This page is part of the CCDA: Consolidated CDA Release (v4.0.0-ballot: CCDA 4.0 Ballot) generated with FHIR (HL7® FHIR® Standard) v5.0.0. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/CharacteristicsofHomeEnvironment | Version: 4.0.0-ballot | |||
| Draft as of 2024-12-20 | Computable Name: CharacteristicsofHomeEnvironment | |||
| Other Identifiers: OID:2.16.840.1.113883.10.20.22.4.109 | ||||
This template represents the patient's home environment including, but not limited to, type of residence (trailer, single family home, assisted living), living arrangement (e.g., alone, with parents), and housing status (e.g., evicted, homeless, home owner).
Usage:
Description of Template, Differentials, Snapshots and how the different presentations work.
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value | 
|    Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
|     templateId:characteristics-home-env | 1..1 | II | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.109 | |
|      @extension | 0..0 | |||
|    @classCode | 1..1 | cs | Fixed Value: OBS | |
|    @moodCode | 1..1 | cs | Fixed Value: EVN | |
|    id | 1..* | II | ||
|    code | 1..1 | CD | ||
|     @code | 1..1 | cs | Required Pattern: 75274-1 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|    text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
|     reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
|    statusCode | 1..1 | CS | ||
|     @code | 1..1 | cs | Fixed Value: completed | |
|    value | 1..1 | CD | Binding: Residence and Accommodation Type  (preferred) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet | URI | 
| Observation.value | preferred | ResidenceAndAccommodationType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.49 | 
| Id | Grade | Path(s) | Details | Requirements | 
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') | 
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value | 
|    @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|    realmCode | 0..* | CS | ||
|    typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @assigningAuthorityName | 0..1 | st | ||
|     @displayable | 0..1 | bl | ||
|     @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|     @extension | 1..1 | st | ||
|    Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
|     templateId:characteristics-home-env | 1..1 | II | ||
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.109 | |
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
|    @negationInd | 0..1 | bl | ||
|    id | 1..* | II | ||
|    sdtcCategory | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc) | |
|    code | 1..1 | CD | Binding: ObservationType (example) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Required Pattern: 75274-1 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|     @codeSystemName | 0..1 | st | ||
|     @codeSystemVersion | 0..1 | st | ||
|     @displayName | 0..1 | st | ||
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|     originalText | 0..1 | ED | ||
|     qualifier | 0..* | CR | ||
|     translation | 0..* | CD | ||
|    derivationExpr | 0..1 | ST | ||
|    text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @compression | 0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
|     @integrityCheck | 0..1 | bin | ||
|     @integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
|     @language | 0..1 | cs | ||
|     @mediaType | 0..1 | cs | Binding: MediaType (example) | |
|     @representation | 0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
|     xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
|     reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
|     thumbnail | 0..1 | ED | ||
|    statusCode | 1..1 | CS | Binding: ActStatus (required) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Fixed Value: completed | |
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|    effectiveTime | 0..1 | IVL_TS | ||
|    priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
|    repeatNumber | 0..1 | IVL_INT | ||
|    languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
|    value | 1..1 | CD | Binding: Residence and Accommodation Type  (preferred) | |
|    interpretationCode | 0..* | CE | Binding: CDAObservationInterpretation (required) | |
|    methodCode | 0..* | CE | Binding: ObservationMethod (example) | |
|    targetSiteCode | 0..* | CD | ||
|    subject | 0..1 | Subject | ||
|    specimen | 0..* | Specimen | ||
|    performer | 0..* | Performer2 | ||
|    author | 0..* | Author | ||
|    informant | 0..* | Informant | ||
|    participant | 0..* | Participant2 | ||
|    entryRelationship | 0..* | EntryRelationship | ||
|    reference | 0..* | Reference | ||
|    precondition | 0..* | Precondition | ||
|    sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
|    referenceRange | 0..* | InfrastructureRoot | ||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     realmCode | 0..* | CS | ||
|     typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|      @extension | 1..1 | st | ||
|     templateId | 0..* | II | ||
|     @typeCode | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV | |
|     observationRange | 1..1 | ObservationRange | ||
|    sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:characteristics-home-env.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | example | ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType | |
| Observation.code.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.compression | required | CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Observation.text.mediaType | example | MediaType http://terminology.hl7.org/ValueSet/v3-MediaType | |
| Observation.text.representation | required | BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.statusCode.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.priorityCode | example | ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Observation.languageCode | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Observation.value | preferred | ResidenceAndAccommodationType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.49 | |
| Observation.interpretationCode | required | CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation | |
| Observation.methodCode | example | ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod | |
| Observation.referenceRange.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeCode | required | Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType | 
| Id | Grade | Path(s) | Details | Requirements | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists() | |
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') | 
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value | 
|    @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|    realmCode | 0..* | CS | ||
|    typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @assigningAuthorityName | 0..1 | st | ||
|     @displayable | 0..1 | bl | ||
|     @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|     @extension | 1..1 | st | ||
|    Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
|     templateId:characteristics-home-env | 1..1 | II | ||
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.109 | |
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
|    @negationInd | 0..1 | bl | ||
|    id | 1..* | II | ||
|    sdtcCategory | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc) | |
|    code | 1..1 | CD | Binding: ObservationType (example) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Required Pattern: 75274-1 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|     @codeSystemName | 0..1 | st | ||
|     @codeSystemVersion | 0..1 | st | ||
|     @displayName | 0..1 | st | ||
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|     originalText | 0..1 | ED | ||
|     qualifier | 0..* | CR | ||
|     translation | 0..* | CD | ||
|    derivationExpr | 0..1 | ST | ||
|    text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @compression | 0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
|     @integrityCheck | 0..1 | bin | ||
|     @integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
|     @language | 0..1 | cs | ||
|     @mediaType | 0..1 | cs | Binding: MediaType (example) | |
|     @representation | 0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
|     xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
|     reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
|     thumbnail | 0..1 | ED | ||
|    statusCode | 1..1 | CS | Binding: ActStatus (required) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Fixed Value: completed | |
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|    effectiveTime | 0..1 | IVL_TS | ||
|    priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
|    repeatNumber | 0..1 | IVL_INT | ||
|    languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
|    value | 1..1 | CD | Binding: Residence and Accommodation Type  (preferred) | |
|    interpretationCode | 0..* | CE | Binding: CDAObservationInterpretation (required) | |
|    methodCode | 0..* | CE | Binding: ObservationMethod (example) | |
|    targetSiteCode | 0..* | CD | ||
|    subject | 0..1 | Subject | ||
|    specimen | 0..* | Specimen | ||
|    performer | 0..* | Performer2 | ||
|    author | 0..* | Author | ||
|    informant | 0..* | Informant | ||
|    participant | 0..* | Participant2 | ||
|    entryRelationship | 0..* | EntryRelationship | ||
|    reference | 0..* | Reference | ||
|    precondition | 0..* | Precondition | ||
|    sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
|    referenceRange | 0..* | InfrastructureRoot | ||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     realmCode | 0..* | CS | ||
|     typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|      @extension | 1..1 | st | ||
|     templateId | 0..* | II | ||
|     @typeCode | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV | |
|     observationRange | 1..1 | ObservationRange | ||
|    sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:characteristics-home-env.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | example | ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType | |
| Observation.code.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.compression | required | CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Observation.text.mediaType | example | MediaType http://terminology.hl7.org/ValueSet/v3-MediaType | |
| Observation.text.representation | required | BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.statusCode.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.priorityCode | example | ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Observation.languageCode | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Observation.value | preferred | ResidenceAndAccommodationType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.49 | |
| Observation.interpretationCode | required | CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation | |
| Observation.methodCode | example | ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod | |
| Observation.referenceRange.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeCode | required | Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType | 
| Id | Grade | Path(s) | Details | Requirements | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists() | |
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') | 
This structure is derived from Observation
Summary
Mandatory: 9 elements
 Fixed: 3 elements
 Prohibited: 1 element
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value | 
|    Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
|     templateId:characteristics-home-env | 1..1 | II | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.109 | |
|      @extension | 0..0 | |||
|    @classCode | 1..1 | cs | Fixed Value: OBS | |
|    @moodCode | 1..1 | cs | Fixed Value: EVN | |
|    id | 1..* | II | ||
|    code | 1..1 | CD | ||
|     @code | 1..1 | cs | Required Pattern: 75274-1 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|    text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
|     reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
|    statusCode | 1..1 | CS | ||
|     @code | 1..1 | cs | Fixed Value: completed | |
|    value | 1..1 | CD | Binding: Residence and Accommodation Type  (preferred) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet | URI | 
| Observation.value | preferred | ResidenceAndAccommodationType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.49 | 
| Id | Grade | Path(s) | Details | Requirements | 
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') | 
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value | 
|    @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|    realmCode | 0..* | CS | ||
|    typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @assigningAuthorityName | 0..1 | st | ||
|     @displayable | 0..1 | bl | ||
|     @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|     @extension | 1..1 | st | ||
|    Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
|     templateId:characteristics-home-env | 1..1 | II | ||
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.109 | |
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
|    @negationInd | 0..1 | bl | ||
|    id | 1..* | II | ||
|    sdtcCategory | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc) | |
|    code | 1..1 | CD | Binding: ObservationType (example) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Required Pattern: 75274-1 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|     @codeSystemName | 0..1 | st | ||
|     @codeSystemVersion | 0..1 | st | ||
|     @displayName | 0..1 | st | ||
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|     originalText | 0..1 | ED | ||
|     qualifier | 0..* | CR | ||
|     translation | 0..* | CD | ||
|    derivationExpr | 0..1 | ST | ||
|    text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @compression | 0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
|     @integrityCheck | 0..1 | bin | ||
|     @integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
|     @language | 0..1 | cs | ||
|     @mediaType | 0..1 | cs | Binding: MediaType (example) | |
|     @representation | 0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
|     xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
|     reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
|     thumbnail | 0..1 | ED | ||
|    statusCode | 1..1 | CS | Binding: ActStatus (required) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Fixed Value: completed | |
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|    effectiveTime | 0..1 | IVL_TS | ||
|    priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
|    repeatNumber | 0..1 | IVL_INT | ||
|    languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
|    value | 1..1 | CD | Binding: Residence and Accommodation Type  (preferred) | |
|    interpretationCode | 0..* | CE | Binding: CDAObservationInterpretation (required) | |
|    methodCode | 0..* | CE | Binding: ObservationMethod (example) | |
|    targetSiteCode | 0..* | CD | ||
|    subject | 0..1 | Subject | ||
|    specimen | 0..* | Specimen | ||
|    performer | 0..* | Performer2 | ||
|    author | 0..* | Author | ||
|    informant | 0..* | Informant | ||
|    participant | 0..* | Participant2 | ||
|    entryRelationship | 0..* | EntryRelationship | ||
|    reference | 0..* | Reference | ||
|    precondition | 0..* | Precondition | ||
|    sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
|    referenceRange | 0..* | InfrastructureRoot | ||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     realmCode | 0..* | CS | ||
|     typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|      @extension | 1..1 | st | ||
|     templateId | 0..* | II | ||
|     @typeCode | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV | |
|     observationRange | 1..1 | ObservationRange | ||
|    sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:characteristics-home-env.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | example | ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType | |
| Observation.code.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.compression | required | CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Observation.text.mediaType | example | MediaType http://terminology.hl7.org/ValueSet/v3-MediaType | |
| Observation.text.representation | required | BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.statusCode.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.priorityCode | example | ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Observation.languageCode | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Observation.value | preferred | ResidenceAndAccommodationType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.49 | |
| Observation.interpretationCode | required | CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation | |
| Observation.methodCode | example | ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod | |
| Observation.referenceRange.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeCode | required | Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType | 
| Id | Grade | Path(s) | Details | Requirements | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists() | |
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') | 
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, sdtcCategory, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value | 
|    @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|    realmCode | 0..* | CS | ||
|    typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @assigningAuthorityName | 0..1 | st | ||
|     @displayable | 0..1 | bl | ||
|     @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|     @extension | 1..1 | st | ||
|    Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
|     templateId:characteristics-home-env | 1..1 | II | ||
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.109 | |
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
|    @negationInd | 0..1 | bl | ||
|    id | 1..* | II | ||
|    sdtcCategory | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc) | |
|    code | 1..1 | CD | Binding: ObservationType (example) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Required Pattern: 75274-1 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|     @codeSystemName | 0..1 | st | ||
|     @codeSystemVersion | 0..1 | st | ||
|     @displayName | 0..1 | st | ||
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|     originalText | 0..1 | ED | ||
|     qualifier | 0..* | CR | ||
|     translation | 0..* | CD | ||
|    derivationExpr | 0..1 | ST | ||
|    text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @compression | 0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
|     @integrityCheck | 0..1 | bin | ||
|     @integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
|     @language | 0..1 | cs | ||
|     @mediaType | 0..1 | cs | Binding: MediaType (example) | |
|     @representation | 0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
|     xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
|     reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | 
|     thumbnail | 0..1 | ED | ||
|    statusCode | 1..1 | CS | Binding: ActStatus (required) | |
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     @code | 1..1 | cs | Fixed Value: completed | |
|     @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
|     @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
|    effectiveTime | 0..1 | IVL_TS | ||
|    priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
|    repeatNumber | 0..1 | IVL_INT | ||
|    languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
|    value | 1..1 | CD | Binding: Residence and Accommodation Type  (preferred) | |
|    interpretationCode | 0..* | CE | Binding: CDAObservationInterpretation (required) | |
|    methodCode | 0..* | CE | Binding: ObservationMethod (example) | |
|    targetSiteCode | 0..* | CD | ||
|    subject | 0..1 | Subject | ||
|    specimen | 0..* | Specimen | ||
|    performer | 0..* | Performer2 | ||
|    author | 0..* | Author | ||
|    informant | 0..* | Informant | ||
|    participant | 0..* | Participant2 | ||
|    entryRelationship | 0..* | EntryRelationship | ||
|    reference | 0..* | Reference | ||
|    precondition | 0..* | Precondition | ||
|    sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
|    referenceRange | 0..* | InfrastructureRoot | ||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|     realmCode | 0..* | CS | ||
|     typeId | C | 0..1 | II | II-1: An II instance must have either a root or an nullFlavor. | 
|      @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
|      @assigningAuthorityName | 0..1 | st | ||
|      @displayable | 0..1 | bl | ||
|      @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
|      @extension | 1..1 | st | ||
|     templateId | 0..* | II | ||
|     @typeCode | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV | |
|     observationRange | 1..1 | ObservationRange | ||
|    sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:characteristics-home-env.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | example | ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType | |
| Observation.code.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.compression | required | CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Observation.text.mediaType | example | MediaType http://terminology.hl7.org/ValueSet/v3-MediaType | |
| Observation.text.representation | required | BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.statusCode.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.priorityCode | example | ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Observation.languageCode | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Observation.value | preferred | ResidenceAndAccommodationType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.49 | |
| Observation.interpretationCode | required | CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation | |
| Observation.methodCode | example | ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod | |
| Observation.referenceRange.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeCode | required | Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType | 
| Id | Grade | Path(s) | Details | Requirements | 
| II-1 | error | Observation.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. : root.exists() or nullFlavor.exists() | |
| should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') | 
This structure is derived from Observation
Summary
Mandatory: 9 elements
 Fixed: 3 elements
 Prohibited: 1 element
Slices
This structure defines the following Slices: