STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Observation.profile.xml

Raw XML (canonical form)

StructureDefinition for observation

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Observation"/>
  <meta>
    <lastUpdated value="2016-03-31T08:01:25.570+11:00"/>
  </meta>
  <text>
    <status value="generated"/>
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          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="The logical name of the element">Name</a>
          </th>
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Information about the use of the element">Flags</a>
          </th>
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a>
          </th>
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a>
          </th>
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a>
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/>
              </a>
            </span>
          </th>
        </tr>
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            Nj6C+QmaxAek5tyAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Resource"/> 
            <span title="Observation : Measurements and simple assertions made about a patient, device or other
             subject.">Observation</span>
            <a name="Observation"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Measurements and simple assertions
            <br/>
            <span style="font-style: italic" title="obs-6">dataAbsentReason SHALL only be present if Observation.value[x] is not present</span>
            <br/>
            <span style="font-style: italic" title="obs-7">Component code SHALL not be same as observation code</span>
          </td>
        </tr>

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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> 
            <span title="Observation.identifier : A unique identifier for the simple observation instance.">identifier</span>
            <a name="Observation.identifier"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Unique Id for this particular observation</td>
        </tr>

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            <span title="Observation.status : The status of the result value.">status</span>
            <a name="Observation.status"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is a modifier element">?! </span>
            <span title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">registered | preliminary | final | amended +
            <br/>
            <a href="valueset-observation-status.html" title="Codes providing the status of an observation.">ObservationStatus</a> (
            <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value
             set.">Required</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> 
            <span title="Observation.category : A code that classifies the general type of observation being made.
              This is used  for searching, sorting and display purposes.">category</span>
            <a name="Observation.category"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Classification of  type of observation
            <br/>
            <a href="valueset-observation-category.html" title="Codes for high level observation categories .">Observation Category Codes</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <span title="Observation.code : Describes what was observed. Sometimes this is called the observation
             &quot;name&quot;.">code</span>
            <a name="Observation.code"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Type of observation (code / type)
            <br/>
            <a href="valueset-observation-codes.html" title="Codes identifying names of simple observations.">LOINC Codes</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
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            <span title="Observation.subject : The patient, or group of patients, location, or device whose characteristics
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              other observer (for example a relative or EMT), or any observation made about the subject.">subject</span>
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            <a href="references.html">Reference</a>(
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            <a href="group.html">Group</a> | 
            <a href="device.html">Device</a> | 
            <a href="location.html">Location</a>)
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        </tr>

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            <span title="Observation.encounter : The healthcare event  (e.g. a patient and healthcare provider
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            <a name="Observation.encounter"> </a>
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            <a href="references.html">Reference</a>(
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          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Healthcare event during which this observation is made</td>
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            <span title="Observation.effective[x] : The time or time-period the observed value is asserted as being
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             collection, but very often the source of the date/time is not known, only the date/time
             itself.">effective[x]</span>
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
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            <span title="A date, date-time or partial date (e.g. just year or year + month).  If hours and minutes
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
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            <a href="datatypes.html#dateTime">dateTime</a>
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        </tr>

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            <span title="A time period defined by a start and end date and optionally time.">effectivePeriod</span>
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Period">Period</a>
          </td>
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            <span title="Observation.issued : The date and time this observation was made available to providers,
             typically after the results have been reviewed and verified.">issued</span>
            <a name="Observation.issued"> </a>
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is included in summaries">Σ</span>
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#instant">instant</a>
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        </tr>

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            <a href="references.html">Reference</a>(
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            <a href="organization.html">Organization</a> | 
            <a href="patient.html">Patient</a> | 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Who is responsible for the observation</td>
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            <a href="datatypes.html#SampledData">SampledData</a>
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            <a href="datatypes.html#time">time</a>
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            <span title="A time period defined by a start and end date and optionally time.">valuePeriod</span>
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Period">Period</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
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            <span title="Observation.dataAbsentReason : Provides a reason why the expected value in the element
             Observation.value[x] is missing.">dataAbsentReason</span>
            <a name="Observation.dataAbsentReason"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Why the result is missing
            <br/>
            <a href="valueset-observation-valueabsentreason.html" title="Codes specifying why the result (Observation.value[x]) is missing.">Observation Value Absent Reason</a> (
            <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value
             set if any of the codes within the value set can apply to the concept being communicated.
              If the value set does not cover the concept (based on human review), alternate codings
             (or, data type allowing, text) may be included instead.">Extensible</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> 
            <span title="Observation.interpretation : The assessment made based on the result of the observation.
              Intended as a simple compact code often placed adjacent to the result value in reports
             and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as
             abnormal flag.">interpretation</span>
            <a name="Observation.interpretation"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">High, low, normal, etc.
            <br/>
            <a href="valueset-observation-interpretation.html" title="Codes identifying interpretations of observations.">Observation Interpretation Codes</a> (
            <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value
             set if any of the codes within the value set can apply to the concept being communicated.
              If the value set does not cover the concept (based on human review), alternate codings
             (or, data type allowing, text) may be included instead.">Extensible</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW
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            <span title="Observation.comment : May include statements about significant, unexpected or unreliable
             values, or information about the source of the value where this may be relevant to the
             interpretation of the result.">comment</span>
            <a name="Observation.comment"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#string">string</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Comments about result</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <span title="Observation.bodySite : Indicates the site on the subject's body where the observation
             was made (i.e. the target site).">bodySite</span>
            <a name="Observation.bodySite"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Observed body part
            <br/>
            <a href="valueset-body-site.html" title="Codes describing anatomical locations. May include laterality.">SNOMED CT Body Structures</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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          CYII=)">
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            <span title="Observation.method : Indicates the mechanism used to perform the observation.">method</span>
            <a name="Observation.method"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">How it was done
            <br/>
            <a href="valueset-observation-methods.html" title="Methods for simple observations.">Observation Methods</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

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            <span title="Observation.specimen : The specimen that was used when this observation was made.">specimen</span>
            <a name="Observation.specimen"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="specimen.html">Specimen</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Specimen used for this observation</td>
        </tr>

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            <span title="Observation.device : The device used to generate the observation data.">device</span>
            <a name="Observation.device"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="device.html">Device</a> | 
            <a href="devicemetric.html">DeviceMetric</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">(Measurement) Device</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <span title="Observation.referenceRange : Guidance on how to interpret the value by comparison to a
             normal or recommended range.">referenceRange</span>
            <a name="Observation.referenceRange"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Provides guide for interpretation
            <br/>
            <span style="font-style: italic" title="obs-3">Must have at least a low or a high or text</span>
          </td>
        </tr>

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            <span title="Observation.referenceRange.low : The value of the low bound of the reference range.  The
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             is &gt;=5 - &lt;=9).   If the low bound is omitted,  it is assumed to be meaningless (e.g.
             reference range is &lt;=2.3).">low</span>
            <a name="Observation.referenceRange.low"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a>
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        </tr>

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            <span title="Observation.referenceRange.high : The value of the high bound of the reference range.
              The high bound of the reference range endpoint is inclusive of the value (e.g.  reference
             range is &gt;=5 - &lt;=9).   If the high bound is omitted,  it is assumed to be meaningless
             (e.g. reference range is &gt;= 2.3).">high</span>
            <a name="Observation.referenceRange.high"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">High Range, if relevant</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <span title="Observation.referenceRange.meaning : Code for the meaning of the reference range.">meaning</span>
            <a name="Observation.referenceRange.meaning"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Indicates the meaning/use of this range of this range
            <br/>
            <a href="valueset-referencerange-meaning.html" title="Code for the meaning of a reference range.">Observation Reference Range Meaning Codes</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            <span title="Observation.referenceRange.age : The age at which this reference range is applicable.
             This is a neonatal age (e.g. number of weeks at term) if the meaning says so.">age</span>
            <a name="Observation.referenceRange.age"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Range">Range</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Applicable age range, if relevant</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW
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            8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> 
            <span title="Observation.referenceRange.text : Text based reference range in an observation which may
             be used when a quantitative range is not appropriate for an observation.  An example would
             be a reference value of &quot;Negative&quot; or a list or table of 'normals'.">text</span>
            <a name="Observation.referenceRange.text"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#string">string</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Text based reference range in an observation</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            <span title="Observation.related : A  reference to another resource (usually another Observation but
             could  also be a QuestionnaireAnswer) whose relationship is defined by the relationship
             type code.">related</span>
            <a name="Observation.related"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Resource related to this observation</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW
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            <span title="Observation.related.type : A code specifying the kind of relationship that exists with
             the target resource.">type</span>
            <a name="Observation.related.type"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
            <br/>
            <a href="valueset-observation-relationshiptypes.html" title="Codes specifying how two observations are related.">ObservationRelationshipType</a> (
            <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value
             set.">Required</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            <span title="Observation.related.target : A reference to the observation or [[[QuestionnaireResponse]]]
             resource that is related to this observation.">target</span>
            <a name="Observation.related.target"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="observation.html">Observation</a> | 
            <a href="questionnaireresponse.html">QuestionnaireResponse</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Resource that is related to this one</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <span title="Observation.component : Some observations have multiple component observations.  These
             component observations are expressed as separate code value pairs that share the same
             attributes.  Examples include systolic and diastolic component observations for blood
             pressure measurement and multiple component observations for genetics observations.">component</span>
            <a name="Observation.component"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Component results</td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
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            <span title="Observation.component.code : Describes what was observed. Sometimes this is called the
             observation &quot;code&quot;.">code</span>
            <a name="Observation.component.code"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is included in summaries">Σ </span>
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Type of component observation (code / type)
            <br/>
            <a href="valueset-observation-codes.html" title="Codes identifying names of simple observations.">LOINC Codes</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

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            <span title="Observation.component.value[x] : The information determined as a result of making the
             observation, if the information has a simple value.">value[x]</span>
            <a name="Observation.component.value_x_"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Actual component result</td>
        </tr>

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            <span title="A measured amount (or an amount that can potentially be measured). Note that measured
             amounts include amounts that are not precisely quantified, including amounts involving
             arbitrary units and floating currencies.">valueQuantity</span>
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            <a href="datatypes.html#time">time</a>
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            f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ
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            WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI
            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> 
            <span title="Observation.component.dataAbsentReason : Provides a reason why the expected value in the
             element Observation.value[x] is missing.">dataAbsentReason</span>
            <a name="Observation.component.dataAbsentReason"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <span title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Why the component result is missing
            <br/>
            <a href="valueset-observation-valueabsentreason.html" title="Codes specifying why the result (Observation.value[x]) is missing.">Observation Value Absent Reason</a> (
            <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value
             set if any of the codes within the value set can apply to the concept being communicated.
              If the value set does not cover the concept (based on human review), alternate codings
             (or, data type allowing, text) may be included instead.">Extensible</a>)
          </td>
        </tr>

        <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
           white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA
          YAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkRjgNAAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/>
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY
            FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/>
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABGdBTUEAAK/INwWK6QAAABl0RVh0U
            29mdHdhcmUAQWRvYmUgSW1hZ2VSZWFkeXHJZTwAAAKjSURBVDjLrZLdT1JhHMfd6q6L7voT3NrEuQq6aTircWFQ04u4MetCZ4UXGY
            2J1UoMdCoWxMZWDWtrrqHgylZ54RbkZtkiJ5aAku8MXXqQl3PgAOfb8xwq5LrOzmfnd34vn+d5tqcMQNm/UPZfBMHXx2ZWvI386od
            Le7jIL7w5EQ68qjhEOFjCmMj+v4LQmCwtCHkSCuSlFOIst4X1KU1mbUqT/kPki57bmL6xEnx55HxRMCqNCTkO6fUBpH5YkFoeBLsy
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            Njx9WDTowW7+YmsGv+9Ov3GijsgxwsNy7iiYOg4L54/nyawQC4lDubYANIRG7g1I9glHVILl5EMNCCXnEfouXSP4JksI+RY5OIfkW
            XGwf8cQSb6hAz2gV2+BXaxFangBSS/n0PCfxq5xAxCg3sFj2TpPB8Hvz2G3dWneOvqhLnPCIfDgd5uPebfNyAyrUR/t1bMmft7MdR
            1NiuXyw8UBDYpJ/AMkhsOPLa2wmKxIBqNIhwOw+Px4EG/Hvb7GoSCc2JucnJS7FEqlb2FizRwNMLHFmPvXnQJN/U6+Px+3LvdApVK
            iebmZlitVuj1ejFWqc7AZNCJEq1WGxMFAVPFtUCPZKhDXZUyGu6IAr+pklOclGNiYgI+nw9erxculws0N2uqjFOBwWDgSu61RCK50
            tLSwlBBfX39eE1NDa9QKFBXVydCY5qjNSqgvSWCw+RRqVTzZrOZcTqd2263G3a7HW1tbWhvbxdjmqM12kN7SwTl5eX7qqurq2pra5
            eampqSGo2GI2TUanUj4RSJ4zRHa7SH9v4C8Nrl+GFh7LoAAAAASUVORK5CYII=" style="background-color: white; background-color: inherit" title="Reference to another Element"/> 
            <span title="Observation.component.referenceRange : Guidance on how to interpret the value by comparison
             to a normal or recommended range.">referenceRange</span>
            <a name="Observation.component.referenceRange"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">see 
            <a href="#Observation.referenceRange" title="Observation.referenceRange">referenceRange</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Provides guide for interpretation of component result</td>
        </tr>

        <tr>
          <td class="hierarchy" colspan="5">
            <br/>
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/> Documentation for this format
            </a>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3"/>
  </extension>
  <url value="http://hl7.org/fhir/StructureDefinition/Observation"/>
  <name value="Observation"/>
  <status value="draft"/>
  <publisher value="Health Level Seven International (Orders and Observations)"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://www.hl7.org/Special/committees/orders/index.cfm"/>
    </telecom>
  </contact>
  <date value="2016-03-31T08:01:25+11:00"/>
  <description value="Base StructureDefinition for Observation Resource"/>
  <requirements value="Observations are a key aspect of healthcare.  This resource is used to capture those that
   do not require more sophisticated mechanisms."/>
  <fhirVersion value="1.4.0"/>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <baseType value="DomainResource"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
  <derivation value="specialization"/>
  <snapshot>
    <element>
      <path value="Observation"/>
      <short value="Measurements and simple assertions"/>
      <definition value="Measurements and simple assertions made about a patient, device or other subject."/>
      <comments value="Used for simple observations such as device measurements, laboratory atomic results, vital
       signs, height, weight, smoking status, comments, etc.  Other resources are used to provide
       context for observations such as lab reports, etc."/>
      <alias value="Vital Signs"/>
      <alias value="Measurement"/>
      <alias value="Results"/>
      <alias value="Tests"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="DomainResource"/>
      </type>
      <constraint>
        <key value="obs-6"/>
        <severity value="error"/>
        <human value="dataAbsentReason SHALL only be present if Observation.value[x] is not present"/>
        <expression value="dataAbsentReason.empty() or value.empty()"/>
        <xpath value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))"/>
      </constraint>
      <constraint>
        <key value="obs-7"/>
        <severity value="error"/>
        <human value="Component code SHALL not be same as observation code"/>
        <expression value="component.where(code = $context.code).empty()"/>
        <xpath value="not(exists(f:component/f:code)) or count(for $coding in f:code/f:coding return parent::*/f:component
        /f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0"/>
      </constraint>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.diagnostics"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Observation.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Observation.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Observation.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="A human language."/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="Observation.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/>
      <comments value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.extension"/>
      <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 resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments 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="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order to make the use
       of extensions safe and manageable, there is a strict set of governance applied to the
       definition and use of extensions. Though any implementer is allowed to define an extension,
       there is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions."/>
      <comments 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="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.identifier"/>
      <short value="Unique Id for this particular observation"/>
      <definition value="A unique identifier for the simple observation instance."/>
      <requirements value="Allows observations to be distinguished and referenced."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="default: final"/>
      </extension>
      <path value="Observation.status"/>
      <short value="registered | preliminary | final | amended +"/>
      <definition value="The status of the result value."/>
      <requirements value="Need to track the status of individual results. Some results are finalized before the
       whole report is finalized."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="Codes providing the status of an observation."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="status  Amended &amp; Final are differentiated by whether it is the subject of a ControlAct
         event with a type of &quot;revise&quot;"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.category"/>
      <short value="Classification of  type of observation"/>
      <definition value="A code that classifies the general type of observation being made.  This is used  for
       searching, sorting and display purposes."/>
      <comments value="The level of granularity is defined by the category concepts in the value set.   More
       fine-grained filtering can be performed using the metadata and/or terminology hierarchy
       in Observation.code."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Codes for high level observation categories ."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quo
        t;].code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.code"/>
      <short value="Type of observation (code / type)"/>
      <definition value="Describes what was observed. Sometimes this is called the observation &quot;name&quot;."/>
      <requirements value="Knowing what kind of observation is being made is essential to understanding the observation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes identifying names of simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.subject"/>
      <short value="Who and/or what this is about"/>
      <definition value="The patient, or group of patients, location, or device whose characteristics (direct or
       indirect) are described by the observation and into whose record the observation is placed.
        Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer
       (for example a relative or EMT), or any observation made about the subject."/>
      <comments value="One would expect this element to be a cardinality  of 1..1.  The only circumstance in
       which the subject can be missing is when the observation is made by a device that does
       not know the patient. In this case, the observation SHALL be matched to a patient through
       some context/channel matching technique, and at this point, the observation should be
       updated.  If the target of the observation is different than the subject, the general
       extension [observation-focal-subject](extension-observation-focal-subject.html).  may
       be used.  However, the distinction between the patient's own value for an observation
       versus that of the fetus, or the donor or blood product unit, etc., are often specified
       in the observation code."/>
      <requirements value="Observations have no value if you don't know who or what they're about."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.encounter"/>
      <short value="Healthcare event during which this observation is made"/>
      <definition value="The healthcare event  (e.g. a patient and healthcare provider interaction) during which
       this observation is made."/>
      <requirements value="For some observations it may be important to know the link between an observation and
       a particular encounter."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="PV1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.effective[x]"/>
      <short value="Clinically relevant time/time-period for observation"/>
      <definition value="The time or time-period the observed value is asserted as being true. For biological subjects
       - e.g. human patients - this is usually called the &quot;physiologically relevant time&quot;.
       This is usually either the time of the procedure or of specimen collection, but very often
       the source of the date/time is not known, only the date/time itself."/>
      <comments value="At least a date should be present unless this observation is a historical report."/>
      <requirements value="Knowing when an observation was deemed true is important to its relevance as well as determining
       trends."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.issued"/>
      <short value="Date/Time this was made available"/>
      <definition value="The date and time this observation was made available to providers, typically after the
       results have been reviewed and verified."/>
      <comments value="Updated when the result is updated."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="instant"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.performer"/>
      <short value="Who is responsible for the observation"/>
      <definition value="Who was responsible for asserting the observed value as &quot;true&quot;."/>
      <requirements value="May give a degree of confidence in the observation and also indicates where follow-up
       questions should be directed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP'
         / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=PRF]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.value[x]"/>
      <short value="Actual result"/>
      <definition value="The information determined as a result of making the observation, if the information has
       a simple value."/>
      <comments value="Normally, an observation will have either a value or a set of related observations. A
       few observations (e.g. Apgar score) may have both a value and related observations (for
       an Apgar score, the observations from which the measure is derived). If a value is present,
       the datatype for this element should be determined by Observation.code. This element has
       a variable name depending on the type as follows: valueQuantity, valueCodeableConcept,
       valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime,
       or valuePeriod. (The name format is &quot;'value' + the type name&quot; with a capital
       on the first letter of the type).   If the data element is usually coded or if the type
       associated with the Observation.value defines a coded value, use CodeableConcept instead
       of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConc
      ept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version
       2 Table 0136](v2/0136/index.html). These &quot;yes/no&quot; concepts can be mapped to
       the display name &quot;true/false&quot; or other mutually exclusive terms that may be
       needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4)
       below."/>
      <requirements value="An observation exists to have a value, though it may not if it is in error, or it represents
       a group of observations."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.2, OBX.5, OBX.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.dataAbsentReason"/>
      <short value="Why the result is missing"/>
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing."/>
      <comments value="Null or exceptional values can be represented two ways in FHIR Observations.  One way
       is to simply include them in the value set and represent the exceptions in the value.
        For example, measurement values for a serology test could be  &quot;detected&quot;, &quot;not
       detected&quot;, &quot;inconclusive&quot;, or  &quot;specimen unsatisfactory&quot;.   The
       alternate way is to use the value element for actual observations and use the explicit
       dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason
       code &quot;error&quot; could be used when the measurement was not completed.  Because
       of these options, use-case agreements are required to interpret general observations for
       exceptional values."/>
      <requirements value="For many results it is necessary to handle exceptional values in measurements."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="obs-6"/>
      <binding>
        <strength value="extensible"/>
        <description value="Codes specifying why the result (Observation.value[x]) is missing."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value.nullFlavor"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.interpretation"/>
      <short value="High, low, normal, etc."/>
      <definition value="The assessment made based on the result of the observation.  Intended as a simple compact
       code often placed adjacent to the result value in reports and flow sheets to signal the
       meaning/normalcy status of the result. Otherwise known as abnormal flag."/>
      <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully
       understand the significance of a result."/>
      <alias value="Abnormal Flag"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <description value="Codes identifying interpretations of observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.comment"/>
      <short value="Comments about result"/>
      <definition value="May include statements about significant, unexpected or unreliable values, or information
       about the source of the value where this may be relevant to the interpretation of the
       result."/>
      <requirements value="Need to be able to provide free text additional information."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="subjectOf.observationEvent[code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.bodySite"/>
      <short value="Observed body part"/>
      <definition value="Indicates the site on the subject's body where the observation was made (i.e. the target
       site)."/>
      <comments value="Only used if not implicit in code found in Observation.code.  If the use case requires
       BodySite to be handled as a separate resource instead of an inline coded element (e.g.
       to identify and track separately) then use the standard extension[ body-site-instance](extension-bod
      y-site-instance.html)."/>
      <requirements value="Knowing where the observation is made is important for tracking if multiple sites are
       possible."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Codes describing anatomical locations. May include laterality."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="targetSiteCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.method"/>
      <short value="How it was done"/>
      <definition value="Indicates the mechanism used to perform the observation."/>
      <comments value="Only used if not implicit in code for Observation.code."/>
      <requirements value="In some cases, method can impact results and is thus used for determining whether results
       can be compared or determining significance of results."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Methods for simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-methods"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-17"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="methodCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.specimen"/>
      <short value="Specimen used for this observation"/>
      <definition value="The specimen that was used when this observation was made."/>
      <comments value="Observations are not made on specimens themselves; they are made on a subject, but usually
       by the means of a specimen. Note that although specimens are often involved, they are
       not always tracked and reported explicitly. Also note that observation resources may be
       used in contexts that track the specimen explicitly (e.g. Diagnostic Report)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Specimen"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="SPM segment"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SPC].specimen"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.device"/>
      <short value="(Measurement) Device"/>
      <definition value="The device used to generate the observation data."/>
      <comments value="An extension should be used if further typing of the device is needed.  Devices used to
       support obtaining an observation can be represented using either extension or through
       the Observation.related element."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-17 / PRT -10"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=DEV]"/>
      </mapping>
    </element>
    <element id="referenceRange">
      <path value="Observation.referenceRange"/>
      <short value="Provides guide for interpretation"/>
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
      <comments value="Most observations only have one generic reference range. Systems MAY choose to restrict
       to only supplying the relevant reference range based on knowledge about the patient (e.g.
       specific to the patient's age, gender, weight and other factors), but this may not be
       possible or appropriate. Whenever more than one reference range is supplied, the differences
       between them SHOULD be provided in the reference range and/or age properties."/>
      <requirements value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance
       of a particular result. Need to be able to provide multiple reference ranges for different
       contexts."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="obs-3"/>
        <severity value="error"/>
        <human value="Must have at least a low or a high or text"/>
        <expression value="low or high or text"/>
        <xpath value="(exists(f:low) or exists(f:high)or exists(f:text))"/>
      </constraint>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.extension"/>
      <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. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments 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>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments 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"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.low"/>
      <short value="Low Range, if relevant"/>
      <definition value="The value of the low bound of the reference range.  The low bound of the reference range
       endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the
       low bound is omitted,  it is assumed to be meaningless (e.g. reference range is &lt;=2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <condition value="obs-3"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.low"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.high"/>
      <short value="High Range, if relevant"/>
      <definition value="The value of the high bound of the reference range.  The high bound of the reference range
       endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the
       high bound is omitted,  it is assumed to be meaningless (e.g. reference range is &gt;=
       2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <condition value="obs-3"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.high"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.meaning"/>
      <short value="Indicates the meaning/use of this range of this range"/>
      <definition value="Code for the meaning of the reference range."/>
      <comments value="This SHOULD be populated if there is more than one range."/>
      <requirements value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic,
       or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Code for the meaning of a reference range."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-10?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.age"/>
      <short value="Applicable age range, if relevant"/>
      <definition value="The age at which this reference range is applicable. This is a neonatal age (e.g. number
       of weeks at term) if the meaning says so."/>
      <requirements value="Some analytes vary greatly over age."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Range"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.text"/>
      <short value="Text based reference range in an observation"/>
      <definition value="Text based reference range in an observation which may be used when a quantitative range
       is not appropriate for an observation.  An example would be a reference value of &quot;Negative&quot
      ; or a list or table of 'normals'."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:ST"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related"/>
      <short value="Resource related to this observation"/>
      <definition value="A  reference to another resource (usually another Observation but could  also be a QuestionnaireAnsw
      er) whose relationship is defined by the relationship type code."/>
      <comments value="For a discussion on the ways Observations can assembled in groups together see [Notes
       below](observation.html#4.20.4)."/>
      <requirements value="Normally, an observation will have either a value or a set of related observations. A
       few observations (e.g. Apgar score) may have both a value and a set of related observations
       or sometimes QuestionnaireResponse  from which the measure is derived."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Relationships established by OBX-4 usage"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outBoundRelationship"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.extension"/>
      <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. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments 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>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments 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"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.type"/>
      <short value="has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by"/>
      <definition value="A code specifying the kind of relationship that exists with the target resource."/>
      <comments value="&quot;derived-from&quot; is only logical choice when referencing QuestionnaireAnswer resource."/>
      <requirements value="A relationship type SHOULD be provided."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="Codes specifying how two observations are related."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-relationshiptypes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".typeCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.target"/>
      <short value="Resource that is related to this one"/>
      <definition value="A reference to the observation or [[[QuestionnaireResponse]]] resource that is related
       to this observation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".targetObservation"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component"/>
      <short value="Component results"/>
      <definition value="Some observations have multiple component observations.  These component observations
       are expressed as separate code value pairs that share the same attributes.  Examples include
       systolic and diastolic component observations for blood pressure measurement and multiple
       component observations for genetics observations."/>
      <comments value="For a discussion on the ways Observations can assembled in groups together see [Notes
       below](observation.html#4.20.4)."/>
      <requirements value="Component observations share the same attributes in the Observation resource as the primary
       observation and are always treated a part of a single observation (they are not separable).
         However, the reference range for the primary observation value is not inherited by the
       component values and is required when appropriate for each component observation."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="containment by OBX-4?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outBoundRelationship[typeCode=COMP]"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.extension"/>
      <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. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments 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>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments 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"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.code"/>
      <short value="Type of component observation (code / type)"/>
      <definition value="Describes what was observed. Sometimes this is called the observation &quot;code&quot;."/>
      <requirements value="Knowing what kind of observation is being made is essential to understanding the observation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="obs-7"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes identifying names of simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.value[x]"/>
      <short value="Actual component result"/>
      <definition value="The information determined as a result of making the observation, if the information has
       a simple value."/>
      <comments value="Normally, an observation will have either a value or a set of related observations. A
       few observations (e.g. Apgar score) may have both a value and related observations (for
       an Apgar score, the observations from which the measure is derived). If a value is present,
       the datatype for this element should be determined by Observation.code. A CodeableConcept
       with just a text would be used instead of a string if the field was usually coded, or
       if the type associated with the Observation.code defines a coded value.   For boolean
       values use valueCodeableConcept and select codes from &lt;http://hl7.org/fhir/ValueSet/v2-0136&gt;
       (These &quot;yes/no&quot; concepts can be mapped to the display name &quot;true/false&quot;
       or other mutually exclusive terms that may be needed&quot;).  The element, Observation.value[x],
       has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept,
       valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format
       is &quot;'value' + the type name&quot; with a capital on the first letter of the type)."/>
      <requirements value="An observation exists to have a value, though it may not if it is in error, or it represents
       a group of observations."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.2, OBX.5, OBX.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.dataAbsentReason"/>
      <short value="Why the component result is missing"/>
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing."/>
      <comments value="&quot;Null&quot; or exceptional values can be represented two ways in FHIR Observations.
        One way is to simply include them in the value set and represent the exceptions in the
       value.  For example, measurement values for a serology test could be  &quot;detected&quot;,
       &quot;not detected&quot;, &quot;inconclusive&quot;, or  &quot;test not done&quot;.   The
       alternate way is to use the value element for actual observations and use the explicit
       dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason
       code &quot;error&quot; could be used when the measurement was not completed.  Because
       of these options, use-case agreements are required to interpret general observations for
       exceptional values."/>
      <requirements value="For many results it is necessary to handle exceptional values in measurements."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="obs-6"/>
      <binding>
        <strength value="extensible"/>
        <description value="Codes specifying why the result (Observation.value[x]) is missing."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value.nullFlavor"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.referenceRange"/>
      <short value="Provides guide for interpretation of component result"/>
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
      <comments value="Most observations only have one generic reference range. Systems MAY choose to restrict
       to only supplying the relevant reference range based on knowledge about the patient (e.g.
       specific to the patient's age, gender, weight and other factors), but this may not be
       possible or appropriate. Whenever more than one reference range is supplied, the differences
       between them SHOULD be provided in the reference range and/or age properties."/>
      <requirements value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance
       of a particular result. Need to be able to provide multiple reference ranges for different
       contexts."/>
      <min value="0"/>
      <max value="*"/>
      <contentReference value="#referenceRange"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Observation"/>
      <short value="Measurements and simple assertions"/>
      <definition value="Measurements and simple assertions made about a patient, device or other subject."/>
      <comments value="Used for simple observations such as device measurements, laboratory atomic results, vital
       signs, height, weight, smoking status, comments, etc.  Other resources are used to provide
       context for observations such as lab reports, etc."/>
      <alias value="Vital Signs"/>
      <alias value="Measurement"/>
      <alias value="Results"/>
      <alias value="Tests"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="DomainResource"/>
      </type>
      <constraint>
        <key value="obs-6"/>
        <severity value="error"/>
        <human value="dataAbsentReason SHALL only be present if Observation.value[x] is not present"/>
        <expression value="dataAbsentReason.empty() or value.empty()"/>
        <xpath value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))"/>
      </constraint>
      <constraint>
        <key value="obs-7"/>
        <severity value="error"/>
        <human value="Component code SHALL not be same as observation code"/>
        <expression value="component.where(code = $context.code).empty()"/>
        <xpath value="not(exists(f:component/f:code)) or count(for $coding in f:code/f:coding return parent::*/f:component
        /f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0"/>
      </constraint>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.diagnostics"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.identifier"/>
      <short value="Unique Id for this particular observation"/>
      <definition value="A unique identifier for the simple observation instance."/>
      <requirements value="Allows observations to be distinguished and referenced."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="default: final"/>
      </extension>
      <path value="Observation.status"/>
      <short value="registered | preliminary | final | amended +"/>
      <definition value="The status of the result value."/>
      <requirements value="Need to track the status of individual results. Some results are finalized before the
       whole report is finalized."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="Codes providing the status of an observation."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="status  Amended &amp; Final are differentiated by whether it is the subject of a ControlAct
         event with a type of &quot;revise&quot;"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.category"/>
      <short value="Classification of  type of observation"/>
      <definition value="A code that classifies the general type of observation being made.  This is used  for
       searching, sorting and display purposes."/>
      <comments value="The level of granularity is defined by the category concepts in the value set.   More
       fine-grained filtering can be performed using the metadata and/or terminology hierarchy
       in Observation.code."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Codes for high level observation categories ."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quo
        t;].code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.code"/>
      <short value="Type of observation (code / type)"/>
      <definition value="Describes what was observed. Sometimes this is called the observation &quot;name&quot;."/>
      <requirements value="Knowing what kind of observation is being made is essential to understanding the observation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes identifying names of simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.subject"/>
      <short value="Who and/or what this is about"/>
      <definition value="The patient, or group of patients, location, or device whose characteristics (direct or
       indirect) are described by the observation and into whose record the observation is placed.
        Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer
       (for example a relative or EMT), or any observation made about the subject."/>
      <comments value="One would expect this element to be a cardinality  of 1..1.  The only circumstance in
       which the subject can be missing is when the observation is made by a device that does
       not know the patient. In this case, the observation SHALL be matched to a patient through
       some context/channel matching technique, and at this point, the observation should be
       updated.  If the target of the observation is different than the subject, the general
       extension [observation-focal-subject](extension-observation-focal-subject.html).  may
       be used.  However, the distinction between the patient's own value for an observation
       versus that of the fetus, or the donor or blood product unit, etc., are often specified
       in the observation code."/>
      <requirements value="Observations have no value if you don't know who or what they're about."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.encounter"/>
      <short value="Healthcare event during which this observation is made"/>
      <definition value="The healthcare event  (e.g. a patient and healthcare provider interaction) during which
       this observation is made."/>
      <requirements value="For some observations it may be important to know the link between an observation and
       a particular encounter."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="PV1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.effective[x]"/>
      <short value="Clinically relevant time/time-period for observation"/>
      <definition value="The time or time-period the observed value is asserted as being true. For biological subjects
       - e.g. human patients - this is usually called the &quot;physiologically relevant time&quot;.
       This is usually either the time of the procedure or of specimen collection, but very often
       the source of the date/time is not known, only the date/time itself."/>
      <comments value="At least a date should be present unless this observation is a historical report."/>
      <requirements value="Knowing when an observation was deemed true is important to its relevance as well as determining
       trends."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.issued"/>
      <short value="Date/Time this was made available"/>
      <definition value="The date and time this observation was made available to providers, typically after the
       results have been reviewed and verified."/>
      <comments value="Updated when the result is updated."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="instant"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.performer"/>
      <short value="Who is responsible for the observation"/>
      <definition value="Who was responsible for asserting the observed value as &quot;true&quot;."/>
      <requirements value="May give a degree of confidence in the observation and also indicates where follow-up
       questions should be directed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP'
         / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=PRF]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.value[x]"/>
      <short value="Actual result"/>
      <definition value="The information determined as a result of making the observation, if the information has
       a simple value."/>
      <comments value="Normally, an observation will have either a value or a set of related observations. A
       few observations (e.g. Apgar score) may have both a value and related observations (for
       an Apgar score, the observations from which the measure is derived). If a value is present,
       the datatype for this element should be determined by Observation.code. This element has
       a variable name depending on the type as follows: valueQuantity, valueCodeableConcept,
       valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime,
       or valuePeriod. (The name format is &quot;'value' + the type name&quot; with a capital
       on the first letter of the type).   If the data element is usually coded or if the type
       associated with the Observation.value defines a coded value, use CodeableConcept instead
       of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConc
      ept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version
       2 Table 0136](v2/0136/index.html). These &quot;yes/no&quot; concepts can be mapped to
       the display name &quot;true/false&quot; or other mutually exclusive terms that may be
       needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4)
       below."/>
      <requirements value="An observation exists to have a value, though it may not if it is in error, or it represents
       a group of observations."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.2, OBX.5, OBX.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.dataAbsentReason"/>
      <short value="Why the result is missing"/>
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing."/>
      <comments value="Null or exceptional values can be represented two ways in FHIR Observations.  One way
       is to simply include them in the value set and represent the exceptions in the value.
        For example, measurement values for a serology test could be  &quot;detected&quot;, &quot;not
       detected&quot;, &quot;inconclusive&quot;, or  &quot;specimen unsatisfactory&quot;.   The
       alternate way is to use the value element for actual observations and use the explicit
       dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason
       code &quot;error&quot; could be used when the measurement was not completed.  Because
       of these options, use-case agreements are required to interpret general observations for
       exceptional values."/>
      <requirements value="For many results it is necessary to handle exceptional values in measurements."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="obs-6"/>
      <binding>
        <strength value="extensible"/>
        <description value="Codes specifying why the result (Observation.value[x]) is missing."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value.nullFlavor"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.interpretation"/>
      <short value="High, low, normal, etc."/>
      <definition value="The assessment made based on the result of the observation.  Intended as a simple compact
       code often placed adjacent to the result value in reports and flow sheets to signal the
       meaning/normalcy status of the result. Otherwise known as abnormal flag."/>
      <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully
       understand the significance of a result."/>
      <alias value="Abnormal Flag"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <description value="Codes identifying interpretations of observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.comment"/>
      <short value="Comments about result"/>
      <definition value="May include statements about significant, unexpected or unreliable values, or information
       about the source of the value where this may be relevant to the interpretation of the
       result."/>
      <requirements value="Need to be able to provide free text additional information."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="subjectOf.observationEvent[code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.bodySite"/>
      <short value="Observed body part"/>
      <definition value="Indicates the site on the subject's body where the observation was made (i.e. the target
       site)."/>
      <comments value="Only used if not implicit in code found in Observation.code.  If the use case requires
       BodySite to be handled as a separate resource instead of an inline coded element (e.g.
       to identify and track separately) then use the standard extension[ body-site-instance](extension-bod
      y-site-instance.html)."/>
      <requirements value="Knowing where the observation is made is important for tracking if multiple sites are
       possible."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Codes describing anatomical locations. May include laterality."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="targetSiteCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.method"/>
      <short value="How it was done"/>
      <definition value="Indicates the mechanism used to perform the observation."/>
      <comments value="Only used if not implicit in code for Observation.code."/>
      <requirements value="In some cases, method can impact results and is thus used for determining whether results
       can be compared or determining significance of results."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Methods for simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-methods"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-17"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="methodCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.specimen"/>
      <short value="Specimen used for this observation"/>
      <definition value="The specimen that was used when this observation was made."/>
      <comments value="Observations are not made on specimens themselves; they are made on a subject, but usually
       by the means of a specimen. Note that although specimens are often involved, they are
       not always tracked and reported explicitly. Also note that observation resources may be
       used in contexts that track the specimen explicitly (e.g. Diagnostic Report)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Specimen"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="SPM segment"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SPC].specimen"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.device"/>
      <short value="(Measurement) Device"/>
      <definition value="The device used to generate the observation data."/>
      <comments value="An extension should be used if further typing of the device is needed.  Devices used to
       support obtaining an observation can be represented using either extension or through
       the Observation.related element."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-17 / PRT -10"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=DEV]"/>
      </mapping>
    </element>
    <element id="referenceRange">
      <path value="Observation.referenceRange"/>
      <short value="Provides guide for interpretation"/>
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
      <comments value="Most observations only have one generic reference range. Systems MAY choose to restrict
       to only supplying the relevant reference range based on knowledge about the patient (e.g.
       specific to the patient's age, gender, weight and other factors), but this may not be
       possible or appropriate. Whenever more than one reference range is supplied, the differences
       between them SHOULD be provided in the reference range and/or age properties."/>
      <requirements value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance
       of a particular result. Need to be able to provide multiple reference ranges for different
       contexts."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="obs-3"/>
        <severity value="error"/>
        <human value="Must have at least a low or a high or text"/>
        <expression value="low or high or text"/>
        <xpath value="(exists(f:low) or exists(f:high)or exists(f:text))"/>
      </constraint>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.low"/>
      <short value="Low Range, if relevant"/>
      <definition value="The value of the low bound of the reference range.  The low bound of the reference range
       endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the
       low bound is omitted,  it is assumed to be meaningless (e.g. reference range is &lt;=2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <condition value="obs-3"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.low"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.high"/>
      <short value="High Range, if relevant"/>
      <definition value="The value of the high bound of the reference range.  The high bound of the reference range
       endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the
       high bound is omitted,  it is assumed to be meaningless (e.g. reference range is &gt;=
       2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <condition value="obs-3"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.high"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.meaning"/>
      <short value="Indicates the meaning/use of this range of this range"/>
      <definition value="Code for the meaning of the reference range."/>
      <comments value="This SHOULD be populated if there is more than one range."/>
      <requirements value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic,
       or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Code for the meaning of a reference range."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-10?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.age"/>
      <short value="Applicable age range, if relevant"/>
      <definition value="The age at which this reference range is applicable. This is a neonatal age (e.g. number
       of weeks at term) if the meaning says so."/>
      <requirements value="Some analytes vary greatly over age."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Range"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.text"/>
      <short value="Text based reference range in an observation"/>
      <definition value="Text based reference range in an observation which may be used when a quantitative range
       is not appropriate for an observation.  An example would be a reference value of &quot;Negative&quot
      ; or a list or table of 'normals'."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:ST"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related"/>
      <short value="Resource related to this observation"/>
      <definition value="A  reference to another resource (usually another Observation but could  also be a QuestionnaireAnsw
      er) whose relationship is defined by the relationship type code."/>
      <comments value="For a discussion on the ways Observations can assembled in groups together see [Notes
       below](observation.html#4.20.4)."/>
      <requirements value="Normally, an observation will have either a value or a set of related observations. A
       few observations (e.g. Apgar score) may have both a value and a set of related observations
       or sometimes QuestionnaireResponse  from which the measure is derived."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Relationships established by OBX-4 usage"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outBoundRelationship"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.type"/>
      <short value="has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by"/>
      <definition value="A code specifying the kind of relationship that exists with the target resource."/>
      <comments value="&quot;derived-from&quot; is only logical choice when referencing QuestionnaireAnswer resource."/>
      <requirements value="A relationship type SHOULD be provided."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="Codes specifying how two observations are related."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-relationshiptypes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".typeCode"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.related.target"/>
      <short value="Resource that is related to this one"/>
      <definition value="A reference to the observation or [[[QuestionnaireResponse]]] resource that is related
       to this observation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".targetObservation"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component"/>
      <short value="Component results"/>
      <definition value="Some observations have multiple component observations.  These component observations
       are expressed as separate code value pairs that share the same attributes.  Examples include
       systolic and diastolic component observations for blood pressure measurement and multiple
       component observations for genetics observations."/>
      <comments value="For a discussion on the ways Observations can assembled in groups together see [Notes
       below](observation.html#4.20.4)."/>
      <requirements value="Component observations share the same attributes in the Observation resource as the primary
       observation and are always treated a part of a single observation (they are not separable).
         However, the reference range for the primary observation value is not inherited by the
       component values and is required when appropriate for each component observation."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="containment by OBX-4?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outBoundRelationship[typeCode=COMP]"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.code"/>
      <short value="Type of component observation (code / type)"/>
      <definition value="Describes what was observed. Sometimes this is called the observation &quot;code&quot;."/>
      <requirements value="Knowing what kind of observation is being made is essential to understanding the observation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="obs-7"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes identifying names of simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.value[x]"/>
      <short value="Actual component result"/>
      <definition value="The information determined as a result of making the observation, if the information has
       a simple value."/>
      <comments value="Normally, an observation will have either a value or a set of related observations. A
       few observations (e.g. Apgar score) may have both a value and related observations (for
       an Apgar score, the observations from which the measure is derived). If a value is present,
       the datatype for this element should be determined by Observation.code. A CodeableConcept
       with just a text would be used instead of a string if the field was usually coded, or
       if the type associated with the Observation.code defines a coded value.   For boolean
       values use valueCodeableConcept and select codes from &lt;http://hl7.org/fhir/ValueSet/v2-0136&gt;
       (These &quot;yes/no&quot; concepts can be mapped to the display name &quot;true/false&quot;
       or other mutually exclusive terms that may be needed&quot;).  The element, Observation.value[x],
       has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept,
       valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format
       is &quot;'value' + the type name&quot; with a capital on the first letter of the type)."/>
      <requirements value="An observation exists to have a value, though it may not if it is in error, or it represents
       a group of observations."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.2, OBX.5, OBX.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.dataAbsentReason"/>
      <short value="Why the component result is missing"/>
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing."/>
      <comments value="&quot;Null&quot; or exceptional values can be represented two ways in FHIR Observations.
        One way is to simply include them in the value set and represent the exceptions in the
       value.  For example, measurement values for a serology test could be  &quot;detected&quot;,
       &quot;not detected&quot;, &quot;inconclusive&quot;, or  &quot;test not done&quot;.   The
       alternate way is to use the value element for actual observations and use the explicit
       dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason
       code &quot;error&quot; could be used when the measurement was not completed.  Because
       of these options, use-case agreements are required to interpret general observations for
       exceptional values."/>
      <requirements value="For many results it is necessary to handle exceptional values in measurements."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="obs-6"/>
      <binding>
        <strength value="extensible"/>
        <description value="Codes specifying why the result (Observation.value[x]) is missing."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value.nullFlavor"/>
      </mapping>
    </element>
    <element>
      <path value="Observation.component.referenceRange"/>
      <short value="Provides guide for interpretation of component result"/>
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
      <comments value="Most observations only have one generic reference range. Systems MAY choose to restrict
       to only supplying the relevant reference range based on knowledge about the patient (e.g.
       specific to the patient's age, gender, weight and other factors), but this may not be
       possible or appropriate. Whenever more than one reference range is supplied, the differences
       between them SHOULD be provided in the reference range and/or age properties."/>
      <requirements value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance
       of a particular result. Need to be able to provide multiple reference ranges for different
       contexts."/>
      <min value="0"/>
      <max value="*"/>
      <contentReference value="#referenceRange"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.