StructureDefinition: Observationbp - XML

Observationbp

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="bp"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary">
    <valueMarkdown value="#### Complete Summary of the Mandatory Requirements

1.  One code in `Observation.category` which must have
    -   a fixed `Observation.category.coding.system`=**'http ://loinc.org'**
    -   a fixed  `Observation.code.coding.code`= **85354-9'**
    -   The code (or codes) for the measurement obtained  in `Observation.code`.
     All codes
        SHALL have a system value
2.  One  `Observation.component.code`  which must have
    -   a fixed `Observation.component.code.coding.system`=**'http://loinc.org'**
    -   fixed  `Observation.component.code.coding.code`= **'8480-6'**
    -   The code (or codes) for the measurement obtained  in `Observation.code`.
     All codes
        SHALL have a system value
3.  One  `Observation.component.code` which must have 
    -   a fixed `Observation.component.code.coding.system`=**'http://loinc.org'**
    -   fixed  `Observation.component.code.coding.code`= **'8462-4'**
    -   The code (or codes) for the measurement obtained  in `Observation.code`.
     All codes
        SHALL have a system value
1. Either one Observation.valueQuantity or, if there is no value, one code in Observation.Dat
    aAbsentReason
   - Each Observation.valueQuantity must have:
     - One numeric value in Observation.valueQuantity.value
     - a fixed Observation.valueQuantity.system=&quot;http://unitsofmeasure.org&quot;
     - a UCUM unit code in Observation.valueQuantity.code = **'mm[Hg]'**"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="5"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="oo"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/tools/StructureDefinition/profile-summary">
    <valueString value="#### Complete Summary of the Mandatory Requirements

1.  One code in `Observation.category` which must have
    -   a fixed `Observation.category.coding.system`=**'http ://loinc.org'**
    -   a fixed  `Observation.code.coding.code`= **85354-9'**
    -   The code (or codes) for the measurement obtained  in `Observation.code`.
     All codes
        SHALL have a system value
2.  One  `Observation.component.code`  which must have
    -   a fixed `Observation.component.code.coding.system`=**'http://loinc.org'**
    -   fixed  `Observation.component.code.coding.code`= **'8480-6'**
    -   The code (or codes) for the measurement obtained  in `Observation.code`.
     All codes
        SHALL have a system value
3.  One  `Observation.component.code` which must have 
    -   a fixed `Observation.component.code.coding.system`=**'http://loinc.org'**
    -   fixed  `Observation.component.code.coding.code`= **'8462-4'**
    -   The code (or codes) for the measurement obtained  in `Observation.code`.
     All codes
        SHALL have a system value
1. Either one Observation.valueQuantity or, if there is no value, one code in Observation.Dat
    aAbsentReason
   - Each Observation.valueQuantity must have:
     - One numeric value in Observation.valueQuantity.value
     - a fixed Observation.valueQuantity.system=&quot;http://unitsofmeasure.org&quot;
     - a UCUM unit code in Observation.valueQuantity.code = **'mm[Hg]'**"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/bp"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.5.1459"/> 
  </identifier> 
  <version value="6.0.0-ballot2"/> 
  <name value="Observationbp"/> 
  <title value="Observation Blood Pressure Profile"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2018-08-11"/> 
  <publisher value="HL7 International / Orders and Observations"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/orders"/> 
    </telecom> 
  </contact> 
  <description value="FHIR Blood Pressure Profile"/> 
  <fhirVersion value="6.0.0-ballot2"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="sct-concept"/> 
    <uri value="http://snomed.info/conceptdomain"/> 
    <name value="SNOMED CT Concept Domain Binding"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 V2 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="sct-attr"/> 
    <uri value="http://snomed.org/attributebinding"/> 
    <name value="SNOMED CT Attribute Binding"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="Observation"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Observation">
      <path value="Observation"/> 
      <short value="FHIR Blood Pressure Profile"/> 
      <definition value="This profile defines  how to represent Blood Pressure observations in FHIR using
       a standard LOINC code and UCUM units of measure.  This is a grouping structure.
       It has no value in Observation.valueQuantity but contains at least one component
       (systolic and/or diastolic)."/> 
      <comment 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 laboratory reports, etc."/> 
      <alias value="Vital Signs"/> 
      <alias value="Measurement"/> 
      <alias value="Results"/> 
      <alias value="Tests"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL be referred to from
         elsewhere in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy
        pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))
         or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical)
         = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmat
        ched', id).empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
         or a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
           display the resource to a human safely. Including a human readable representation
           in the resource makes for a much more robust eco-system and cheaper handling of
           resources by intermediary systems. Some ecosystems restrict distribution of resources
           to only those systems that do fully understand the resources, and as a consequence
           implementers may believe that the narrative is superfluous. However experience
           shows that such eco-systems often open up to new participants over time."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <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()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </constraint> 
      <constraint> 
        <key value="obs-7"/> 
        <severity value="error"/> 
        <human value="If Observation.component.code is the same as Observation.code, then Observation.value
         SHALL NOT be present (the Observation.component.value[x] holds the value)."/> 
        <expression value="value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty
        ()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </constraint> 
      <constraint> 
        <key value="obs-8"/> 
        <severity value="error"/> 
        <human value="bodyStructure SHALL only be present if Observation.bodySite is not present"/> 
        <expression value="bodySite.exists() implies bodyStructure.empty()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </constraint> 
      <constraint> 
        <key value="vs-2"/> 
        <severity value="error"/> 
        <human value="If there is no component or hasMember element then either a value[x] or a data
         absent reason must be present."/> 
        <expression value="(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or
         value.exists())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity, Role, or Act,Observation[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.diagnostics"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 363787002 |Observable entity|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX"/> 
      </mapping> 
    </element> 
    <element id="Observation.id">
      <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."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Observation.meta">
      <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 might 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="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Observation.implicitRules">
      <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. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc."/> 
      <comment 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. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,
       value sets, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies its meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Observation.language">
      <path value="Observation.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment 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="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot2"/> 
        <additional> 
          <purpose value="starter"/> 
          <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
        </additional> 
      </binding> 
    </element> 
    <element id="Observation.text">
      <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 can be used
       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &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."/> 
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <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="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="Observation.contained">
      <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, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource
       if and only if it is referenced by a resource that provides context/meaning."/> 
      <comment 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. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels."/> 
      <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> 
      <condition value="dom-2"/> 
      <condition value="dom-4"/> 
      <condition value="dom-3"/> 
      <condition value="dom-5"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.extension">
      <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. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.modifierExtension">
      <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 and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and managable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.identifier">
      <path value="Observation.identifier"/> 
      <short value="Business Identifier for observation"/> 
      <definition value="A unique identifier assigned to this observation."/> 
      <requirements value="Allows observations to be distinguished and referenced."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR
         and OBX must be negotiated between trading partners to uniquely identify the OBX
         segment. Depending on how V2 has been implemented each of these may be an option:
         1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 3) some other way
         to uniquely ID the OBR/ORC + OBX-3 + OBX-4."/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="id"/> 
      </mapping> 
    </element> 
    <element id="Observation.instantiates[x]">
      <path value="Observation.instantiates[x]"/> 
      <short value="Instantiates FHIR ObservationDefinition"/> 
      <definition value="The reference to a FHIR ObservationDefinition resource that provides the definition
       that is adhered to in whole or in part by this Observation instance."/> 
      <comment value="ObservationDefinition can be referenced by its canonical url using instantiatesCanonical,
       or by a name or an identifier using the appropriate sub-elements of instantiatesReference."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.instantiates[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ObservationDefinition"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ObservationDefinition"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.instantiatesCanonical"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DEFN].target"/> 
      </mapping> 
    </element> 
    <element id="Observation.basedOn">
      <path value="Observation.basedOn"/> 
      <short value="Fulfills plan, proposal or order"/> 
      <definition value="A plan, proposal or order that is fulfilled in whole or in part by this event.
        For example, a MedicationRequest may require a patient to have laboratory test
       performed before  it is dispensed."/> 
      <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations
       were acted upon."/> 
      <alias value="Fulfills"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.basedOn"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ORC"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy">
      <path value="Observation.triggeredBy"/> 
      <short value="Triggering observation(s)"/> 
      <definition value="Identifies the observation(s) that triggered the performance of this observation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.triggeredBy"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ORC"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy.id">
      <path value="Observation.triggeredBy.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy.extension">
      <path value="Observation.triggeredBy.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. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy.modifierExtension">
      <path value="Observation.triggeredBy.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy.observation">
      <path value="Observation.triggeredBy.observation"/> 
      <short value="Triggering observation"/> 
      <definition value="Reference to the triggering observation."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.triggeredBy.observation"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outBoundRelationship"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy.type">
      <path value="Observation.triggeredBy.type"/> 
      <short value="reflex | repeat | re-run"/> 
      <definition value="The type of trigger.
Reflex | Repeat | Re-run."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.triggeredBy.type"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TriggeredByType"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The type of TriggeredBy Observation."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-triggeredbytype|6.0.0-ballot2"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="code"/> 
      </mapping> 
    </element> 
    <element id="Observation.triggeredBy.reason">
      <path value="Observation.triggeredBy.reason"/> 
      <short value="Reason that the observation was triggered"/> 
      <definition value="Provides the reason why this observation was performed as a result of the observation(s)
       referenced."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.triggeredBy.reason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="annotation"/> 
      </mapping> 
    </element> 
    <element id="Observation.partOf">
      <path value="Observation.partOf"/> 
      <short value="Part of referenced event"/> 
      <definition value="A larger event of which this particular Observation is a component or step.  For
       example,  an observation as part of a procedure."/> 
      <comment value="To link an Observation to an Encounter use `encounter`.  See the  [Notes](observation.html#ob
      sgrouping) below for guidance on referencing another Observation."/> 
      <alias value="Container"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.partOf"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/GenomicStudy"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.partOf"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="Varies by domain"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target"/> 
      </mapping> 
    </element> 
    <element id="Observation.status">
      <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 | corrected | appended | cancelled |
       entered-in-error | unknown"/> 
      <definition value="The status of the result value."/> 
      <comment value="This element is labeled as a modifier because the status contains codes that mark
       the resource as not currently valid."/> 
      <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"/> 
      <base> 
        <path value="Observation.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because it is a status element that contains
       status entered-in-error which means that the resource should not be treated as
       valid"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Status"/> 
        </extension> 
        <strength value="required"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-status"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 445584004 |Report by finality status|"/> 
      </mapping> 
      <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> 
    </element> 
    <element id="Observation.category">
      <path value="Observation.category"/> 
      <slicing> 
        <discriminator> 
          <type value="pattern"/> 
          <path value="$this"/> 
        </discriminator> 
        <rules value="open"/> 
      </slicing> 
      <short value="Classification of  type of observation"/> 
      <definition value="A code that classifies the general type of observation being made."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <requirements value="Used for filtering what observations are retrieved and displayed."/> 
      <min value="2"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This value set includes the required vital sign interoperability categories."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-category"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 
      </mapping> 
    </element> 
    <element id="Observation.category:VSCat">
      <path value="Observation.category"/> 
      <sliceName value="VSCat"/> 
      <short value="Classification of  type of observation"/> 
      <definition value="A code that classifies the general type of observation being made."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <requirements value="Used for filtering what observations are retrieved and displayed."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/observation-category"/> 
          <code value="vital-signs"/> 
        </coding> 
      </patternCodeableConcept> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level observation categories."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 
      </mapping> 
    </element> 
    <element id="Observation.category:BPCode">
      <path value="Observation.category"/> 
      <sliceName value="BPCode"/> 
      <short value="Classification of  type of observation"/> 
      <definition value="A code that classifies the general type of observation being made."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <requirements value="Used for filtering what observations are retrieved and displayed."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="85354-9"/> 
        </coding> 
      </patternCodeableConcept> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This value set includes the required vital sign interoperability categories."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-category"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;
        EVN&quot;].code"/> 
      </mapping> 
    </element> 
    <element id="Observation.code">
      <path value="Observation.code"/> 
      <short value="Blood Pressure"/> 
      <definition value="Blood Pressure."/> 
      <comment value="*All* code-value and, if present, component.code-component.value pairs need to
       be taken into account to correctly understand the meaning of the observation."/> 
      <requirements value="Knowing what kind of observation is being made is essential to understanding the
       observation."/> 
      <alias value="Name"/> 
      <alias value="Test"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignBPPanel"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the set of LOINC codes that are appropriate for representing an
         arterial systolic and diastolic BP panel of vital sign measurements in Observation.code."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-bppanel"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 363787002 |Observable entity| OR &lt; 386053000 |Evaluation procedure|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="code"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="116680003 |Is a|"/> 
      </mapping> 
    </element> 
    <element id="Observation.subject">
      <path value="Observation.subject"/> 
      <short value="Who and/or what the observation is about"/> 
      <definition value="The patient, or group of patients, location, device, organization, procedure or
       practitioner this observation is about and into whose or what record the observation
       is placed. If the actual focus of the observation is different from the subject
       (or a sample of, part, or region of the subject), the `focus` element or the `code`
       itself specifies the actual focus of the observation."/> 
      <comment 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. The subject of an Observation may in some cases
       be a procedure.  This supports the regulatory inspection use case where observations
       are captured during inspections of a procedure that is being performed (independent
       of any particular patient or whether patient related at all)."/> 
      <requirements value="Observations have no value if you don't know who or what they're about."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.subject"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=RTGT]"/> 
      </mapping> 
    </element> 
    <element id="Observation.focus">
      <path value="Observation.focus"/> 
      <short value="What the observation is about, when it is not about the subject of record"/> 
      <definition value="The actual focus of an observation when it is not the patient of record representing
       something or someone associated with the patient such as a spouse, parent, fetus,
       or donor. For example, fetus observations in a mother's record.  The focus of an
       observation could also be an existing condition,  an intervention, the subject's
       diet,  another observation of the subject,  or a body structure such as tumor or
       implanted device.   An example use case would be using the Observation resource
       to capture whether the mother is trained to change her child's tracheostomy tube.
       In this example, the child is the patient of record and the mother is the focus."/> 
      <comment value="Typically, an observation is made about the subject - a patient, or group of patients,
       location, or device - and the distinction between the subject and what is directly
       measured for an observation is specified in the observation code itself ( e.g.,
       &quot;Blood Glucose&quot;) and does not need to be represented separately using
       this element.  Use `specimen` if a reference to a specimen is required.  If a code
       is required instead of a resource use either  `bodysite` for bodysites or the standard
       extension [http://hl7.org/fhir/StructureDefinition/observation-focusCode](http://hl7.org/fhir
      /extensions/StructureDefinition-observation-focusCode.html)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.focus"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=SBJ]"/> 
      </mapping> 
    </element> 
    <element id="Observation.encounter">
      <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."/> 
      <comment value="This will typically be the encounter the event occurred within, but some events
       may be initiated prior to or after the official completion of an encounter but
       still be tied to the context of the encounter (e.g. pre-admission laboratory tests)."/> 
      <requirements value="For some observations it may be important to know the link between an observation
       and a particular encounter."/> 
      <alias value="Context"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.encounter"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PV1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="Observation.effective[x]">
      <path value="Observation.effective[x]"/> 
      <short value="Often just a dateTime for Vital Signs"/> 
      <definition value="Often just a dateTime for Vital Signs."/> 
      <comment value="At least a date should be present unless this observation is a historical report.
        For recording imprecise or &quot;fuzzy&quot; times (For example, a blood glucose
       measurement taken &quot;after breakfast&quot;) use the [Timing](datatypes.html#timing)
       datatype which allow the measurement to be tied to regular life events."/> 
      <requirements value="Knowing when an observation was deemed true is important to its relevance as well
       as determining trends."/> 
      <alias value="Occurrence"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.effective[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <condition value="vs-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="vs-1"/> 
        <severity value="error"/> 
        <human value="if Observation.effective[x] is dateTime and has a value then that value shall be
         precise to the day"/> 
        <expression value="($this as dateTime).toString().length() &gt;= 8"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.done[x]"/> 
      </mapping> 
      <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> 
    </element> 
    <element id="Observation.issued">
      <path value="Observation.issued"/> 
      <short value="Date/Time this version was made available"/> 
      <definition value="The date and time this version of the observation was made available to providers,
       typically after the results have been reviewed and verified."/> 
      <comment value="For Observations that don't require review and verification, it may be the same
       as the [`lastUpdated` ](resource-definitions.html#Meta.lastUpdated) time of the
       resource itself.  For Observations that do require review and verification for
       certain updates, it might not be the same as the `lastUpdated` time of the resource
       itself due to a non-clinically significant update that doesn't require the new
       version to be reviewed and verified again."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.issued"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="instant"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <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> 
    </element> 
    <element id="Observation.performer">
      <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="*"/> 
      <base> 
        <path value="Observation.performer"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.actor"/> 
      </mapping> 
      <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> 
    </element> 
    <element id="Observation.value[x]">
      <path value="Observation.value[x]"/> 
      <slicing> 
        <discriminator> 
          <type value="type"/> 
          <path value="$this"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="closed"/> 
      </slicing> 
      <short value="Vital Signs value are recorded using the Quantity data type. For supporting observations
       such as Cuff size could use other datatypes such as CodeableConcept."/> 
      <definition value="Vital Signs value are recorded using the Quantity data type. For supporting observations
       such as Cuff size could use other datatypes such as CodeableConcept."/> 
      <comment value="- An observation may have:
  1.  a single value here
  1.  both a value and a set of related or component values
  1.  only a set of related or component values.
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <condition value="obs-7"/> 
      <condition value="obs-6"/> 
      <condition value="vs-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.value[x]:valueQuantity">
      <path value="Observation.value[x]"/> 
      <sliceName value="valueQuantity"/> 
      <short value="Vital Sign Value recorded with UCUM (preferred)"/> 
      <definition value="Vital Sign Value recorded with UCUM (preferred)."/> 
      <comment value="- An observation may have:
  1.  a single value here
  1.  both a value and a set of related or component values
  1.  only a set of related or component values.
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="0"/> 
      <base> 
        <path value="Observation.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <condition value="obs-7"/> 
      <condition value="obs-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsUnits"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Commonly encountered UCUM units for recording Vital Signs."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.dataAbsentReason">
      <path value="Observation.dataAbsentReason"/> 
      <short value="Why the result value is missing"/> 
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is
       missing."/> 
      <comment 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."/> 
      <requirements value="For many results it is necessary to handle exceptional values in measurements."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.dataAbsentReason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-6"/> 
      <condition value="vs-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationValueAbsentReason"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes specifying why the result (`Observation.value[x]`) is missing."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value.nullFlavor"/> 
      </mapping> 
    </element> 
    <element id="Observation.interpretation">
      <path value="Observation.interpretation"/> 
      <short value="High, low, normal, etc"/> 
      <definition value="A categorical assessment of an observation value.  For example, high, low, normal."/> 
      <comment value="Historically used for laboratory results (known as 'abnormal flag' ),  its use
       extends to other use cases where coded interpretations  are relevant.  Often reported
       as one or more simple compact codes this element is often placed adjacent to the
       result value in reports and flow sheets to signal the meaning/normalcy status of
       the result."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.interpretation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationInterpretation"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying interpretations of observations."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="interpretationCode"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363713009 |Has interpretation|"/> 
      </mapping> 
    </element> 
    <element id="Observation.note">
      <path value="Observation.note"/> 
      <short value="Comments about the observation"/> 
      <definition value="Comments about the observation or the results."/> 
      <comment value="May include general statements about the observation, or statements about significant,
       unexpected or unreliable results values, or information about its source when relevant
       to its interpretation."/> 
      <requirements value="Need to be able to provide free text additional information."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.note"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <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 id="Observation.bodySite">
      <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)."/> 
      <comment value="Only used if not implicit in code found in Observation.code.  In many systems,
       this may be represented as a related observation instead of an inline component."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.bodySite"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-8"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/> 
        </extension> 
        <strength value="example"/> 
        <description value="SNOMED CT Body site concepts"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/body-site"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 123037004 |Body structure|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-20"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="targetSiteCode"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="718497002 |Inherent location|"/> 
      </mapping> 
    </element> 
    <element id="Observation.bodyStructure">
      <path value="Observation.bodyStructure"/> 
      <short value="Observed body structure"/> 
      <definition value="Indicates the body structure on the subject's body where the observation was made
       (i.e. the target site)."/> 
      <comment value="Only used if not implicit in code found in Observation.code or bodySite is used.
       In many systems, this may be represented as a related observation instead of an
       inline component."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.bodyStructure"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure"/> 
      </type> 
      <condition value="obs-8"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="targetSiteCode"/> 
      </mapping> 
    </element> 
    <element id="Observation.method">
      <path value="Observation.method"/> 
      <short value="How it was done"/> 
      <definition value="Indicates the mechanism used to perform the observation."/> 
      <comment 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"/> 
      <base> 
        <path value="Observation.method"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationMethod"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Methods for simple observations."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-methods"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-17"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="methodCode"/> 
      </mapping> 
    </element> 
    <element id="Observation.specimen">
      <path value="Observation.specimen"/> 
      <short value="Specimen used for this observation"/> 
      <definition value="The specimen that was used when this observation was made."/> 
      <comment value="Should only be used if not implicit in code found in `Observation.code`.  Observations
       are not made on specimens themselves; they are made on a subject, but in many cases
       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"/> 
      <base> 
        <path value="Observation.specimen"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="obs-9"/> 
        <severity value="error"/> 
        <human value="If Observation.specimen is a reference to Group, the group can only have specimens"/> 
        <expression value="(reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().m
        ember.entity.resolve().all($this is Specimen)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 123038009 |Specimen|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="SPM segment"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=SPC].specimen"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="704319004 |Inherent in|"/> 
      </mapping> 
    </element> 
    <element id="Observation.device">
      <path value="Observation.device"/> 
      <short value="A reference to the device that generates the measurements or the device settings
       for the device"/> 
      <definition value="A reference to the device that generates the measurements or the device settings
       for the device."/> 
      <comment value="Note that this is not meant to represent a device involved in the transmission
       of the result, e.g., a gateway.  Such devices may be documented using the Provenance
       resource where relevant."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.device"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 49062001 |Device|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-17 / PRT -10"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=DEV]"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="424226004 |Using device|"/> 
      </mapping> 
    </element> 
    <element id="Observation.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.  Multiple reference ranges are interpreted as an &quot;OR&quot;.   In other
       words, to represent two distinct target populations, two `referenceRange` elements
       would be used."/> 
      <comment 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 might not be possible or appropriate. Whenever more than one reference
       range is supplied, the differences between them SHOULD be provided in the reference
       range and/or age properties."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.referenceRange"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="obs-3"/> 
        <severity value="error"/> 
        <human value="Must have at least a low or a high or text"/> 
        <expression value="low.exists() or high.exists() or text.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <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 id="Observation.referenceRange.id">
      <path value="Observation.referenceRange.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.extension">
      <path value="Observation.referenceRange.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.modifierExtension">
      <path value="Observation.referenceRange.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.low">
      <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"/> 
      <base> 
        <path value="Observation.referenceRange.low"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <condition value="obs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value:IVL_PQ.low"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.high">
      <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"/> 
      <base> 
        <path value="Observation.referenceRange.high"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <condition value="obs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value:IVL_PQ.high"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.normalValue">
      <path value="Observation.referenceRange.normalValue"/> 
      <short value="Normal value, if relevant"/> 
      <definition value="The value of the normal value of the reference range."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.referenceRange.normalValue"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationReferenceRangeNormalValue"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying the normal value of the observation."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-referencerange-normalvalue"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value:IVL_PQ.normal"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.type">
      <path value="Observation.referenceRange.type"/> 
      <short value="Reference range qualifier"/> 
      <definition value="Codes to indicate the what part of the targeted reference population it applies
       to. For example, the normal or therapeutic range."/> 
      <comment value="This SHOULD be populated if there is more than one range.  If this element is not
       present then the normal range is assumed."/> 
      <requirements value="Need to be able to say what kind of reference range this is - normal, recommended,
       therapeutic, etc.,  - for proper interpretation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.referenceRange.type"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationRangeMeaning"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Code for the meaning of a reference range."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values| OR  
&lt; 365860008 |General clinical state finding| 
OR 
&lt; 250171008 |Clinical history or observation findings| OR  
&lt; 415229000 |Racial group| OR 
&lt; 365400002 |Finding of puberty stage| OR
&lt; 443938003 |Procedure carried out on subject|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-10"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="interpretationCode"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.appliesTo">
      <path value="Observation.referenceRange.appliesTo"/> 
      <short value="Reference range population"/> 
      <definition value="Codes to indicate the target population this reference range applies to.  For example,
       a reference range may be based on the normal population or a particular sex or
       race.  Multiple `appliesTo`  are interpreted as an &quot;AND&quot; of the target
       populations.  For example, to represent a target population of African American
       females, both a code of female and a code for African American would be used."/> 
      <comment value="This SHOULD be populated if there is more than one range.  If this element is not
       present then the normal population is assumed."/> 
      <requirements value="Need to be able to identify the target population for proper interpretation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.referenceRange.appliesTo"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationRangeType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes identifying the population the reference range applies to."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/referencerange-appliesto"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values| OR  
&lt; 365860008 |General clinical state finding| 
OR 
&lt; 250171008 |Clinical history or observation findings| OR  
&lt; 415229000 |Racial group| OR 
&lt; 365400002 |Finding of puberty stage| OR
&lt; 443938003 |Procedure carried out on subject|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-10"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="interpretationCode"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.age">
      <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"/> 
      <base> 
        <path value="Observation.referenceRange.age"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Range"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="Observation.referenceRange.text">
      <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 &quot;normals&quot;."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.referenceRange.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <condition value="obs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-7"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value:ST"/> 
      </mapping> 
    </element> 
    <element id="Observation.hasMember">
      <path value="Observation.hasMember"/> 
      <short value="Used when reporting vital signs panel components"/> 
      <definition value="Used when reporting vital signs panel components."/> 
      <comment value="When using this element, an observation will typically have either a value or a
       set of related resources, although both may be present in some cases.  For a discussion
       on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgr
      ouping) below.  Note that a system may calculate results from [QuestionnaireResponse](question
      naireresponse.html)  into a final score and represent the score as an Observation."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.hasMember"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <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 id="Observation.derivedFrom">
      <path value="Observation.derivedFrom"/> 
      <short value="Related resource from which the observation is made"/> 
      <definition value="The target resource that represents a measurement from which this observation value
       is derived. For example, a calculated anion gap or a fetal measurement based on
       an ultrasound image."/> 
      <comment value="All the reference choices that are listed in this element can represent clinical
       observations and other measurements that may be the source for a derived value.
        The most common reference will be another Observation.  For a discussion on the
       ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping)
       below."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.derivedFrom"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="Relationships established by OBX-4 usage"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".targetObservation"/> 
      </mapping> 
    </element> 
    <element id="Observation.component">
      <path value="Observation.component"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="code.coding.code"/> 
        </discriminator> 
        <discriminator> 
          <type value="value"/> 
          <path value="code.coding.system"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Used when reporting systolic and diastolic blood pressure."/> 
      <definition value="Used when reporting systolic and diastolic blood pressure."/> 
      <comment value="For a discussion on the ways Observations can be assembled in groups together see
       [Notes](observation.html#notes) below."/> 
      <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="2"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.component"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="vs-3"/> 
        <severity value="error"/> 
        <human value="If there is no a value a data absent reason must be present"/> 
        <expression value="value.exists() or dataAbsentReason.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <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 id="Observation.component.id">
      <path value="Observation.component.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.extension">
      <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. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.modifierExtension">
      <path value="Observation.component.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.code">
      <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;."/> 
      <comment value="*All* code-value and  component.code-component.value pairs need to be taken into
       account to correctly understand the meaning of the observation."/> 
      <requirements value="Knowing what kind of observation is being made is essential to understanding the
       observation."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsComponent"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the vital sign component measurement."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-component-measurement"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 363787002 |Observable entity| OR 
&lt; 386053000 |Evaluation procedure|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="code"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.value[x]">
      <path value="Observation.component.value[x]"/> 
      <slicing> 
        <discriminator> 
          <type value="type"/> 
          <path value="$this"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Vital Sign Value"/> 
      <definition value="Vital Sign Value."/> 
      <comment value="Used when observation has a set of component observations:
-  An observation may have both a value (e.g. an  Apgar score) and component observations
       (the observations from which the Apgar score was derived). 
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="Range"/> 
      </type> 
      <type> 
        <code value="Ratio"/> 
      </type> 
      <type> 
        <code value="SampledData"/> 
      </type> 
      <type> 
        <code value="time"/> 
      </type> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <type> 
        <code value="Attachment"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/> 
      </type> 
      <condition value="vs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.value[x]:valueQuantity">
      <path value="Observation.component.value[x]"/> 
      <sliceName value="valueQuantity"/> 
      <short value="Vital Sign Component Value recorded with UCUM (preferred)"/> 
      <definition value="Vital Sign Component Value recorded with UCUM (preferred)."/> 
      <comment value="Used when observation has a set of component observations:
-  An observation may have both a value (e.g. an  Apgar score) and component observations
       (the observations from which the Apgar score was derived). 
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
          <valueString value="Common UCUM units for recording Vital Signs."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsComponentUnits"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Commonly encountered UCUM units for recording Vital Signs Components."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.dataAbsentReason">
      <path value="Observation.component.dataAbsentReason"/> 
      <short value="Why the component result value is missing"/> 
      <definition value="Provides a reason why the expected value in the element Observation.component.value[x]
       is missing."/> 
      <comment 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&q
      uot;, &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"/> 
      <base> 
        <path value="Observation.component.dataAbsentReason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="vs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationValueAbsentReason"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes specifying why the result (`Observation.value[x]`) is missing."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value.nullFlavor"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.interpretation">
      <path value="Observation.component.interpretation"/> 
      <short value="High, low, normal, etc"/> 
      <definition value="A categorical assessment of an observation value.  For example, high, low, normal."/> 
      <comment value="Historically used for laboratory results (known as 'abnormal flag' ),  its use
       extends to other use cases where coded interpretations  are relevant.  Often reported
       as one or more simple compact codes this element is often placed adjacent to the
       result value in reports and flow sheets to signal the meaning/normalcy status of
       the result."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.component.interpretation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationInterpretation"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying interpretations of observations."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="interpretationCode"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363713009 |Has interpretation|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component.referenceRange">
      <path value="Observation.component.referenceRange"/> 
      <short value="Provides guide for interpretation of component result value"/> 
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended
       range."/> 
      <comment 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 might not be possible or appropriate. Whenever more than one reference
       range is supplied, the differences between them SHOULD be provided in the reference
       range and/or age properties."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.component.referenceRange"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <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 id="Observation.component:SystolicBP">
      <path value="Observation.component"/> 
      <sliceName value="SystolicBP"/> 
      <short value="Used when reporting systolic and diastolic blood pressure."/> 
      <definition value="Used when reporting systolic and diastolic blood pressure."/> 
      <comment value="For a discussion on the ways Observations can be assembled in groups together see
       [Notes](observation.html#notes) below."/> 
      <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="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="vs-3"/> 
        <severity value="error"/> 
        <human value="If there is no a value a data absent reason must be present"/> 
        <expression value="value.exists() or dataAbsentReason.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <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 id="Observation.component:SystolicBP.id">
      <path value="Observation.component.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.extension">
      <path value="Observation.component.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <discriminator> 
          <type value="pattern"/> 
          <path value="valueCodeableConcept"/> 
        </discriminator> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode">
      <path value="Observation.component.extension"/> 
      <sliceName value="SBPCode"/> 
      <short value="Classification of type of observation component"/> 
      <definition value="A code that classifies the general type of observation being made in the component."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-componentCategory"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode.id">
      <path value="Observation.component.extension.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode.extension">
      <path value="Observation.component.extension.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <description value="Extensions are always sliced by (at least) url"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="0"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode.url">
      <path value="Observation.component.extension.url"/> 
      <representation value="xmlAttr"/> 
      <short value="identifies the meaning of the extension"/> 
      <definition value="Source of the definition for the extension code - a logical name or a URL."/> 
      <comment value="The definition may point directly to a computable or human-readable definition
       of the extensibility codes, or it may be a logical URI as declared in some other
       specification. The definition SHALL be a URI for the Structure Definition defining
       the extension."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.url"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/observation-componentCategory"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode.value[x]">
      <path value="Observation.component.extension.value[x]"/> 
      <slicing> 
        <discriminator> 
          <type value="type"/> 
          <path value="$this"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="closed"/> 
      </slicing> 
      <short value="Value of extension"/> 
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](
      extensibility.html) for a list)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="ext-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationComponentCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level observation categories of the component."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode.value[x]:valueCodeableConcept">
      <path value="Observation.component.extension.value[x]"/> 
      <sliceName value="valueCodeableConcept"/> 
      <short value="Value of extension"/> 
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](
      extensibility.html) for a list)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="8480-6"/> 
        </coding> 
      </patternCodeableConcept> 
      <condition value="ext-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationComponentCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level observation categories of the component."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.modifierExtension">
      <path value="Observation.component.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.code">
      <path value="Observation.component.code"/> 
      <short value="Systolic Blood Pressure"/> 
      <definition value="Systolic Blood Pressure."/> 
      <comment value="*All* code-value and  component.code-component.value pairs need to be taken into
       account to correctly understand the meaning of the observation."/> 
      <requirements value="Knowing what kind of observation is being made is essential to understanding the
       observation."/> 
      <alias value="Component Test"/> 
      <alias value="Component Name"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignSystolicBP"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the set of LOINC codes that are appropriate for representing an
         arterial systolic BP vital sign measurement in Observation.component.code."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-systolicbp"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 363787002 |Observable entity| OR 
&lt; 386053000 |Evaluation procedure|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="code"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]">
      <path value="Observation.component.value[x]"/> 
      <slicing> 
        <discriminator> 
          <type value="type"/> 
          <path value="$this"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="closed"/> 
      </slicing> 
      <short value="Vital Sign Value"/> 
      <definition value="Vital Sign Value."/> 
      <comment value="Used when observation has a set of component observations:
-  An observation may have both a value (e.g. an  Apgar score) and component observations
       (the observations from which the Apgar score was derived). 
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <condition value="vs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity">
      <path value="Observation.component.value[x]"/> 
      <sliceName value="valueQuantity"/> 
      <short value="Vital Sign Component Value recorded with UCUM (preferred)"/> 
      <definition value="Vital Sign Component Value recorded with UCUM (preferred)."/> 
      <comment value="Used when observation has a set of component observations:
-  An observation may have both a value (e.g. an  Apgar score) and component observations
       (the observations from which the Apgar score was derived). 
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsComponentUnits"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Commonly encountered UCUM units for recording Vital Signs Components."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.id">
      <path value="Observation.component.value[x].id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.extension">
      <path value="Observation.component.value[x].extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <description value="Extensions are always sliced by (at least) url"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.value">
      <path value="Observation.component.value[x].value"/> 
      <short value="Numerical value (with implicit precision)"/> 
      <definition value="The value of the measured amount. The value includes an implicit precision in the
       presentation of the value."/> 
      <comment value="The implicit precision in the value should always be honored. Monetary values have
       their own rules for handling precision (refer to standard accounting text books)."/> 
      <requirements value="Precision is handled implicitly in almost all cases of measurement."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.value"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="SN.2  / CQ - N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.comparator">
      <path value="Observation.component.value[x].comparator"/> 
      <short value="&lt; | &lt;= | &gt;= | &gt; | ad - how to understand the value"/> 
      <definition value="How the value should be understood and represented - whether the actual value is
       greater or less than the stated value due to measurement issues; e.g. if the comparator
       is &quot;&lt;&quot; , then the real value is &lt; stated value."/> 
      <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L
       due to the limitations of measuring methodology."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.comparator"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <meaningWhenMissing value="If there is no comparator, then there is no modification of the value"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because the comparator modifies the
       interpretation of the value significantly. If there is no comparator, then there
       is no modification of the value"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuantityComparator"/> 
        </extension> 
        <strength value="required"/> 
        <description value="How the Quantity should be understood and represented."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|6.0.0-ballot2"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="SN.1  / CQ.1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="IVL properties"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.unit">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Observation.component.value[x].unit"/> 
      <short value="Unit representation"/> 
      <definition value="A human-readable form of the unit."/> 
      <requirements value="There are many representations for units of measure and in many contexts, particular
       representations are fixed and required. I.e. mcg for micrograms."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.unit"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="(see OBX.6 etc.) / CQ.2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ.unit"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.system">
      <path value="Observation.component.value[x].system"/> 
      <short value="System that defines coded unit form"/> 
      <definition value="The identification of the system that provides the coded form of the unit."/> 
      <requirements value="Need to know the system that defines the coded form of the unit."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.system"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <fixedUri value="http://unitsofmeasure.org"/> 
      <condition value="qty-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="(see OBX.6 etc.) / CQ.2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="CO.codeSystem, PQ.translation.codeSystem"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.value[x]:valueQuantity.code">
      <path value="Observation.component.value[x].code"/> 
      <short value="Coded responses from the common UCUM units for vital signs value set."/> 
      <definition value="Coded responses from the common UCUM units for vital signs value set."/> 
      <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units)
       or ISO 4217 for currency.  The context of use may additionally require a code from
       a particular system."/> 
      <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides
       this for quantities, but SNOMED CT provides many units of interest."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <fixedCode value="mm[Hg]"/> 
      <condition value="qty-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="(see OBX.6 etc.) / CQ.2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ.code, MO.currency, PQ.translation.code"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.dataAbsentReason">
      <path value="Observation.component.dataAbsentReason"/> 
      <short value="Why the component result value is missing"/> 
      <definition value="Provides a reason why the expected value in the element Observation.component.value[x]
       is missing."/> 
      <comment 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&q
      uot;, &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"/> 
      <base> 
        <path value="Observation.component.dataAbsentReason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="vs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationValueAbsentReason"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes specifying why the result (`Observation.value[x]`) is missing."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value.nullFlavor"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.interpretation">
      <path value="Observation.component.interpretation"/> 
      <short value="High, low, normal, etc"/> 
      <definition value="A categorical assessment of an observation value.  For example, high, low, normal."/> 
      <comment value="Historically used for laboratory results (known as 'abnormal flag' ),  its use
       extends to other use cases where coded interpretations  are relevant.  Often reported
       as one or more simple compact codes this element is often placed adjacent to the
       result value in reports and flow sheets to signal the meaning/normalcy status of
       the result."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.component.interpretation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationInterpretation"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying interpretations of observations."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="interpretationCode"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363713009 |Has interpretation|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:SystolicBP.referenceRange">
      <path value="Observation.component.referenceRange"/> 
      <short value="Provides guide for interpretation of component result value"/> 
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended
       range."/> 
      <comment 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 might not be possible or appropriate. Whenever more than one reference
       range is supplied, the differences between them SHOULD be provided in the reference
       range and/or age properties."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.component.referenceRange"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <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 id="Observation.component:DiastolicBP">
      <path value="Observation.component"/> 
      <sliceName value="DiastolicBP"/> 
      <short value="Used when reporting systolic and diastolic blood pressure."/> 
      <definition value="Used when reporting systolic and diastolic blood pressure."/> 
      <comment value="For a discussion on the ways Observations can be assembled in groups together see
       [Notes](observation.html#notes) below."/> 
      <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="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="vs-3"/> 
        <severity value="error"/> 
        <human value="If there is no a value a data absent reason must be present"/> 
        <expression value="value.exists() or dataAbsentReason.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/vitalsigns"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <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 id="Observation.component:DiastolicBP.id">
      <path value="Observation.component.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension">
      <path value="Observation.component.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <discriminator> 
          <type value="pattern"/> 
          <path value="valueCodeableConcept"/> 
        </discriminator> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode">
      <path value="Observation.component.extension"/> 
      <sliceName value="DBPCode"/> 
      <short value="Classification of type of observation component"/> 
      <definition value="A code that classifies the general type of observation being made in the component."/> 
      <comment value="In addition to the required category valueset, this element allows various categorization
       schemes based on the owner’s definition of the category and effectively multiple
       categories can be used at once.  The level of granularity is defined by the category
       concepts in the value set."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-componentCategory"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode.id">
      <path value="Observation.component.extension.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode.extension">
      <path value="Observation.component.extension.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <description value="Extensions are always sliced by (at least) url"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="0"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode.url">
      <path value="Observation.component.extension.url"/> 
      <representation value="xmlAttr"/> 
      <short value="identifies the meaning of the extension"/> 
      <definition value="Source of the definition for the extension code - a logical name or a URL."/> 
      <comment value="The definition may point directly to a computable or human-readable definition
       of the extensibility codes, or it may be a logical URI as declared in some other
       specification. The definition SHALL be a URI for the Structure Definition defining
       the extension."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.url"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/observation-componentCategory"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode.value[x]">
      <path value="Observation.component.extension.value[x]"/> 
      <slicing> 
        <discriminator> 
          <type value="type"/> 
          <path value="$this"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="closed"/> 
      </slicing> 
      <short value="Value of extension"/> 
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](
      extensibility.html) for a list)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="ext-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationComponentCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level observation categories of the component."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode.value[x]:valueCodeableConcept">
      <path value="Observation.component.extension.value[x]"/> 
      <sliceName value="valueCodeableConcept"/> 
      <short value="Value of extension"/> 
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](
      extensibility.html) for a list)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Extension.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="8462-4"/> 
        </coding> 
      </patternCodeableConcept> 
      <condition value="ext-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationComponentCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Codes for high level observation categories of the component."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.modifierExtension">
      <path value="Observation.component.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.code">
      <path value="Observation.component.code"/> 
      <short value="Diastolic Blood Pressure"/> 
      <definition value="Diastolic Blood Pressure."/> 
      <comment value="*All* code-value and  component.code-component.value pairs need to be taken into
       account to correctly understand the meaning of the observation."/> 
      <requirements value="Knowing what kind of observation is being made is essential to understanding the
       observation."/> 
      <alias value="Component Test"/> 
      <alias value="Component Name"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-7"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignDiastolicBP"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the set of LOINC codes that are appropriate for representing an
         arterial diastolic BP vital sign measurement in Observation.component.code."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-diastolicbp"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 363787002 |Observable entity| OR 
&lt; 386053000 |Evaluation procedure|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="code"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]">
      <path value="Observation.component.value[x]"/> 
      <slicing> 
        <discriminator> 
          <type value="type"/> 
          <path value="$this"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="closed"/> 
      </slicing> 
      <short value="Vital Sign Value"/> 
      <definition value="Vital Sign Value."/> 
      <comment value="Used when observation has a set of component observations:
-  An observation may have both a value (e.g. an  Apgar score) and component observations
       (the observations from which the Apgar score was derived). 
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <condition value="vs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity">
      <path value="Observation.component.value[x]"/> 
      <sliceName value="valueQuantity"/> 
      <short value="Vital Sign Component Value recorded with UCUM (preferred)"/> 
      <definition value="Vital Sign Component Value recorded with UCUM (preferred)."/> 
      <comment value="Used when observation has a set of component observations:
-  An observation may have both a value (e.g. an  Apgar score) and component observations
       (the observations from which the Apgar score was derived). 
-  If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- If a value is present, the datatype for this element should be determined by
       the `code`.
-  *CodeableConcept* with just a text would be used instead of a string if the
       field was usually coded, or if the type associated with the `code` defines a coded
       value.
-  *Attachment* is used if the observation result value is a binary file such as
       an image.  If the observation result value is derived from the binary file (for
       example 'X' detected and here is the the proof in this image), the binary file
       may be directly represented using *DocumentReference* and referenced by `derivedFrom`.
- The usage of valueReference is restricted to the MolecularSequence resource when
       used as a definitional resource, not as a patient-specific finding. .
- For additional guidance, see the [Notes section](observation.html#notes) below."/> 
      <requirements value="An observation exists to have a value, though it might not if it is in error, or
       if it represents a group of observations."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.component.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignsComponentUnits"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="Commonly encountered UCUM units for recording Vital Signs Components."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 441742003 |Evaluation finding|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-2, OBX-5, OBX-6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363714003 |Interprets|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.id">
      <path value="Observation.component.value[x].id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.extension">
      <path value="Observation.component.value[x].extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <description value="Extensions are always sliced by (at least) url"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part
       of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.value">
      <path value="Observation.component.value[x].value"/> 
      <short value="Numerical value (with implicit precision)"/> 
      <definition value="The value of the measured amount. The value includes an implicit precision in the
       presentation of the value."/> 
      <comment value="The implicit precision in the value should always be honored. Monetary values have
       their own rules for handling precision (refer to standard accounting text books)."/> 
      <requirements value="Precision is handled implicitly in almost all cases of measurement."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.value"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="SN.2  / CQ - N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.comparator">
      <path value="Observation.component.value[x].comparator"/> 
      <short value="&lt; | &lt;= | &gt;= | &gt; | ad - how to understand the value"/> 
      <definition value="How the value should be understood and represented - whether the actual value is
       greater or less than the stated value due to measurement issues; e.g. if the comparator
       is &quot;&lt;&quot; , then the real value is &lt; stated value."/> 
      <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L
       due to the limitations of measuring methodology."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.comparator"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <meaningWhenMissing value="If there is no comparator, then there is no modification of the value"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because the comparator modifies the
       interpretation of the value significantly. If there is no comparator, then there
       is no modification of the value"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuantityComparator"/> 
        </extension> 
        <strength value="required"/> 
        <description value="How the Quantity should be understood and represented."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|6.0.0-ballot2"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="SN.1  / CQ.1"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="IVL properties"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.unit">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Observation.component.value[x].unit"/> 
      <short value="Unit representation"/> 
      <definition value="A human-readable form of the unit."/> 
      <requirements value="There are many representations for units of measure and in many contexts, particular
       representations are fixed and required. I.e. mcg for micrograms."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.unit"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="(see OBX.6 etc.) / CQ.2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ.unit"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.system">
      <path value="Observation.component.value[x].system"/> 
      <short value="System that defines coded unit form"/> 
      <definition value="The identification of the system that provides the coded form of the unit."/> 
      <requirements value="Need to know the system that defines the coded form of the unit."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.system"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <fixedUri value="http://unitsofmeasure.org"/> 
      <condition value="qty-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="(see OBX.6 etc.) / CQ.2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="CO.codeSystem, PQ.translation.codeSystem"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.value[x]:valueQuantity.code">
      <path value="Observation.component.value[x].code"/> 
      <short value="Coded responses from the common UCUM units for vital signs value set."/> 
      <definition value="Coded responses from the common UCUM units for vital signs value set."/> 
      <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units)
       or ISO 4217 for currency.  The context of use may additionally require a code from
       a particular system."/> 
      <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides
       this for quantities, but SNOMED CT provides many units of interest."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <fixedCode value="mm[Hg]"/> 
      <condition value="qty-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="(see OBX.6 etc.) / CQ.2"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ.code, MO.currency, PQ.translation.code"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.dataAbsentReason">
      <path value="Observation.component.dataAbsentReason"/> 
      <short value="Why the component result value is missing"/> 
      <definition value="Provides a reason why the expected value in the element Observation.component.value[x]
       is missing."/> 
      <comment 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&q
      uot;, &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"/> 
      <base> 
        <path value="Observation.component.dataAbsentReason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="vs-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationValueAbsentReason"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes specifying why the result (`Observation.value[x]`) is missing."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value.nullFlavor"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.interpretation">
      <path value="Observation.component.interpretation"/> 
      <short value="High, low, normal, etc"/> 
      <definition value="A categorical assessment of an observation value.  For example, high, low, normal."/> 
      <comment value="Historically used for laboratory results (known as 'abnormal flag' ),  its use
       extends to other use cases where coded interpretations  are relevant.  Often reported
       as one or more simple compact codes this element is often placed adjacent to the
       result value in reports and flow sheets to signal the meaning/normalcy status of
       the result."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.component.interpretation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationInterpretation"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying interpretations of observations."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-8"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="interpretationCode"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-attr"/> 
        <map value="363713009 |Has interpretation|"/> 
      </mapping> 
    </element> 
    <element id="Observation.component:DiastolicBP.referenceRange">
      <path value="Observation.component.referenceRange"/> 
      <short value="Provides guide for interpretation of component result value"/> 
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended
       range."/> 
      <comment 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 might not be possible or appropriate. Whenever more than one reference
       range is supplied, the differences between them SHOULD be provided in the reference
       range and/or age properties."/> 
      <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="*"/> 
      <base> 
        <path value="Observation.component.referenceRange"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <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 id="Observation">
      <path value="Observation"/> 
      <short value="FHIR Blood Pressure Profile"/> 
      <definition value="This profile defines  how to represent Blood Pressure observations in FHIR using
       a standard LOINC code and UCUM units of measure.  This is a grouping structure.
       It has no value in Observation.valueQuantity but contains at least one component
       (systolic and/or diastolic)."/> 
      <min value="0"/> 
      <max value="*"/> 
    </element> 
    <element id="Observation.category">
      <path value="Observation.category"/> 
      <slicing> 
        <discriminator> 
          <type value="pattern"/> 
          <path value="$this"/> 
        </discriminator> 
        <rules value="open"/> 
      </slicing> 
      <min value="2"/> 
    </element> 
    <element id="Observation.category:BPCode">
      <path value="Observation.category"/> 
      <sliceName value="BPCode"/> 
      <min value="1"/> 
      <max value="1"/> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="85354-9"/> 
        </coding> 
      </patternCodeableConcept> 
    </element> 
    <element id="Observation.code">
      <path value="Observation.code"/> 
      <short value="Blood Pressure"/> 
      <definition value="Blood Pressure."/> 
      <alias value="Test"/> 
      <alias value="Name"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignBPPanel"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the set of LOINC codes that are appropriate for representing an
         arterial systolic and diastolic BP panel of vital sign measurements in Observation.code."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-bppanel"/> 
      </binding> 
    </element> 
    <element id="Observation.valueQuantity">
      <path value="Observation.valueQuantity"/> 
      <min value="0"/> 
      <max value="0"/> 
    </element> 
    <element id="Observation.component">
      <path value="Observation.component"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="code.coding.code"/> 
        </discriminator> 
        <discriminator> 
          <type value="value"/> 
          <path value="code.coding.system"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <min value="2"/> 
      <max value="*"/> 
    </element> 
    <element id="Observation.component:SystolicBP">
      <path value="Observation.component"/> 
      <sliceName value="SystolicBP"/> 
      <min value="1"/> 
      <max value="1"/> 
    </element> 
    <element id="Observation.component:SystolicBP.extension">
      <path value="Observation.component.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <discriminator> 
          <type value="pattern"/> 
          <path value="valueCodeableConcept"/> 
        </discriminator> 
        <rules value="open"/> 
      </slicing> 
      <min value="1"/> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode">
      <path value="Observation.component.extension"/> 
      <sliceName value="SBPCode"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-componentCategory"/> 
      </type> 
    </element> 
    <element id="Observation.component:SystolicBP.extension:SBPCode.valueCodeableConcept">
      <path value="Observation.component.extension.valueCodeableConcept"/> 
      <min value="1"/> 
      <max value="1"/> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="8480-6"/> 
        </coding> 
      </patternCodeableConcept> 
    </element> 
    <element id="Observation.component:SystolicBP.code">
      <path value="Observation.component.code"/> 
      <short value="Systolic Blood Pressure"/> 
      <definition value="Systolic Blood Pressure."/> 
      <alias value="Component Test"/> 
      <alias value="Component Name"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignSystolicBP"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the set of LOINC codes that are appropriate for representing an
         arterial systolic BP vital sign measurement in Observation.component.code."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-systolicbp"/> 
      </binding> 
    </element> 
    <element id="Observation.component:SystolicBP.valueQuantity">
      <path value="Observation.component.valueQuantity"/> 
      <type> 
        <code value="Quantity"/> 
      </type> 
    </element> 
    <element id="Observation.component:SystolicBP.valueQuantity.value">
      <path value="Observation.component.valueQuantity.value"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:SystolicBP.valueQuantity.unit">
      <path value="Observation.component.valueQuantity.unit"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:SystolicBP.valueQuantity.system">
      <path value="Observation.component.valueQuantity.system"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
      <fixedUri value="http://unitsofmeasure.org"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:SystolicBP.valueQuantity.code">
      <path value="Observation.component.valueQuantity.code"/> 
      <short value="Coded responses from the common UCUM units for vital signs value set."/> 
      <definition value="Coded responses from the common UCUM units for vital signs value set."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <fixedCode value="mm[Hg]"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:DiastolicBP">
      <path value="Observation.component"/> 
      <sliceName value="DiastolicBP"/> 
      <min value="1"/> 
      <max value="1"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension">
      <path value="Observation.component.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <discriminator> 
          <type value="pattern"/> 
          <path value="valueCodeableConcept"/> 
        </discriminator> 
        <rules value="open"/> 
      </slicing> 
      <min value="1"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode">
      <path value="Observation.component.extension"/> 
      <sliceName value="DBPCode"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-componentCategory"/> 
      </type> 
    </element> 
    <element id="Observation.component:DiastolicBP.extension:DBPCode.valueCodeableConcept">
      <path value="Observation.component.extension.valueCodeableConcept"/> 
      <min value="1"/> 
      <max value="1"/> 
      <patternCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="8462-4"/> 
        </coding> 
      </patternCodeableConcept> 
    </element> 
    <element id="Observation.component:DiastolicBP.code">
      <path value="Observation.component.code"/> 
      <short value="Diastolic Blood Pressure"/> 
      <definition value="Diastolic Blood Pressure."/> 
      <alias value="Component Test"/> 
      <alias value="Component Name"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="VitalSignDiastolicBP"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="This identifies the set of LOINC codes that are appropriate for representing an
         arterial diastolic BP vital sign measurement in Observation.component.code."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsign-diastolicbp"/> 
      </binding> 
    </element> 
    <element id="Observation.component:DiastolicBP.valueQuantity">
      <path value="Observation.component.valueQuantity"/> 
      <type> 
        <code value="Quantity"/> 
      </type> 
    </element> 
    <element id="Observation.component:DiastolicBP.valueQuantity.value">
      <path value="Observation.component.valueQuantity.value"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.valueQuantity.unit">
      <path value="Observation.component.valueQuantity.unit"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.valueQuantity.system">
      <path value="Observation.component.valueQuantity.system"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
      <fixedUri value="http://unitsofmeasure.org"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.component:DiastolicBP.valueQuantity.code">
      <path value="Observation.component.valueQuantity.code"/> 
      <short value="Coded responses from the common UCUM units for vital signs value set."/> 
      <definition value="Coded responses from the common UCUM units for vital signs value set."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <fixedCode value="mm[Hg]"/> 
      <mustSupport value="true"/> 
    </element> 
  </differential> 
</StructureDefinition>