Clinical Document Architecture V2.0.1
2.1.0-draft1 - 1st Draft

This page is part of the CDA: Clinical Document Architecture (v2.1.0-draft1: CDA 2.1 Draft) based on FHIR v5.0.0. . For a full list of available versions, see the Directory of published versions

Logical Model: CDAR2.Observation - XML Profile

Active as of 2023-01-16

XML representation of the Observation logical model.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Observation"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>A derivative of the RIM Observation class, used for representing coded and other observations.</p>
      <p>Observation.negationInd, when set to &quot;true&quot;, is a positive assertion that the Observation as a whole is negated. Some properties such as Observation.id, Observation.moodCode, and the participations are not negated. These properties always have the same meaning: i.e., the author remains the author of the negative Observation. An observation statement with negationInd is still a statement about the specific fact described by the Observation. For instance, a negated &quot;finding of wheezing on July 1&quot; means that the author positively denies that there was wheezing on July 1, and that he takes the same responsibility for such statement and the same requirement to have evidence for such statement than if he had not used negation.</p>
    </div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/elementdefinition-namespace">
    <valueUri value="urn:hl7-org:v3"/>
  </extension>
  <url value="http://hl7.org/fhir/cda/StructureDefinition/Observation"/>
  <version value="2.1.0-draft1"/>
  <name value="CDAR2.Observation"/>
  <title value="Observation (CDA Class)"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2023-01-16T16:39:50+11:00"/>
  <publisher value="Health Level 7"/>
  <contact>
    <name value="HL7 International - Cross-Group Projects"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cgp"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="cgp@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="A derivative of the RIM Observation class, used for representing coded and other observations.
Observation.negationInd, when set to &quot;true&quot;, is a positive assertion that the Observation as a whole is negated. Some properties such as Observation.id, Observation.moodCode, and the participations are not negated. These properties always have the same meaning: i.e., the author remains the author of the negative Observation. An observation statement with negationInd is still a statement about the specific fact described by the Observation. For instance, a negated &quot;finding of wheezing on July 1&quot; means that the author positively denies that there was wheezing on July 1, and that he takes the same responsibility for such statement and the same requirement to have evidence for such statement than if he had not used negation."/>
  <fhirVersion value="5.0.0-snapshot3"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <kind value="logical"/>
  <abstract value="false"/>
  <type value="Observation"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="Observation">
      <path value="Observation"/>
      <short value="Base for all types and resources"/>
      <definition
                  value="Base definition for all types defined in FHIR type system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Base"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.classCode">
      <path value="Observation.classCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.classCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ActClassObservation"/>
      </binding>
    </element>
    <element id="Observation.moodCode">
      <path value="Observation.moodCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.moodCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
    </element>
    <element id="Observation.negationInd">
      <path value="Observation.negationInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.negationInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element id="Observation.realmCode">
      <path value="Observation.realmCode"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.realmCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CS"/>
      </type>
    </element>
    <element id="Observation.typeId">
      <path value="Observation.typeId"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.typeId"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Observation.templateId">
      <path value="Observation.templateId"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.templateId"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Observation.id">
      <path value="Observation.id"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Observation.code">
      <path value="Observation.code"/>
      <representation value="typeAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CD"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ObservationType"/>
      </binding>
    </element>
    <element id="Observation.derivationExpr">
      <path value="Observation.derivationExpr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.derivationExpr"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ST"/>
      </type>
    </element>
    <element id="Observation.text">
      <path value="Observation.text"/>
      <representation value="typeAttr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ED"/>
      </type>
    </element>
    <element id="Observation.statusCode">
      <path value="Observation.statusCode"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.statusCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CS"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActStatus"/>
      </binding>
    </element>
    <element id="Observation.effectiveTime">
      <path value="Observation.effectiveTime"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.effectiveTime"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-TS"/>
      </type>
    </element>
    <element id="Observation.priorityCode">
      <path value="Observation.priorityCode"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.priorityCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActPriority"/>
      </binding>
    </element>
    <element id="Observation.repeatNumber">
      <path value="Observation.repeatNumber"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.repeatNumber"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-INT"/>
      </type>
    </element>
    <element id="Observation.languageCode">
      <path value="Observation.languageCode"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.languageCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CS"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-HumanLanguage"/>
      </binding>
    </element>
    <element id="Observation.value">
      <path value="Observation.value"/>
      <representation value="typeAttr"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.value"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/BL"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ED"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ST"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CD"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CV"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/SC"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/TEL"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/AD"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/EN"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/INT"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/REAL"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/PQ"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/MO"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-PQ"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/PIVL-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/EIVL-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/SXPR-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/RTO-PQ-PQ"/>
      </type>
    </element>
    <element id="Observation.interpretationCode">
      <path value="Observation.interpretationCode"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.interpretationCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ObservationInterpretation"/>
      </binding>
    </element>
    <element id="Observation.methodCode">
      <path value="Observation.methodCode"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.methodCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ObservationMethod"/>
      </binding>
    </element>
    <element id="Observation.targetSiteCode">
      <path value="Observation.targetSiteCode"/>
      <definition value="Drawn from concept domain ActSite"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.targetSiteCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CD"/>
      </type>
    </element>
    <element id="Observation.subject">
      <path value="Observation.subject"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="Observation.subject.id">
      <path value="Observation.subject.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.subject.extension">
      <path value="Observation.subject.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.subject.typeCode">
      <path value="Observation.subject.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.subject.typeCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="SBJ"/>
      <fixedCode value="SBJ"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ParticipationTargetSubject"/>
      </binding>
    </element>
    <element id="Observation.subject.contextControlCode">
      <path value="Observation.subject.contextControlCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.subject.contextControlCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="OP"/>
      <fixedCode value="OP"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ContextControl"/>
      </binding>
    </element>
    <element id="Observation.subject.awarenessCode">
      <path value="Observation.subject.awarenessCode"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.subject.awarenessCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-TargetAwareness"/>
      </binding>
    </element>
    <element id="Observation.subject.relatedSubject">
      <path value="Observation.subject.relatedSubject"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.subject.relatedSubject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/RelatedSubject"/>
      </type>
    </element>
    <element id="Observation.specimen">
      <path value="Observation.specimen"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Specimen"/>
      </type>
    </element>
    <element id="Observation.performer">
      <path value="Observation.performer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Performer2"/>
      </type>
    </element>
    <element id="Observation.author">
      <path value="Observation.author"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.author"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Author"/>
      </type>
    </element>
    <element id="Observation.informant">
      <path value="Observation.informant"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.informant"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="Observation.informant.id">
      <path value="Observation.informant.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.informant.extension">
      <path value="Observation.informant.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.informant.typeCode">
      <path value="Observation.informant.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.informant.typeCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="INF"/>
      <fixedCode value="INF"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ParticipationInformationGenerator"/>
      </binding>
    </element>
    <element id="Observation.informant.contextControlCode">
      <path value="Observation.informant.contextControlCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.informant.contextControlCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="OP"/>
      <fixedCode value="OP"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ContextControl"/>
      </binding>
    </element>
    <element id="Observation.informant.assignedEntity">
      <path value="Observation.informant.assignedEntity"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.informant.assignedEntity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/AssignedEntity"/>
      </type>
    </element>
    <element id="Observation.informant.relatedEntity">
      <path value="Observation.informant.relatedEntity"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.informant.relatedEntity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/RelatedEntity"/>
      </type>
    </element>
    <element id="Observation.participant">
      <path value="Observation.participant"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.participant"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/Participant2"/>
      </type>
    </element>
    <element id="Observation.entryRelationship">
      <path value="Observation.entryRelationship"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.entryRelationship"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="obs-er-1"/>
        <severity value="error"/>
        <human
               value="Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act"/>
        <expression
                    value="(observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1"/>
      </constraint>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="Observation.entryRelationship.id">
      <path value="Observation.entryRelationship.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.entryRelationship.extension">
      <path value="Observation.entryRelationship.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.entryRelationship.typeCode">
      <path value="Observation.entryRelationship.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.typeCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.inversionInd">
      <path value="Observation.entryRelationship.inversionInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.inversionInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.contextConductionInd">
      <path value="Observation.entryRelationship.contextConductionInd"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.contextConductionInd"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <defaultValueBoolean value="true"/>
    </element>
    <element id="Observation.entryRelationship.sequenceNumber">
      <path value="Observation.entryRelationship.sequenceNumber"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.sequenceNumber"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/INT"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.negationInd">
      <path value="Observation.entryRelationship.negationInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.negationInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.seperatableInd">
      <path value="Observation.entryRelationship.seperatableInd"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.seperatableInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/BL"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.observation">
      <path value="Observation.entryRelationship.observation"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.observation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/Observation"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.regionOfInterest">
      <path value="Observation.entryRelationship.regionOfInterest"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.regionOfInterest"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/RegionOfInterest"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.observationMedia">
      <path value="Observation.entryRelationship.observationMedia"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.observationMedia"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ObservationMedia"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.substanceAdministration">
      <path value="Observation.entryRelationship.substanceAdministration"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.substanceAdministration"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/SubstanceAdministration"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.supply">
      <path value="Observation.entryRelationship.supply"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.supply"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Supply"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.procedure">
      <path value="Observation.entryRelationship.procedure"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.procedure"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Procedure"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.encounter">
      <path value="Observation.entryRelationship.encounter"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Encounter"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.organizer">
      <path value="Observation.entryRelationship.organizer"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.organizer"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Organizer"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.act">
      <path value="Observation.entryRelationship.act"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.entryRelationship.act"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Act"/>
      </type>
    </element>
    <element id="Observation.reference">
      <path value="Observation.reference"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.reference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="Observation.reference.id">
      <path value="Observation.reference.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.reference.extension">
      <path value="Observation.reference.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.reference.typeCode">
      <path value="Observation.reference.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.reference.typeCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
    </element>
    <element id="Observation.reference.seperatableInd">
      <path value="Observation.reference.seperatableInd"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.reference.seperatableInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/BL"/>
      </type>
    </element>
    <element id="Observation.reference.externalAct">
      <path value="Observation.reference.externalAct"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.reference.externalAct"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalAct"/>
      </type>
    </element>
    <element id="Observation.reference.externalObservation">
      <path value="Observation.reference.externalObservation"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.reference.externalObservation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalObservation"/>
      </type>
    </element>
    <element id="Observation.reference.externalProcedure">
      <path value="Observation.reference.externalProcedure"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.reference.externalProcedure"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalProcedure"/>
      </type>
    </element>
    <element id="Observation.reference.externalDocument">
      <path value="Observation.reference.externalDocument"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.reference.externalDocument"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalDocument"/>
      </type>
    </element>
    <element id="Observation.precondition">
      <path value="Observation.precondition"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.precondition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/Precondition"/>
      </type>
    </element>
    <element id="Observation.referenceRange">
      <path value="Observation.referenceRange"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.referenceRange"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="Observation.referenceRange.id">
      <path value="Observation.referenceRange.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.extension">
      <path value="Observation.referenceRange.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.typeCode">
      <path value="Observation.referenceRange.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.typeCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="REFV"/>
      <fixedCode value="REFV"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ActRelationshipPertains"/>
      </binding>
    </element>
    <element id="Observation.referenceRange.observationRange">
      <path value="Observation.referenceRange.observationRange"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.observationRange"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ObservationRange"/>
      </type>
    </element>
  </snapshot>
  <differential>
    <element id="Observation">
      <path value="Observation"/>
      <min value="1"/>
      <max value="1"/>
    </element>
    <element id="Observation.classCode">
      <path value="Observation.classCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ActClassObservation"/>
      </binding>
    </element>
    <element id="Observation.moodCode">
      <path value="Observation.moodCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
    </element>
    <element id="Observation.negationInd">
      <path value="Observation.negationInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element id="Observation.realmCode">
      <path value="Observation.realmCode"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CS"/>
      </type>
    </element>
    <element id="Observation.typeId">
      <path value="Observation.typeId"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Observation.templateId">
      <path value="Observation.templateId"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Observation.id">
      <path value="Observation.id"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Observation.code">
      <path value="Observation.code"/>
      <representation value="typeAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CD"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ObservationType"/>
      </binding>
    </element>
    <element id="Observation.derivationExpr">
      <path value="Observation.derivationExpr"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ST"/>
      </type>
    </element>
    <element id="Observation.text">
      <path value="Observation.text"/>
      <representation value="typeAttr"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ED"/>
      </type>
    </element>
    <element id="Observation.statusCode">
      <path value="Observation.statusCode"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CS"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActStatus"/>
      </binding>
    </element>
    <element id="Observation.effectiveTime">
      <path value="Observation.effectiveTime"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-TS"/>
      </type>
    </element>
    <element id="Observation.priorityCode">
      <path value="Observation.priorityCode"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActPriority"/>
      </binding>
    </element>
    <element id="Observation.repeatNumber">
      <path value="Observation.repeatNumber"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-INT"/>
      </type>
    </element>
    <element id="Observation.languageCode">
      <path value="Observation.languageCode"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CS"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-HumanLanguage"/>
      </binding>
    </element>
    <element id="Observation.value">
      <path value="Observation.value"/>
      <representation value="typeAttr"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/BL"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ED"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/ST"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CD"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CV"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/SC"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/II"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/TEL"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/AD"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/EN"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/INT"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/REAL"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/PQ"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/MO"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-PQ"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/IVL-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/PIVL-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/EIVL-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/SXPR-TS"/>
      </type>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/RTO-PQ-PQ"/>
      </type>
    </element>
    <element id="Observation.interpretationCode">
      <path value="Observation.interpretationCode"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ObservationInterpretation"/>
      </binding>
    </element>
    <element id="Observation.methodCode">
      <path value="Observation.methodCode"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ObservationMethod"/>
      </binding>
    </element>
    <element id="Observation.targetSiteCode">
      <path value="Observation.targetSiteCode"/>
      <definition value="Drawn from concept domain ActSite"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CD"/>
      </type>
    </element>
    <element id="Observation.subject">
      <path value="Observation.subject"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Element"/>
      </type>
    </element>
    <element id="Observation.subject.typeCode">
      <path value="Observation.subject.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="SBJ"/>
      <fixedCode value="SBJ"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ParticipationTargetSubject"/>
      </binding>
    </element>
    <element id="Observation.subject.contextControlCode">
      <path value="Observation.subject.contextControlCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="OP"/>
      <fixedCode value="OP"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ContextControl"/>
      </binding>
    </element>
    <element id="Observation.subject.awarenessCode">
      <path value="Observation.subject.awarenessCode"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-TargetAwareness"/>
      </binding>
    </element>
    <element id="Observation.subject.relatedSubject">
      <path value="Observation.subject.relatedSubject"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/RelatedSubject"/>
      </type>
    </element>
    <element id="Observation.specimen">
      <path value="Observation.specimen"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Specimen"/>
      </type>
    </element>
    <element id="Observation.performer">
      <path value="Observation.performer"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Performer2"/>
      </type>
    </element>
    <element id="Observation.author">
      <path value="Observation.author"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Author"/>
      </type>
    </element>
    <element id="Observation.informant">
      <path value="Observation.informant"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Element"/>
      </type>
    </element>
    <element id="Observation.informant.typeCode">
      <path value="Observation.informant.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="INF"/>
      <fixedCode value="INF"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ParticipationInformationGenerator"/>
      </binding>
    </element>
    <element id="Observation.informant.contextControlCode">
      <path value="Observation.informant.contextControlCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="OP"/>
      <fixedCode value="OP"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ContextControl"/>
      </binding>
    </element>
    <element id="Observation.informant.assignedEntity">
      <path value="Observation.informant.assignedEntity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/AssignedEntity"/>
      </type>
    </element>
    <element id="Observation.informant.relatedEntity">
      <path value="Observation.informant.relatedEntity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/RelatedEntity"/>
      </type>
    </element>
    <element id="Observation.participant">
      <path value="Observation.participant"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/Participant2"/>
      </type>
    </element>
    <element id="Observation.entryRelationship">
      <path value="Observation.entryRelationship"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="obs-er-1"/>
        <severity value="error"/>
        <human
               value="Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act"/>
        <expression
                    value="(observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1"/>
      </constraint>
    </element>
    <element id="Observation.entryRelationship.typeCode">
      <path value="Observation.entryRelationship.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.inversionInd">
      <path value="Observation.entryRelationship.inversionInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.contextConductionInd">
      <path value="Observation.entryRelationship.contextConductionInd"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <defaultValueBoolean value="true"/>
    </element>
    <element id="Observation.entryRelationship.sequenceNumber">
      <path value="Observation.entryRelationship.sequenceNumber"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/INT"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.negationInd">
      <path value="Observation.entryRelationship.negationInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.seperatableInd">
      <path value="Observation.entryRelationship.seperatableInd"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/BL"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.observation">
      <path value="Observation.entryRelationship.observation"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/Observation"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.regionOfInterest">
      <path value="Observation.entryRelationship.regionOfInterest"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/RegionOfInterest"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.observationMedia">
      <path value="Observation.entryRelationship.observationMedia"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ObservationMedia"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.substanceAdministration">
      <path value="Observation.entryRelationship.substanceAdministration"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/SubstanceAdministration"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.supply">
      <path value="Observation.entryRelationship.supply"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Supply"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.procedure">
      <path value="Observation.entryRelationship.procedure"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Procedure"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.encounter">
      <path value="Observation.entryRelationship.encounter"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Encounter"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.organizer">
      <path value="Observation.entryRelationship.organizer"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Organizer"/>
      </type>
    </element>
    <element id="Observation.entryRelationship.act">
      <path value="Observation.entryRelationship.act"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/Act"/>
      </type>
    </element>
    <element id="Observation.reference">
      <path value="Observation.reference"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Element"/>
      </type>
    </element>
    <element id="Observation.reference.typeCode">
      <path value="Observation.reference.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
    </element>
    <element id="Observation.reference.seperatableInd">
      <path value="Observation.reference.seperatableInd"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="http://hl7.org/fhir/cda/StructureDefinition/BL"/>
      </type>
    </element>
    <element id="Observation.reference.externalAct">
      <path value="Observation.reference.externalAct"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalAct"/>
      </type>
    </element>
    <element id="Observation.reference.externalObservation">
      <path value="Observation.reference.externalObservation"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalObservation"/>
      </type>
    </element>
    <element id="Observation.reference.externalProcedure">
      <path value="Observation.reference.externalProcedure"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalProcedure"/>
      </type>
    </element>
    <element id="Observation.reference.externalDocument">
      <path value="Observation.reference.externalDocument"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ExternalDocument"/>
      </type>
    </element>
    <element id="Observation.precondition">
      <path value="Observation.precondition"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/Precondition"/>
      </type>
    </element>
    <element id="Observation.referenceRange">
      <path value="Observation.referenceRange"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Element"/>
      </type>
    </element>
    <element id="Observation.referenceRange.typeCode">
      <path value="Observation.referenceRange.typeCode"/>
      <representation value="xmlAttr"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <defaultValueCode value="REFV"/>
      <fixedCode value="REFV"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-ActRelationshipPertains"/>
      </binding>
    </element>
    <element id="Observation.referenceRange.observationRange">
      <path value="Observation.referenceRange.observationRange"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code
              value="http://hl7.org/fhir/cda/StructureDefinition/ObservationRange"/>
      </type>
    </element>
  </differential>
</StructureDefinition>