StructureDefinition: Example Lipid Profile

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10.3.13.7 StructureDefinition: Example Lipid Profile

Orders and Observations

Work Group

Maturity Level: 0

Trial Use

Use Context: Not yet ready for Production use, Not yet ready for Production use

The canonical URL for this profile is:

http://hl7.org/fhir/StructureDefinition/cholesterol

Describes how the lab report is used for a standard Lipid Profile - Cholesterol, Triglyceride and Cholesterol fractions. Uses LOINC codes

This profile was published on Sat, Feb 21, 2015 00:00+1100 as a draft by Health Level Seven, Inc. - FHIR WG.

10.3.13.7.1 Formal Views of Profile Content

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

Text Summary
Differential View
Full Structure
XML Template
JSON Template
All

This structure is derived from Observation.

Summary

Mandatory: 3 elements (+3 nested mandatory elements)
Must-Support: 9 elements
Fixed Value: 5 elements
Prohibited: 7 elements

This indicates the differences between this profile and the base Observation structure.

Name	Flags	Card.	Type	Description & Constraints
Observation		1..1	Observation	Measurements and simple assertions
code	S	1..1	CodeableConcept	Cholesterol Fixed Value: As shown
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 35200-5
display		1..1	string	Representation defined by the system Fixed Value: Cholesterol [Moles/volume] in Serum or Plasma
valueQuantity	S	0..1	Quantity	Cholesterol value
value	S	0..1	decimal	Actual numerical value
comparator		0..0
unit	S	1..1	string	Unit representation Fixed Value: mmol/L
system	S	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	Coded form of the unit Fixed Value: mmol/L
interpretation	S	0..1	CodeableConcept	+ \| ++ \| +++ \| - \| -- \| ---
note	S	0..*	Annotation	Comments about result
referenceRange	S	1..1	BackboneElement	Provides guide for interpretation
low		0..0
high		1..1	SimpleQuantity	A fixed quantity (no comparator) Fixed Value: As shown
value		1..1	decimal	Numerical value (with implicit precision) Fixed Value: 4.5
type		0..0
appliesTo		0..0
age		0..0
hasMember		0..0
derivedFrom		0..0
Documentation for this format

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observation structure.

Description & Constraints

Observation

1..1

Observation

Measurements and simple assertions

0..1

Logical id of this artifact

category

0..*

CodeableConcept

Classification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.

code

SΣ

1..1

CodeableConcept

Cholesterol
Binding: LOINC Codes (example): Codes identifying names of simple observations.

Fixed Value: As shown

0..0

Unique id for inter-element referencing

extension

0..0

Extension

Additional content defined by implementations

coding

1..1

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..0

Unique id for inter-element referencing

extension

0..0

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://loinc.org

version

0..0

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: 35200-5

display

1..1

string

Representation defined by the system
Fixed Value: Cholesterol [Moles/volume] in Serum or Plasma

userSelected

0..0

boolean

If this coding was chosen directly by the user

text

0..0

string

Plain text representation of the concept

subject

0..1

Who and/or what the observation is about

focus

0..*

Reference(Resource)

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

encounter

0..1

Reference(Encounter)

Healthcare event during which this observation is made

effective[x]

0..1

Clinically relevant time/time-period for observation

effectiveDateTime

effectivePeriod

effectiveTiming

effectiveInstant

issued

0..1

instant

Date/Time this version was made available

performer

0..*

Who is responsible for the observation

Slices for value[x]

ΣC

0..1

Quantity

Actual result
Slice: Unordered, Closed by type:$this

value[x]:valueQuantity

SΣC

0..1

Quantity

Cholesterol value

0..1

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

0..1

decimal

Actual numerical value

unit

SΣ

1..1

string

Unit representation
Fixed Value: mmol/L

system

SΣC

1..1

uri

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

SΣ

1..1

code

Coded form of the unit
Fixed Value: mmol/L

dataAbsentReason

0..1

CodeableConcept

Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

0..1

CodeableConcept

+ | ++ | +++ | - | -- | ---
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

note

0..*

Annotation

Comments about result

bodySite

0..1

CodeableConcept

Observed body part
Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts

bodyStructure

0..1

Reference(BodyStructure)

Observed body structure

method

0..1

CodeableConcept

How it was done
Binding: Observation Methods (example): Methods for simple observations.

specimen

0..1

Reference(Specimen | Group)

Specimen used for this observation

device

0..1

Reference(Device | DeviceMetric)

(Measurement) Device

referenceRange

1..1

BackboneElement

Provides guide for interpretation

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

high

1..1

SimpleQuantity

A fixed quantity (no comparator)
Fixed Value: As shown

0..0

Unique id for inter-element referencing

extension

0..0

Extension

Additional content defined by implementations

value

1..1

decimal

Numerical value (with implicit precision)
Fixed Value: 4.5

comparator

0..0

code

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

0..0

Unit representation

0..0

System that defines coded unit form

code

0..0

code

Coded form of the unit

normalValue

0..1

CodeableConcept

Normal value, if relevant
Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation.

text

0..1

string

Text based reference range in an observation

component

0..*

BackboneElement

Component results

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

code

1..1

CodeableConcept

Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.

value[x]

0..1

Actual component result

valueQuantity

valueCodeableConcept

valueString

valueBoolean

valueInteger

valueRange

valueRatio

valueSampledData

valueTime

valueDateTime

valuePeriod

valueAttachment

0..1

Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

0..*

CodeableConcept

High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

referenceRange

0..*

See referenceRange (Observation)

Provides guide for interpretation of component result

Documentation for this format

<!-- Example Lipid Profile -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- I 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- I 0..1 Language of the resource content   -->
 <text><!-- I 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- I 0..* Identifier 
     Business Identifier for observation --></identifier>
 <instantiates[x]><!-- I 0..1 canonical|Reference(ObservationDefinition) 
     Instantiates FHIR ObservationDefinition --></instantiates[x]>
 <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <triggeredBy> I 0..* BackboneElement  <!-- I 0..* Triggering observation(s) -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <observation><!-- I 1..1 Reference(Observation) 
      Triggering observation --></observation>
  <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run   -->
  <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered -->
 </triggeredBy>
 <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- I 1..1 registered | preliminary | final | amended +   -->
 <category><!-- I 0..* CodeableConcept Classification of  type of observation   --></category>
 <code><!-- I 1..1 CodeableConcept Cholesterol   --></code>
 <subject><!-- I 0..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- I 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- I 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- I 0..1 dateTime|Period|Timing|instant 
     Clinically relevant time/time-period for observation --></effective[x]>
 <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available -->
 <performer><!-- I 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity> I 0..1 Quantity  <!-- I 0..1 Cholesterol value -->
  <value value="[decimal]"/><!-- I 0..1 Actual numerical value -->
  <comparator value="[code]"/><!-- I 0..0 < | <= | >= | > | ad - how to understand the value   -->
  <unit value="[string]"/><!-- I 1..1 Unit representation -->
  <system value="[uri]"/><!-- I 1..1 System that defines coded unit form -->
  <code value="[code]"/><!-- I 1..1 Coded form of the unit -->
 </valueQuantity>
 <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- I 0..1 CodeableConcept + | ++ | +++ | - | -- | ---   --></interpretation>
 <note><!-- I 0..* Annotation Comments about result --></note>
 <bodySite><!-- I 0..1 CodeableConcept Observed body part   --></bodySite>
 <bodyStructure><!-- I 0..1 Reference(BodyStructure) Observed body structure --></bodyStructure>
 <method><!-- I 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- I 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> I 1..1 BackboneElement  <!-- I 1..1 Provides guide for interpretation -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- I 0..0 Quantity 
      Low Range, if relevant --></low>
  <high><!-- I 1..1 Quantity 
      A fixed quantity (no comparator) --></high>
  <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant   --></normalValue>
  <type><!-- I 0..0 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- I 0..0 CodeableConcept Reference range population   --></appliesTo>
  <age><!-- I 0..0 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- I 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- I 0..0 Reference(Observation) 
     Related resource that belongs to the Observation group --></hasMember>
 <derivedFrom><!-- I 0..0 Reference(DocumentReference) 
     Related resource from which the observation is made --></derivedFrom>
 <component> I 0..* BackboneElement  <!-- I 0..* Component results -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- I 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- I 0..1 Quantity|CodeableConcept|string|
    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment 
      Actual component result --></value[x]>
  <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

{ // Example Lipid Profile
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | preliminary | final | amended +
    "category" : [{ CodeableConcept }], // IClassification of  type of observation
    "code" : { CodeableConcept }, // I R! 
    "subject" : { Reference(Patient) }, // IWho and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Clinically relevant time/time-period for observation. One of these 4:
    "effectiveDateTime" : "<dateTime>", // IClinically relevant time/time-period for observation
    "effectivePeriod" : { Period }, // IClinically relevant time/time-period for observation
    "effectiveTiming" : { Timing }, // IClinically relevant time/time-period for observation
    "effectiveInstant" : "<instant>", // IClinically relevant time/time-period for observation
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Cholesterol value // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "value" : <decimal>, // IActual numerical value
        "unit" : "mmol/L", // I R! 
        "system" : "http://unitsofmeasure.org", // I R! 
        "code" : "mmol/L" // I R! 
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result is missing
    "interpretation" : { CodeableConcept }, // I+ | ++ | +++ | - | -- | ---
    "note" : [{ Annotation }], // IComments about result
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // I(Measurement) Device
    "referenceRange" : { BackboneElement }, // I R! Provides guide for interpretation
    "component" : [{ BackboneElement }], // IComponent results
  }

This structure is derived from Observation.

Summary

Mandatory: 3 elements (+3 nested mandatory elements)
Must-Support: 9 elements
Fixed Value: 5 elements
Prohibited: 7 elements

Differential View

This indicates the differences between this profile and the base Observation structure.

Name	Flags	Card.	Type	Description & Constraints
Observation		1..1	Observation	Measurements and simple assertions
code	S	1..1	CodeableConcept	Cholesterol Fixed Value: As shown
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 35200-5
display		1..1	string	Representation defined by the system Fixed Value: Cholesterol [Moles/volume] in Serum or Plasma
valueQuantity	S	0..1	Quantity	Cholesterol value
value	S	0..1	decimal	Actual numerical value
comparator		0..0
unit	S	1..1	string	Unit representation Fixed Value: mmol/L
system	S	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	Coded form of the unit Fixed Value: mmol/L
interpretation	S	0..1	CodeableConcept	+ \| ++ \| +++ \| - \| -- \| ---
note	S	0..*	Annotation	Comments about result
referenceRange	S	1..1	BackboneElement	Provides guide for interpretation
low		0..0
high		1..1	SimpleQuantity	A fixed quantity (no comparator) Fixed Value: As shown
value		1..1	decimal	Numerical value (with implicit precision) Fixed Value: 4.5
type		0..0
appliesTo		0..0
age		0..0
hasMember		0..0
derivedFrom		0..0
Documentation for this format

Snapshot View

This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observation structure.

Description & Constraints

Observation

1..1

Observation

Measurements and simple assertions

0..1

Logical id of this artifact

category

0..*

CodeableConcept

Classification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories.

code

SΣ

1..1

CodeableConcept

Cholesterol
Binding: LOINC Codes (example): Codes identifying names of simple observations.

Fixed Value: As shown

0..0

Unique id for inter-element referencing

extension

0..0

Extension

Additional content defined by implementations

coding

1..1

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..0

Unique id for inter-element referencing

extension

0..0

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://loinc.org

version

0..0

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: 35200-5

display

1..1

string

Representation defined by the system
Fixed Value: Cholesterol [Moles/volume] in Serum or Plasma

userSelected

0..0

boolean

If this coding was chosen directly by the user

text

0..0

string

Plain text representation of the concept

subject

0..1

Who and/or what the observation is about

focus

0..*

Reference(Resource)

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

encounter

0..1

Reference(Encounter)

Healthcare event during which this observation is made

effective[x]

0..1

Clinically relevant time/time-period for observation

effectiveDateTime

effectivePeriod

effectiveTiming

effectiveInstant

issued

0..1

instant

Date/Time this version was made available

performer

0..*

Who is responsible for the observation

Slices for value[x]

ΣC

0..1

Quantity

Actual result
Slice: Unordered, Closed by type:$this

value[x]:valueQuantity

SΣC

0..1

Quantity

Cholesterol value

0..1

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

0..1

decimal

Actual numerical value

unit

SΣ

1..1

string

Unit representation
Fixed Value: mmol/L

system

SΣC

1..1

uri

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

SΣ

1..1

code

Coded form of the unit
Fixed Value: mmol/L

dataAbsentReason

0..1

CodeableConcept

Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

0..1

CodeableConcept

+ | ++ | +++ | - | -- | ---
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

note

0..*

Annotation

Comments about result

bodySite

0..1

CodeableConcept

Observed body part
Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts

bodyStructure

0..1

Reference(BodyStructure)

Observed body structure

method

0..1

CodeableConcept

How it was done
Binding: Observation Methods (example): Methods for simple observations.

specimen

0..1

Reference(Specimen | Group)

Specimen used for this observation

device

0..1

Reference(Device | DeviceMetric)

(Measurement) Device

referenceRange

1..1

BackboneElement

Provides guide for interpretation

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

high

1..1

SimpleQuantity

A fixed quantity (no comparator)
Fixed Value: As shown

0..0

Unique id for inter-element referencing

extension

0..0

Extension

Additional content defined by implementations

value

1..1

decimal

Numerical value (with implicit precision)
Fixed Value: 4.5

comparator

0..0

code

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

0..0

Unit representation

0..0

System that defines coded unit form

code

0..0

code

Coded form of the unit

normalValue

0..1

CodeableConcept

Normal value, if relevant
Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation.

text

0..1

string

Text based reference range in an observation

component

0..*

BackboneElement

Component results

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

code

1..1

CodeableConcept

Type of component observation (code / type)
Binding: LOINC Codes (example): Codes identifying names of simple observations.

value[x]

0..1

Actual component result

valueQuantity

valueCodeableConcept

valueString

valueBoolean

valueInteger

valueRange

valueRatio

valueSampledData

valueTime

valueDateTime

valuePeriod

valueAttachment

0..1

Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

0..*

CodeableConcept

High, low, normal, etc.
Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.

referenceRange

0..*

See referenceRange (Observation)

Provides guide for interpretation of component result

Documentation for this format

XML Template

<!-- Example Lipid Profile -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- I 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- I 0..1 Language of the resource content   -->
 <text><!-- I 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- I 0..* Identifier 
     Business Identifier for observation --></identifier>
 <instantiates[x]><!-- I 0..1 canonical|Reference(ObservationDefinition) 
     Instantiates FHIR ObservationDefinition --></instantiates[x]>
 <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn>
 <triggeredBy> I 0..* BackboneElement  <!-- I 0..* Triggering observation(s) -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <observation><!-- I 1..1 Reference(Observation) 
      Triggering observation --></observation>
  <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run   -->
  <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered -->
 </triggeredBy>
 <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf>
 <status value="[code]"/><!-- I 1..1 registered | preliminary | final | amended +   -->
 <category><!-- I 0..* CodeableConcept Classification of  type of observation   --></category>
 <code><!-- I 1..1 CodeableConcept Cholesterol   --></code>
 <subject><!-- I 0..1 Reference(Patient) 
     Who and/or what the observation is about --></subject>
 <focus><!-- I 0..* Reference(Resource) 
     What the observation is about, when it is not about the subject of record --></focus>
 <encounter><!-- I 0..1 Reference(Encounter) 
     Healthcare event during which this observation is made --></encounter>
 <effective[x]><!-- I 0..1 dateTime|Period|Timing|instant 
     Clinically relevant time/time-period for observation --></effective[x]>
 <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available -->
 <performer><!-- I 0..* Reference(Practitioner) 
     Who is responsible for the observation --></performer>
 <-- valueQuantity sliced by type:$this  in the specified orderClosed-->
 <valueQuantity> I 0..1 Quantity  <!-- I 0..1 Cholesterol value -->
  <value value="[decimal]"/><!-- I 0..1 Actual numerical value -->
  <comparator value="[code]"/><!-- I 0..0 < | <= | >= | > | ad - how to understand the value   -->
  <unit value="[string]"/><!-- I 1..1 Unit representation -->
  <system value="[uri]"/><!-- I 1..1 System that defines coded unit form -->
  <code value="[code]"/><!-- I 1..1 Coded form of the unit -->
 </valueQuantity>
 <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result is missing   --></dataAbsentReason>
 <interpretation><!-- I 0..1 CodeableConcept + | ++ | +++ | - | -- | ---   --></interpretation>
 <note><!-- I 0..* Annotation Comments about result --></note>
 <bodySite><!-- I 0..1 CodeableConcept Observed body part   --></bodySite>
 <bodyStructure><!-- I 0..1 Reference(BodyStructure) Observed body structure --></bodyStructure>
 <method><!-- I 0..1 CodeableConcept How it was done   --></method>
 <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- I 0..1 Reference(Device) (Measurement) Device --></device>
 <referenceRange> I 1..1 BackboneElement  <!-- I 1..1 Provides guide for interpretation -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <low><!-- I 0..0 Quantity 
      Low Range, if relevant --></low>
  <high><!-- I 1..1 Quantity 
      A fixed quantity (no comparator) --></high>
  <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant   --></normalValue>
  <type><!-- I 0..0 CodeableConcept Reference range qualifier   --></type>
  <appliesTo><!-- I 0..0 CodeableConcept Reference range population   --></appliesTo>
  <age><!-- I 0..0 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- I 0..1 Text based reference range in an observation -->
 </referenceRange>
 <hasMember><!-- I 0..0 Reference(Observation) 
     Related resource that belongs to the Observation group --></hasMember>
 <derivedFrom><!-- I 0..0 Reference(DocumentReference) 
     Related resource from which the observation is made --></derivedFrom>
 <component> I 0..* BackboneElement  <!-- I 0..* Component results -->
  <modifierExtension><!-- I 0..* Extension  Extensions that cannot be ignored even if unrecognized  --></modifierExtension>
  <code><!-- I 1..1 CodeableConcept Type of component observation (code / type)   --></code>
  <value[x]><!-- I 0..1 Quantity|CodeableConcept|string|
    boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment 
      Actual component result --></value[x]>
  <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result is missing   --></dataAbsentReason>
  <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc.   --></interpretation>
  <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

JSON Template

{ // Example Lipid Profile
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | preliminary | final | amended +
    "category" : [{ CodeableConcept }], // IClassification of  type of observation
    "code" : { CodeableConcept }, // I R! 
    "subject" : { Reference(Patient) }, // IWho and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Clinically relevant time/time-period for observation. One of these 4:
    "effectiveDateTime" : "<dateTime>", // IClinically relevant time/time-period for observation
    "effectivePeriod" : { Period }, // IClinically relevant time/time-period for observation
    "effectiveTiming" : { Timing }, // IClinically relevant time/time-period for observation
    "effectiveInstant" : "<instant>", // IClinically relevant time/time-period for observation
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Cholesterol value // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "value" : <decimal>, // IActual numerical value
        "unit" : "mmol/L", // I R! 
        "system" : "http://unitsofmeasure.org", // I R! 
        "code" : "mmol/L" // I R! 
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result is missing
    "interpretation" : { CodeableConcept }, // I+ | ++ | +++ | - | -- | ---
    "note" : [{ Annotation }], // IComments about result
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // I(Measurement) Device
    "referenceRange" : { BackboneElement }, // I R! Provides guide for interpretation
    "component" : [{ BackboneElement }], // IComponent results
  }

Alternate definitions: Master Definition (XML, JSON), Schematron

10.3.13.7.2 Terminology Bindings

Path	Name	Conformance	ValueSet
Observation.language	Common Languages	preferred	Common Languages
Observation.triggeredBy.type	triggeredBytype	required	triggeredBytype
Observation.status	ObservationStatus	required	ObservationStatus
Observation.category	Observation Category Codes	preferred	Observation Category Codes
Observation.code	LOINC Codes	example	LOINC Codes
Observation.dataAbsentReason	DataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	Observation Interpretation Codes	extensible	Observation Interpretation Codes
Observation.bodySite	SNOMED CT Body Structures	example	SNOMED CT Body Structures
Observation.method	Observation Methods	example	Observation Methods
Observation.referenceRange.normalValue	Observation Reference Range Normal Value Codes	extensible	Observation Reference Range Normal Value Codes
Observation.component.code	LOINC Codes	example	LOINC Codes
Observation.component.dataAbsentReason	DataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	Observation Interpretation Codes	extensible	Observation Interpretation Codes