R6 Ballot (2nd Draft)

Publish-box (todo)

Orders and Observations icon Work Group  Maturity Level: 0 Trial Use Use Context: Not yet ready for Production use

Mappings for the ldlcholesterol Profile (see Mappings to Other Standards for further information & status).

ExampleLipidProfile
Observation Event
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier Event.identifier
   instantiates[x] Event.instantiatesCanonical
   basedOn Event.basedOn
   triggeredBy
      id
      extension
      modifierExtension
      observation
      type
      reason
   partOf Event.partOf
   status Event.status
   category
   code Event.code
   subject Event.subject
   focus
   encounter Event.encounter
   effective[x] Event.occurrence[x]
   issued
   performer Event.performer.actor
   value[x]
   value[x] valueQuantity
   dataAbsentReason
   interpretation
   note
   bodySite
   bodyStructure
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      high
      normalValue
      text
   component
      id
      extension
      modifierExtension
      code
      value[x]
      dataAbsentReason
      interpretation
      referenceRange

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
ExampleLipidProfile
Observation < 363787002 |Observable entity|
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   instantiates[x]
   basedOn
   triggeredBy
      id
      extension
      modifierExtension
      observation
      type
      reason
   partOf
   status < 445584004 |Report by finality status|
   category
   code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   subject
   focus
   encounter
   effective[x]
   issued
   performer
   value[x] < 441742003 |Evaluation finding|
   value[x] valueQuantity < 441742003 |Evaluation finding|
   dataAbsentReason
   interpretation < 260245000 |Findings values|
   note
   bodySite < 123037004 |Body structure|
   bodyStructure
   method
   specimen < 123038009 |Specimen|
   device < 49062001 |Device|
   referenceRange
      id
      extension
      modifierExtension
      high
      normalValue
      text
   component
      id
      extension
      modifierExtension
      code < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      value[x] 363714003 |Interprets| < 441742003 |Evaluation finding|
      dataAbsentReason
      interpretation < 260245000 |Findings values|
      referenceRange
ExampleLipidProfile
Observation OBX
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier 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.
   instantiates[x]
   basedOn ORC
   triggeredBy ORC
      id
      extension
      modifierExtension
      observation
      type
      reason
   partOf Varies by domain
   status OBX-11
   category
   code OBX-3
   subject PID-3
   focus OBX-3
   encounter PV1
   effective[x] OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   issued OBR-22 (or MSH-7), or perhaps OBX-19 (depends on who observation made)
   performer 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'
   value[x] OBX-2, OBX-5, OBX-6
   value[x] valueQuantity OBX-2, OBX-5, OBX-6
   dataAbsentReason N/A
   interpretation OBX-8
   note NTE-3 (partner NTE to OBX, or sometimes another (child?) OBX)
   bodySite OBX-20
   bodyStructure
   method OBX-17
   specimen SPM segment
   device OBX-17 / PRT -10
   referenceRange OBX-7
      id
      extension
      modifierExtension
      high OBX-7
      normalValue OBX-7
      text OBX-7
   component containment by OBX-4?
      id
      extension
      modifierExtension
      code OBX-3
      value[x] OBX-2, OBX-5, OBX-6
      dataAbsentReason N/A
      interpretation OBX-8
      referenceRange OBX-7
ExampleLipidProfile
Observation Entity, Role, or Act,Observation[classCode=OBS, moodCode=EVN]
   id
   meta
   implicitRules
   language
   text Act.text?
   contained N/A
   extension N/A
   modifierExtension N/A
   identifier id
   instantiates[x] .outboundRelationship[typeCode=DEFN].target
   basedOn .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
   triggeredBy .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
      id n/a
      extension n/a
      modifierExtension N/A
      observation outBoundRelationship
      type code
      reason annotation
   partOf .outboundRelationship[typeCode=FLFS].target
   status status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
   category .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   code code
   subject participation[typeCode=RTGT]
   focus participation[typeCode=SBJ]
   encounter inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
   effective[x] effectiveTime
   issued participation[typeCode=AUT].time
   performer participation[typeCode=PRF]
   value[x] value
   value[x] valueQuantity value
   dataAbsentReason value.nullFlavor
   interpretation interpretationCode
   note subjectOf.observationEvent[code="annotation"].value
   bodySite targetSiteCode
   bodyStructure targetSiteCode
   method methodCode
   specimen participation[typeCode=SPC].specimen
   device participation[typeCode=DEV]
   referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
      id n/a
      extension n/a
      modifierExtension N/A
      high value:IVL_PQ.high
      normalValue value:IVL_PQ.normal
      text value:ST
   component outBoundRelationship[typeCode=COMP]
      id n/a
      extension n/a
      modifierExtension N/A
      code code
      value[x] value
      dataAbsentReason value.nullFlavor
      interpretation interpretationCode
      referenceRange outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
ExampleLipidProfile
Observation clinical.diagnostics
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier FiveWs.identifier
   instantiates[x]
   basedOn
   triggeredBy
      id
      extension
      modifierExtension
      observation
      type
      reason
   partOf
   status FiveWs.status
   category FiveWs.class
   code FiveWs.what[x]
   subject FiveWs.subject[x]
   focus FiveWs.subject[x]
   encounter FiveWs.context
   effective[x] FiveWs.done[x]
   issued FiveWs.recorded
   performer FiveWs.actor
   value[x]
   value[x] valueQuantity
   dataAbsentReason
   interpretation
   note
   bodySite
   bodyStructure
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      high
      normalValue
      text
   component
      id
      extension
      modifierExtension
      code FiveWs.what[x]
      value[x]
      dataAbsentReason
      interpretation
      referenceRange

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
ExampleLipidProfile
Observation
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   instantiates[x]
   basedOn
   triggeredBy
      id
      extension
      modifierExtension
      observation
      type
      reason
   partOf
   status
   category
   code 116680003 |Is a|
   subject
   focus
   encounter
   effective[x]
   issued
   performer
   value[x] 363714003 |Interprets|
   value[x] valueQuantity 363714003 |Interprets|
   dataAbsentReason
   interpretation 363713009 |Has interpretation|
   note
   bodySite 718497002 |Inherent location|
   bodyStructure
   method
   specimen 704319004 |Inherent in|
   device 424226004 |Using device|
   referenceRange
      id
      extension
      modifierExtension
      high
      normalValue
      text
   component
      id
      extension
      modifierExtension
      code
      value[x] 363714003 |Interprets|
      dataAbsentReason
      interpretation 363713009 |Has interpretation|
      referenceRange