions can still get an idea about the confidence level by looking at standardDeviation.

Control 0..1

Type Extension(Uncertainty) (Extension Type: decimal)

Is Modifier false

Summary false

Requirements

EHDSObservation.result.uncertainty

90. Observation.value[x]:valueQuantity.comparator

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Short < | <= | >= | > - how to understand the value

Control 0..1

The codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
(required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

How the Quantity should be understood and represented.

Is Modifier true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if Missing If there is no comparator, then there is no modification of the value

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

92. Observation.value[x]:valueString

Slice Name valueString

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type string, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

94. Observation.value[x]:valueDateTime

Slice Name valueDateTime

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

96. Observation.value[x]:valueCodeableConcept

Slice Name valueCodeableConcept

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Binding The codes SHOULD be taken from For codes, see Results Coded Values Laboratory/Pathology - IPS
(preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-pathology-uv-ips)

Type CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

98. Observation.value[x]:valueRange

Slice Name valueRange

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Range(Range (Eu Lab)), dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

100. Observation.value[x]:valueRatio

Slice Name valueRatio

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Ratio(Ratio (Eu Lab)), dateTime, boolean, string, SampledData, Quantity, Period, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. Observation.value[x]:valueTime

Slice Name valueTime

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type time, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

104. Observation.value[x]:valuePeriod

Slice Name valuePeriod

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Period, dateTime, boolean, string, SampledData, Quantity, Ratio, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

106. Observation.value[x]:valueBoolean

Slice Name valueBoolean

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type boolean, dateTime, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

108. Observation.value[x]:valueInteger

Slice Name valueInteger

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type integer, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

110. Observation.value[x]:valueSampledData

Slice Name valueSampledData

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type SampledData, dateTime, boolean, string, Quantity, Period, Ratio, integer, time, Range, CodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

112. Observation.referenceRange

Definition

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

Short Provides guide for interpretation

Comments

Reference-range bounds are inclusive when no comparator is present. Use lowComparator or highComparator to state the comparator for an exclusive or explicitly inclusive bound. These modifier extensions pre-adopt the comparator on the reference-range bounds introduced in FHIR R6.

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Control 0..*

BackboneElement

Is Modifier false

Must Support true

Summary false

Requirements

EHDSObservation.referenceRange

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())

114. Observation.referenceRange.modifierExtension

Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short ExtensionExtensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

This element introduces a set of slices on Observation.referenceRange.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

116. Observation.referenceRange.modifierExtension:lowComparator

Slice Name lowComparator

Definition

The comparator for Observation.referenceRange.low. This modifier extension pre-adopts the R6 comparator on the low reference-range bound.

Short Observation Reference Range Low Comparator

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Observation Reference Range Low Comparator) (Extension Type: code)

Is Modifier true because Changes the interpretation of Observation.referenceRange.low by stating whether the bound is inclusive or exclusive.

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

118. Observation.referenceRange.modifierExtension:highComparator

Slice Name highComparator

Definition

The comparator for Observation.referenceRange.high. This modifier extension pre-adopts the R6 comparator on the high reference-range bound.

Short Observation Reference Range High Comparator

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Observation Reference Range High Comparator) (Extension Type: code)

Is Modifier true because Changes the interpretation of Observation.referenceRange.high by stating whether the bound is inclusive or exclusive.

Summary true

120. Observation.derivedFrom

Definition

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Short Related measurements the observation is made from

Comments

All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

Control 0..*

Type Reference(Observation: Medical Test Result (EU core), ImagingStudy, DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)

Is Modifier false

Summary true

Requirements

EHDSObservation.derivedFrom[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.derivedFrom. The slices are Unordered and Open, and can be differentiated using the following discriminators:

profile @ resolve()

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

See the documentation on how to interpret the contents of this table

0. Observation

2. Observation.identifier

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..?

Must Support true

4. Observation.status

Short Observation Status (HL7 v2 OBX-11)

6. Observation.category:geCategory

Slice Name geCategory

Control 0..1

Pattern Value

{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "GE"
    }
  ]
}

<category>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
    <code value="GE"/>
  </coding>
</category>

8. Observation.code

Short The type of observation (code / type). (HL7 v2 OBX-3)

10. Observation.subject

Type Reference(Patient)

12. Observation.subject.reference

Control 1..?

Must Support true

14. Observation.subject.identifier

Note This is a business identifier, not a resource identifier (see discussion)

Type Identifier(NHS Identifier)

16. Observation.encounter

Must Support true

18. Observation.encounter.identifier

Note This is a business identifier, not a resource identifier (see discussion)

Type Identifier(Correlation Identifier)

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:populate-if-known

SHALL:populate-if-known

20. Observation.effective[x]

Short Clinically relevant time/time-period for observation (HL7 v2 OBX-14)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Obligations

Obligations

Actor

SHOULD:populate-if-known

SHOULD:populate-if-known

SHOULD:populate-if-known

22. Observation.performer

Type Reference(PractitionerRole)

24. Observation.value[x]

Short Actual result (HL7 v2 OBX-5)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

26. Observation.value[x]:valueQuantity

Slice Name valueQuantity

Type Quantity(Quantity (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Must Support true

28. Observation.value[x]:valueString

Slice Name valueString

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

30. Observation.value[x]:valueDateTime

Slice Name valueDateTime

dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

32. Observation.value[x]:valueCodeableConcept

Slice Name valueCodeableConcept

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Must Support true

34. Observation.referenceRange

Must Support true

36. Observation.derivedFrom

This element introduces a set of slices on Observation.derivedFrom. The slices are Unordered and Open, and can be differentiated using the following discriminators:

profile @ resolve()

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

See the documentation on how to interpret the contents of this table

0. Observation

Definition

Short Laboratory result for a simple test or for a panel/study

Comments

Represents either a lab simple observation or the group of observations produced by a laboratory study.

Control 0..*

Is Modifier false

Summary false

Alternate Names Vital Signs, Measurement, Results, Tests

Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
obs-value-1: The elements Observation.extension:value-r5 and Observation.value[x] SHALL not be used simultaneously. (value.empty() or extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value').empty())
eu-lab-1: If observation status is other then "registered" or "cancelled", at least one of these Observation elements shall be provided with an actual value: "value", the R5 "value[x]" extension, "dataAbsentReason", "hasMember" or "component" ((status in ('registered'|'cancelled')) or value.hasValue() or value.children().exclude(value.extension).exists() or extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value').value.exists() or hasMember.exists() or component.exists() or dataAbsentReason.exists())
eu-lab-2: If observation status is other then "registered" or "cancelled", every Observation.component shall provide one of these elements with an actual value: "value", the R5 "component.value[x]" extension or "dataAbsentReason" ((status in ('registered'|'cancelled')) or component.all(value.hasValue() or value.children().exclude(value.extension).exists() or extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.component.value').value.exists() or dataAbsentReason.exists()))

2. Observation.id

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Short Logical id of this artifact

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control 0..1

Is Modifier false

Summary true

4. Observation.meta

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Short Metadata about the resource

Control 0..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. Observation.implicitRules

Definition

Short A set of rules under which this content was created

Comments

Control 0..1

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

8. Observation.language

Definition

The base language in which the resource is written.

Short Language of the observation

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control 0..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

10. Observation.text

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Short Text summary of the resource, for human interpretation

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control 0..1

Narrative

Is Modifier false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

12. Observation.contained

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Short Contained, inline Resources

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control 0..*

Resource

Is Modifier false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

14. Observation.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Observation.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

16. Observation.extension:bodyStructure

Slice Name bodyStructure

Definition

R5: Observation.bodyStructure (new:Reference(BodyStructure))

Short R5: Observed body structure (new)

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Extension UK Core Observation Body Structure) (Extension Type: Reference(BodyStructure))

Is Modifier false

Summary false

Requirements

EHDSObservation.anatomicLocation

18. Observation.extension:triggeredBy

Slice Name triggeredBy

Definition

R5: Observation.triggeredBy (new:BackboneElement)

Short R5: Triggering observation(s) (new)

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Extension UK Core Observation Triggered By) (Complex Extension)

Is Modifier false

20. Observation.extension:triggeredBy.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

22. Observation.extension:triggeredBy.extension

Definition

An Extension

Short Extension

Control 2..*

Is Modifier false

Summary false

This element introduces a set of slices on Observation.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

24. Observation.extension:triggeredBy.extension:observation

Slice Name observation

Definition

An Extension

Short Extension

Control 1..1

Is Modifier false

Summary false

26. Observation.extension:triggeredBy.extension:observation.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

28. Observation.extension:triggeredBy.extension:observation.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Observation.extension.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

30. Observation.extension:triggeredBy.extension:observation.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "observation"
}

<url value="observation"/>

32. Observation.extension:triggeredBy.extension:observation.value[x]

Definition

Reference to the triggering observation.

Short Triggering observation

Control 1..1

Type Reference(Observation: Medical Test Result (EU core))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Requirements

EHDSObservation.triggeredBy[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

34. Observation.extension:triggeredBy.extension:type

Slice Name type

Definition

R5: Observation.triggeredBy.type (new:code)

Short R5: reflex | repeat | re-run (new)

Comments

Control 1..1

Is Modifier false

Summary false

Requirements

36. Observation.extension:triggeredBy.extension:type.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

38. Observation.extension:triggeredBy.extension:type.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.extension.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

40. Observation.extension:triggeredBy.extension:type.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "type"
}

<url value="type"/>

42. Observation.extension:triggeredBy.extension:type.value[x]

Definition

The type of trigger. Reflex | Repeat | Re-run.

Short reflex | repeat | re-run

Control 1..1

The codes SHALL be taken from R5ObservationTriggeredbytypeForR4 (0.1.0)
(required to http://hl7.org/fhir/uv/xver/ValueSet/R5-observation-triggeredbytype-for-R4|0.1.0)

The type of TriggeredBy Observation.

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

44. Observation.extension:triggeredBy.extension:reason

Slice Name reason

Definition

R5: Observation.triggeredBy.reason (new:string)

Short R5: Reason that the observation was triggered (new)

Comments

Control 0..1

Is Modifier false

Summary false

Requirements

46. Observation.extension:triggeredBy.extension:reason.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

48. Observation.extension:triggeredBy.extension:reason.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.extension.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

50. Observation.extension:triggeredBy.extension:reason.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "reason"
}

<url value="reason"/>

52. Observation.extension:triggeredBy.extension:reason.value[x]

Definition

Provides the reason why this observation was performed as a result of the observation(s) referenced.

Short Reason that the observation was triggered

Control 0..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

54. Observation.extension:triggeredBy.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
}

<url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"/>

56. Observation.extension:triggeredBy.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

58. Observation.extension:value-r5

Slice Name value-r5

Definition

Short only for Diagrams or Pictures

Comments

An observation may have:
1. a single value here
2. both a value and a set of related or component values
3. only a set of related or component values.
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
The usage of valueReference is restricted to the MolecularSequence resource when used as a definitional resource, not as a patient-specific finding. .
For additional guidance, see the Notes section below.

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: value additional types) (Extension Type: Choice of: Attachment, Reference(Cross-version Profile for R5.MolecularSequence for use in FHIR R4, MolecularSequence))

Is Modifier false

Summary false

60. Observation.extension:value-r5.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

62. Observation.extension:value-r5.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Observation.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

64. Observation.extension:value-r5.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value"
}

<url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.value"/>

66. Observation.extension:value-r5.value[x]

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

An observation may have:
1. a single value here
2. both a value and a set of related or component values
3. only a set of related or component values.
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
The usage of valueReference is restricted to the MolecularSequence resource when used as a definitional resource, not as a patient-specific finding. .
For additional guidance, see the Notes section below.

Control 0..1

Attachment

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

68. Observation.extension:supportingInfo

Slice Name supportingInfo

Definition

Short Other information that may be relevant to this event.

Control 0..*

Type Extension(Supporting info) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

70. Observation.extension:labTestKit

Slice Name labTestKit

Definition

The laboratory test kit used for this test.

Short Laboratory Test Kit

Control 0..*

Type Extension(Device Laboratory Test Kit) (Extension Type: Reference(Device))

Is Modifier false

Summary false

72. Observation.extension:certifiedRefMaterialCodeable

Slice Name certifiedRefMaterialCodeable

Definition

Short Certified Reference Material: CodeableConcept

Control 0..*

Type Extension(Certified Reference Material: CodeableConcept) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

74. Observation.extension:certifiedRefMaterialIdentifer

Slice Name certifiedRefMaterialIdentifer

Definition

Short Certified Reference Material: Identifier

Control 0..*

Type Extension(Certified Reference Material: Identifier) (Extension Type: Identifier)

Is Modifier false

Summary false

76. Observation.extension:accredited

Slice Name accredited

Definition

Indicates that this laboratory test was/is accredited.

Short Accredited test

Control 0..1

Type Extension(Many: Laboratory Accredited) (Extension Type: boolean)

Is Modifier false

Summary false

78. Observation.extension:statusReason

Slice Name statusReason

Definition

Captures the reason for the current state of this observation, which is of interest whenever the result was withdrawn or revised.

Short Reason for the current status

Comments

Control 0..1

Type Extension(Event status reason) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

80. Observation.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

Alternate Names extensions, user content

82. Observation.identifier

Definition

A unique identifier assigned to this observation.

Short Business Identifier for observation

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..*

Identifier

Is Modifier false

Must Support true

Summary true

Requirements

EHDSObservation.header.identifier

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

84. Observation.basedOn

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Short Fulfills plan, proposal or order

Control 0..*

Type Reference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)

Is Modifier false

Summary true

Requirements

EHDSObservation.order

Alternate Names Fulfills

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

86. Observation.partOf

Definition

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

Short Part of referenced event

Comments

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

Control 0..*

Type Reference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)

Is Modifier false

Summary true

Alternate Names Container

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

88. Observation.status

Definition

The status of the result value.

Short Observation Status (HL7 v2 OBX-11)

Comments

The statuses amended, corrected, cancelled and entered-in-error SHOULD be accompanied by the reason for that status, conveyed in the statusReason extension.

Control 1..1

The codes SHALL be taken from ObservationStatus
(required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

Codes providing the status of an observation.

Is Modifier true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

EHDSObservation.header.status

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

90. Observation.category

Definition

A code that classifies the general type of observation being made.

Short Classification of type of observation

Comments

"laboratory" includes laboratory medicine and pathology

Control 1..*

The codes SHOULD be taken from ObservationCategoryCodes
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.category. The slices are Unordered and Open, and can be differentiated using the following discriminators:

pattern @ $this

92. Observation.category:laboratory

Slice Name laboratory

Definition

A code that classifies the general type of observation being made.

Short Classification of type of observation

Comments

Control 1..1

The codes SHOULD be taken from ObservationCategoryCodes
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Pattern Value

{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "laboratory"
    }
  ]
}

<category>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
    <code value="laboratory"/>
  </coding>
</category>

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

94. Observation.category:studyType

Slice Name studyType

Definition

A code that classifies the general type of observation being made.

Short The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)

Comments

Control 0..*

Binding The codes SHALL be taken from Laboratory Study Types
(required to http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab)

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

96. Observation.category:specialty

Slice Name specialty

Definition

A code that classifies the general type of observation being made.

Short The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)

Comments

Control 0..*

Binding The codes SHALL be taken from Laboratory Specialty
(required to http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab)

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

98. Observation.category:geCategory

Slice Name geCategory

Definition

A code that classifies the general type of observation being made.

Short Classification of type of observation

Comments

Control 0..1

The codes SHOULD be taken from ObservationCategoryCodes
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

Is Modifier false

Summary false

Requirements

Used for filtering what observations are retrieved and displayed.

Pattern Value

{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code" : "GE"
    }
  ]
}

<category>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
    <code value="GE"/>
  </coding>
</category>

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

100. Observation.code

Definition

Short The type of observation (code / type). (HL7 v2 OBX-3)

Comments

Control 1..1

Binding The codes SHOULD be taken from Laboratory Code
(preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab)

Is Modifier false

Summary true

Requirements

EHDSObservation.code

Alternate Names Name

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. Observation.subject

Definition

Short Who and/or what the observation is about

Comments

Control 1..1

Type Reference(Patient)

Is Modifier false

Summary true

Requirements

EHDSObservation.header.subject

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

104. Observation.subject.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

106. Observation.subject.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.subject.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

108. Observation.subject.reference

Definition

Short Literal reference, Relative, internal or absolute URL

Comments

Control 1..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

110. Observation.subject.type

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Short Type the reference refers to (e.g. "Patient")

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control 0..1

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

112. Observation.subject.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Type Identifier(NHS Identifier)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

114. Observation.subject.display

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Short Text alternative for the resource

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

116. Observation.focus

Definition

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Short What the observation is about, when it is not about the subject of record

Comments

Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

Control 0..*

Type Reference(Patient (EU core), RelatedPerson: AnimalSpecimen, Group, Device, Location (EU core), Substance, BiologicallyDerivedProduct)

Is Modifier false

Summary true

Requirements

EHDSObservation.directSubject[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

118. Observation.encounter

Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

Short Healthcare event during which this observation is made

Comments

Control 0..1

Type Reference(Encounter)

Is Modifier false

Must Support true

Summary true

Requirements

For some observations it may be important to know the link between an observation and a particular encounter.

Alternate Names Context

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

120. Observation.encounter.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

122. Observation.encounter.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.encounter.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

124. Observation.encounter.reference

Definition

Short Literal reference, Relative, internal or absolute URL

Comments

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. Observation.encounter.type

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Short Type the reference refers to (e.g. "Patient")

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

128. Observation.encounter.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Type Identifier(Correlation Identifier)

Is Modifier false

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:populate-if-known

SHALL:populate-if-known

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

130. Observation.encounter.display

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Short Text alternative for the resource

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

132. Observation.effective[x]

Definition

Short Clinically relevant time/time-period for observation (HL7 v2 OBX-14)

Comments

Control 1..1

Type Choice of: dateTime, Period

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Obligations

Obligations

Actor

SHOULD:populate-if-known

SHOULD:populate-if-known

SHOULD:populate-if-known

Summary true

Requirements

EHDSObservation.observationDate[x]

Alternate Names Occurrence

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

134. Observation.issued

Definition

The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

Short Date/Time this result was made available

Comments

For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

Control 0..1

instant

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

EHDSObservation.header.authorship.datetime

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

136. Observation.performer

Definition

Who was responsible for asserting the observed value as "true".

Short Who is responsible for the observation

Control 1..*

Type Reference(PractitionerRole)

Is Modifier false

Summary true

Requirements

EHDSObservation.header.performer

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

138. Observation.performer.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

140. Observation.performer.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.performer.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

142. Observation.performer.extension:performerFunction

Slice Name performerFunction

Definition

Distinguishes the type of involvement of the performer in the event. For example, 'author', 'verifier' or 'responsible party'.

Short Type of performance

Comments

If a Practitioner(Role) is involved in multiple roles, the Practitioner(Role) has to be added multiple times.

Control 0..1

Type Extension(Performer function) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

Requirements

EHDSObservation.performer.function

144. Observation.performer.reference

Definition

Short Literal reference, Relative, internal or absolute URL

Comments

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

146. Observation.performer.type

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Short Type the reference refers to (e.g. "Patient")

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

148. Observation.performer.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Identifier

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

150. Observation.performer.display

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Short Text alternative for the resource

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. Observation.value[x]

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result (HL7 v2 OBX-5)

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

EHDSObservation.result.value[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.value[x]. The slices are Unordered and Closed, and can be differentiated using the following discriminators:

type @ $this

154. Observation.value[x]:valueQuantity

Slice Name valueQuantity

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Quantity(Quantity (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

156. Observation.value[x]:valueQuantity.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

158. Observation.value[x]:valueQuantity.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.value[x].extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

160. Observation.value[x]:valueQuantity.extension:uncertainty

Slice Name uncertainty

Definition

The primary measure of variance/uncertainty of the value (the square root of the sum of the squares of the differences between all data points and the mean).

Short Standard Deviation (same units as the quantity)

Comments

Control 0..1

Type Extension(Uncertainty) (Extension Type: decimal)

Is Modifier false

Summary false

Requirements

EHDSObservation.result.uncertainty

162. Observation.value[x]:valueQuantity.value

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Short Numerical value (with implicit precision)

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control 0..1

decimal

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Precision is handled implicitly in almost all cases of measurement.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

164. Observation.value[x]:valueQuantity.comparator

Definition

Short < | <= | >= | > - how to understand the value

Control 0..1

The codes SHALL be taken from QuantityComparator
(required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

How the Quantity should be understood and represented.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if Missing If there is no comparator, then there is no modification of the value

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

166. Observation.value[x]:valueQuantity.unit

Definition

A human-readable form of the unit.

Short Unit representation

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

168. Observation.value[x]:valueQuantity.system

Definition

The identification of the system that provides the coded form of the unit.

Short System that defines coded unit form

Control 0..1
This element is affected by the following invariants: qty-3

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to know the system that defines the coded form of the unit.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

170. Observation.value[x]:valueQuantity.code

Definition

A computer processable form of the unit in some unit representation system.

Short Coded form of the unit

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

172. Observation.value[x]:valueString

Slice Name valueString

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

174. Observation.value[x]:valueDateTime

Slice Name valueDateTime

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

176. Observation.value[x]:valueCodeableConcept

Slice Name valueCodeableConcept

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Binding The codes SHOULD be taken from Results Coded Values Laboratory/Pathology - IPS
(preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-pathology-uv-ips)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Must Support true

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

178. Observation.value[x]:valueRange

Slice Name valueRange

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Range(Range (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

180. Observation.value[x]:valueRatio

Slice Name valueRatio

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Type Ratio(Ratio (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

182. Observation.value[x]:valueTime

Slice Name valueTime

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

184. Observation.value[x]:valuePeriod

Slice Name valuePeriod

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

Period

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

186. Observation.value[x]:valueBoolean

Slice Name valueBoolean

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

boolean

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

188. Observation.value[x]:valueInteger

Slice Name valueInteger

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

190. Observation.value[x]:valueSampledData

Slice Name valueSampledData

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual result

Comments

Control 0..1
This element is affected by the following invariants: obs-7

SampledData

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

192. Observation.dataAbsentReason

Definition

Provides a reason why the expected value in the element Observation.value[x] is missing.

Short Provides a reason why the expected value is missing.

Comments

Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

Control 0..1
This element is affected by the following invariants: obs-6

Unless not suitable, these codes SHALL be taken from DataAbsentReason
(extensible to http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1)

Codes specifying why the result (Observation.value[x]) is missing.

Is Modifier false

Summary false

Requirements

EHDSObservation.dataAbsentReason

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

194. Observation.interpretation

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Short High, low, normal, etc.

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Control 0..*

Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
(extensible to http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1)

Codes identifying interpretations of observations.

Is Modifier false

Summary false

Requirements

EHDSObservation.interpretation

Alternate Names Abnormal Flag

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

196. Observation.note

Definition

Comments about the observation or the results.

Short Comments about the observation

Comments

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Control 0..*

Annotation

Is Modifier false

Summary false

Requirements

EHDSObservation.resultDescription

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. Observation.bodySite

Definition

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Short Observed body part

Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Control 0..1

For example codes, see SNOMEDCTBodyStructures
(example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

Codes describing anatomical locations. May include laterality.

Is Modifier false

Summary false

Requirements

EHDSObservation.anatomicLocation

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

200. Observation.method

Definition

Laboratory technigue that has been used

Short How it was done

Comments

Laboratory technique (method of measurement) are integral parts of the test specification of some laboratory test coding systems (e.g. NPU), in LOINC hovewer measurement principle is not always present in the test definition. In some cases however knowledge of the used measurment techique is important for proper interpretation of the test result. That's why it is important to explicitly include informaiton about measurement method is such cases.

Control 0..1

Binding The codes SHOULD be taken from Laboratory Techniques
(preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-technique-eu-lab)

Is Modifier false

Summary false

Requirements

EHDSObservation.method

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

202. Observation.specimen

Definition

The specimen that was used when this observation was made.

Short Specimen used for the observation

Comments

When the specimen is applicable and known it shall be documented

Control 0..1

Type Reference(Specimen: Laboratory)

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

204. Observation.device

Definition

The device used to generate the observation data.

Short Measuring instrument

Comments

Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

Control 0..1

Type Reference(Device, DeviceMetric)

Is Modifier false

Summary false

Requirements

Device information for laboratory observations

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

206. Observation.referenceRange

Definition

Short Provides guide for interpretation

Comments

Control 0..*

BackboneElement

Is Modifier false

Must Support true

Summary false

Requirements

EHDSObservation.referenceRange

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())

208. Observation.referenceRange.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

210. Observation.referenceRange.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

212. Observation.referenceRange.modifierExtension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

This element introduces a set of slices on Observation.referenceRange.modifierExtension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

214. Observation.referenceRange.modifierExtension:lowComparator

Slice Name lowComparator

Definition

The comparator for Observation.referenceRange.low. This modifier extension pre-adopts the R6 comparator on the low reference-range bound.

Short Observation Reference Range Low Comparator

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Observation Reference Range Low Comparator) (Extension Type: code)

Is Modifier true because Changes the interpretation of Observation.referenceRange.low by stating whether the bound is inclusive or exclusive.

Summary true

216. Observation.referenceRange.modifierExtension:highComparator

Slice Name highComparator

Definition

The comparator for Observation.referenceRange.high. This modifier extension pre-adopts the R6 comparator on the high reference-range bound.

Short Observation Reference Range High Comparator

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Observation Reference Range High Comparator) (Extension Type: code)

Is Modifier true because Changes the interpretation of Observation.referenceRange.high by stating whether the bound is inclusive or exclusive.

Summary true

218. Observation.referenceRange.low

Definition

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

Short Low Range, if relevant

Control 0..1
This element is affected by the following invariants: obs-3

Type Quantity(SimpleQuantity)

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())

220. Observation.referenceRange.high

Definition

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Short High Range, if relevant

Control 0..1
This element is affected by the following invariants: obs-3

Type Quantity(SimpleQuantity)

Is Modifier false

Summary false

222. Observation.referenceRange.type

Definition

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

Short Reference range qualifier

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

Control 0..1

The codes SHOULD be taken from ObservationReferenceRangeMeaningCodes
(preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning|4.0.1)

Code for the meaning of a reference range.

Is Modifier false

Summary false

Requirements

Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

224. Observation.referenceRange.appliesTo

Definition

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

Short Reference range population

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

Control 0..*

For example codes, see ObservationReferenceRangeAppliesToCodes
(example to http://hl7.org/fhir/ValueSet/referencerange-appliesto|4.0.1)

Codes identifying the population the reference range applies to.

Is Modifier false

Summary false

Requirements

Need to be able to identify the target population for proper interpretation.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

226. Observation.referenceRange.age

Definition

The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

Short Applicable age range, if relevant

Control 0..1

Range

Is Modifier false

Summary false

Requirements

Some analytes vary greatly over age.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

228. Observation.referenceRange.text

Definition

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

Short Text based reference range in an observation

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

230. Observation.hasMember

Definition

A reference to another Observation profiled by Observation-results-laboratory-uv-ips. The target observation (for instance an individual test member of a panel) is considered as a sub-observation of the current one, which plays the role of a grouper.

Short Related resource that belongs to the Observation group

Comments

This element is used in the context of international patient summary when there is a need to group a collection of observations, because they belong to the same panel, or because they share a common interpretation comment, or a common media attachment (illustrative image or graph). In these cases, the current observation is the grouper, and its set of sub-observations are related observations using the type "has-member". For a discussion on the ways Observations can be assembled in groups together see Observation Grouping.

Control 0..*

Type Reference(Observation Results: laboratory)

Is Modifier false

Summary true

Requirements

EHDSObservation.hasMember[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

232. Observation.derivedFrom

Definition

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Short Related measurements the observation is made from

Comments

Control 0..*

Type Reference(Observation: Medical Test Result (EU core), ImagingStudy)

Is Modifier false

Summary true

Requirements

EHDSObservation.derivedFrom[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.derivedFrom. The slices are Unordered and Open, and can be differentiated using the following discriminators:

profile @ resolve()

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

234. Observation.component

Definition

Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

Short Laboratory result

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

Control 0..*

BackboneElement

Is Modifier false

Summary true

Requirements

EHDSObservation.component

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
obs-value-2: The elements Observation.component.extension:value-r5 and Observation.component.value[x] SHALL not be used simultaneously. (value.empty() or extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.component.value').empty())

236. Observation.component.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

238. Observation.component.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Observation.component.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

240. Observation.component.extension:value-r5

Slice Name value-r5

Definition

When the result is a Diagram or Picture (Microbiology), then the Attachment data type should be used. In FHIR R4 this can be done by preadopting the R5 Observation.component.value[x] element using the cross-version extension.

Short only for Diagrams or Pictures

Comments

Element Observation.component.value[x] is mapped to FHIR R4 element Observation.component.value[x] as SourceIsBroaderThanTarget. The mappings for Observation.component.value[x] do not cover the following types: Attachment, Reference. The target context Observation.component.value[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Observation.component. Used when observation has a set of component observations:

An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived).
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
The usage of valueReference is restricted to the MolecularSequence resource when used as a definitional resource, not as a patient-specific finding. .
For additional guidance, see the Notes section below.

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: value additional types) (Extension Type: Choice of: Attachment, Reference(Cross-version Profile for R5.MolecularSequence for use in FHIR R4, MolecularSequence))

Is Modifier false

Summary false

242. Observation.component.extension:value-r5.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

244. Observation.component.extension:value-r5.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Observation.component.extension.extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

246. Observation.component.extension:value-r5.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value

{
  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.component.value"
}

<url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.component.value"/>

248. Observation.component.extension:value-r5.value[x]

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Used when observation has a set of component observations:

An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived).
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
If a value is present, the datatype for this element should be determined by the code.
CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the code defines a coded value.
Attachment is used if the observation result value is a binary file such as an image. If the observation result value is derived from the binary file (for example 'X' detected and here is the the proof in this image), the binary file may be directly represented using DocumentReference and referenced by derivedFrom.
The usage of valueReference is restricted to the MolecularSequence resource when used as a definitional resource, not as a patient-specific finding. .
For additional guidance, see the Notes section below.

Control 0..1

Attachment

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

250. Observation.component.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

252. Observation.component.code

Definition

Describes what was observed. Sometimes this is called the observation "code".

Short Type of component observation (code / type)

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Control 1..1

Binding The codes SHOULD be taken from Laboratory Code
(preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-obsCode-eu-lab)

Is Modifier false

Summary true

Requirements

EHDSObservation.component.code

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

254. Observation.component.value[x]

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Control 0..1

Type Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

EHDSObservation.component.result.value[x]

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Observation.component.value[x]. The slices are Unordered and Closed, and can be differentiated using the following discriminators:

type @ $this

256. Observation.component.value[x]:valueQuantity

Slice Name valueQuantity

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

Type Quantity(Quantity (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

258. Observation.component.value[x]:valueQuantity.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

260. Observation.component.value[x]:valueQuantity.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Observation.component.value[x].extension. The slices are Unordered and Open, and can be differentiated using the following discriminators:

value @ url

262. Observation.component.value[x]:valueQuantity.extension:uncertainty

Slice Name uncertainty

Definition

The primary measure of variance/uncertainty of the value (the square root of the sum of the squares of the differences between all data points and the mean).

Short Standard Deviation (same units as the quantity)

Comments

Control 0..1

Type Extension(Uncertainty) (Extension Type: decimal)

Is Modifier false

Summary false

Requirements

EHDSObservation.component.result.uncertainty

264. Observation.component.value[x]:valueQuantity.value

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Short Numerical value (with implicit precision)

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control 0..1

decimal

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Precision is handled implicitly in almost all cases of measurement.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

266. Observation.component.value[x]:valueQuantity.comparator

Definition

Short < | <= | >= | > - how to understand the value

Control 0..1

The codes SHALL be taken from QuantityComparator
(required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

How the Quantity should be understood and represented.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if Missing If there is no comparator, then there is no modification of the value

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

268. Observation.component.value[x]:valueQuantity.unit

Definition

A human-readable form of the unit.

Short Unit representation

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

270. Observation.component.value[x]:valueQuantity.system

Definition

The identification of the system that provides the coded form of the unit.

Short System that defines coded unit form

Control 0..1
This element is affected by the following invariants: qty-3

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to know the system that defines the coded form of the unit.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

272. Observation.component.value[x]:valueQuantity.code

Definition

A computer processable form of the unit in some unit representation system.

Short Coded form of the unit

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

274. Observation.component.value[x]:valueString

Slice Name valueString

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

276. Observation.component.value[x]:valueRange

Slice Name valueRange

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

Type Range(Range (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

278. Observation.component.value[x]:valueRatio

Slice Name valueRatio

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

Type Ratio(Ratio (Eu Lab))

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

280. Observation.component.value[x]:valueTime

Slice Name valueTime

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

282. Observation.component.value[x]:valueDateTime

Slice Name valueDateTime

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

284. Observation.component.value[x]:valuePeriod

Slice Name valuePeriod

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

Period

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

286. Observation.component.value[x]:valueBoolean

Slice Name valueBoolean

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

boolean

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

288. Observation.component.value[x]:valueInteger

Slice Name valueInteger

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

290. Observation.component.value[x]:valueSampledData

Slice Name valueSampledData

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

SampledData

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

292. Observation.component.value[x]:valueCodeableConcept

Slice Name valueCodeableConcept

Definition

The information determined as a result of making the observation, if the information has a simple value.

Short Actual component result

Comments

Control 0..1

Binding The codes SHOULD be taken from Results Coded Values Laboratory/Pathology - IPS
(preferred to http://hl7.org/fhir/uv/ips/ValueSet/results-coded-values-laboratory-pathology-uv-ips)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary true

Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

294. Observation.component.dataAbsentReason

Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Short Why the component result is missing

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

Control 0..1
This element is affected by the following invariants: obs-6

Unless not suitable, these codes SHALL be taken from DataAbsentReason
(extensible to http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1)

Codes specifying why the result (Observation.value[x]) is missing.

Is Modifier false

Summary false

Requirements

EHDSObservation.component.dataAbsentReason

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

296. Observation.component.interpretation

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Short High, low, normal, etc.

Comments

Control 0..*

Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
(extensible to http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1)

Codes identifying interpretations of observations.