This page is part of the FHIR Specification v6.0.0-ballot3: Release 6 Ballot (3rd Draft) (see Ballot Notes). The current version is 5.0.0.  For a full list of available versions, see the Directory of published versions 
| Orders and Observations  Work Group | Maturity Level: 1 | Trial Use | Use Context: Not yet ready for Production use | 
The canonical URL for this profile is:
http://hl7.org/fhir/StructureDefinition/cholesterol
Describes how the lab report is used for a standard Lipid Profile - Cholesterol, Triglyceride and Cholesterol fractions. Uses LOINC codes
This profile was published on Sat, Feb 21, 2015 00:00+1100 as a draft by Health Level Seven, Inc. - FHIR WG.
Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.
This structure is derived from Observation.
Summary
Mandatory: 3 elements (+3 nested mandatory elements)
 Must-Support: 9 elements
 Fixed Value: 5 elements
 Prohibited: 7 elements
This indicates the differences between this profile and the base Observation structure.
| Name  | Flags  | Card.  | Type  | Description & Constraints   | 
|---|---|---|---|---|
|   Observation | 1..1 | Observation | Measurements and simple assertions | |
|    code | S | 1..1 | CodeableConcept | Cholesterol Fixed Value: As shown | 
|     coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
|      system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
|      code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 35200-5 | |
|      display | 1..1 | string | Representation defined by the system Fixed Value: Cholesterol [Mass or Moles/volume] in Serum or Plasma | |
|    valueQuantity | S | 0..1 | Quantity | Cholesterol value | 
|     value | S | 0..1 | decimal | Actual numerical value | 
|     comparator | 0..0 | |||
|     unit | S | 1..1 | string | Unit representation Fixed Value: mmol/L | 
|     system | S | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org | 
|     code | S | 1..1 | code | Coded form of the unit Fixed Value: mmol/L | 
|    interpretation | S | 0..1 | CodeableConcept | + | ++ | +++ | - | -- | --- | 
|    note | S | 0..* | Annotation | Comments about result | 
|    referenceRange | S | 1..1 | BackboneElement | Provides guide for interpretation | 
|     low | 0..0 | |||
|     high | 1..1 | SimpleQuantity | High Range, if relevant Fixed Value: As shown | |
|      value | 1..1 | decimal | Numerical value (with implicit precision) Fixed Value: 4.5 | |
|     type | 0..0 | |||
|     appliesTo | 0..0 | |||
|     age | 0..0 | |||
|    hasMember | 0..0 | |||
|    derivedFrom | 0..0 | |||
|  | ||||
This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observation structure.
| Name  | Flags  | Card.  | Type  | Description & Constraints   | ||||
|---|---|---|---|---|---|---|---|---|
|   Observation | C  | 1..1 | Observation | Measurements and simple assertions obs-6: Observation.dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: 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). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present obs-10: Observation.component.dataAbsentReason SHALL only be present if Observation.component.value[x] is not present obs-11: if organizer exists and organizer = true, then value[x], dataAbsentReason and component SHALL NOT be present | ||||
|    id | Σ | 0..1 | id | Logical id of this artifact | ||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    language | 0..1 | code | Language of the resource content Binding: All Languages (required): IETF language tag for a human language 
 | |||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    extension | 0..* | Extension | Additional content defined by implementations | |||||
|    modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | Σ | 0..* | Identifier | Business Identifier for observation | ||||
|    instantiates[x] | Σ | 0..1 | canonical(ObservationDefinition), Reference(ObservationDefinition) | Instantiates FHIR ObservationDefinition | ||||
|    basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
|    triggeredBy | 0..* | BackboneElement | Triggering observation(s) | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     observation | Σ | 1..1 | Reference(Observation) | Triggering observation | ||||
|     type | Σ | 1..1 | code | reflex | repeat | re-run Binding: triggered Bytype (required): The type of TriggeredBy Observation. | ||||
|     reason | 0..1 | string | Reason that the observation was triggered | |||||
|    partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) | Part of referenced event | ||||
|    status | ?!Σ | 1..1 | code | registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained Binding: Observation Status (required): Codes providing the status of an observation. | ||||
|    category | 0..* | CodeableConcept | Classification of  type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories. | |||||
|    code | SΣC  | 1..1 | CodeableConcept | Cholesterol Binding: LOINC Codes (example): Codes identifying names of simple observations. Fixed Value: As shown | ||||
|     id | 0..0 | string | Unique id for inter-element referencing | |||||
|     extension | 0..0 | Extension | Additional content defined by implementations | |||||
|     coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
|      id | 0..0 | string | Unique id for inter-element referencing | |||||
|      extension | 0..0 | Extension | Additional content defined by implementations | |||||
|      system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
|      version | 0..0 | string | Version of the system - if relevant | |||||
|      code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 35200-5 | |||||
|      display | 1..1 | string | Representation defined by the system Fixed Value: Cholesterol [Mass or Moles/volume] in Serum or Plasma | |||||
|      userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |||||
|     text | 0..0 | string | Plain text representation of the concept | |||||
|    subject | Σ | 0..1 | Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct) | Who and/or what the observation is about | ||||
|    focus | ?!Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | ||||
|    organizer | ΣC  | 0..1 | boolean | This observation organizes/groups a set of sub-observations | ||||
|    encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | ||||
|    effective[x] | Σ | 0..1 | Clinically relevant time/time-period for observation | |||||
|     effectiveDateTime | dateTime | |||||||
|     effectivePeriod | Period | |||||||
|     effectiveTiming | Timing | |||||||
|     effectiveInstant | instant | |||||||
|    issued | Σ | 0..1 | instant | Date/Time this version was made available | ||||
|    performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService) | Who is responsible for the observation | ||||
|    Slices for value[x] | ΣC  | 0..1 | Quantity | Actual result Slice: Unordered, Closed by type:$this | ||||
|     value[x]:valueQuantity | SΣC  | 0..1 | Quantity | Cholesterol value | ||||
|      id | 0..1 | id | Unique id for inter-element referencing | |||||
|      extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
|      value | S | 0..1 | decimal | Actual numerical value | ||||
|      unit | S | 1..1 | string | Unit representation Fixed Value: mmol/L | ||||
|      system | SC  | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org | ||||
|      code | SC  | 1..1 | code | Coded form of the unit Fixed Value: mmol/L | ||||
|    dataAbsentReason | C  | 0..1 | CodeableConcept | Why the result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
|    interpretation | S | 0..1 | CodeableConcept | + | ++ | +++ | - | -- | --- Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations. | ||||
|    note | S | 0..* | Annotation | Comments about result | ||||
|    bodySite | C  | 0..1 | CodeableConcept | Observed body part Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts | ||||
|    bodyStructure | C  | 0..1 | Reference(BodyStructure) | Observed body structure | ||||
|    method | 0..1 | CodeableConcept | How it was done Binding: Observation Methods (example): Methods for simple observations. | |||||
|    specimen | C  | 0..1 | Reference(Specimen | Group) | Specimen used for this observation obs-9: If Observation.specimen is a reference to Group, the group can only have specimens | ||||
|    device | 0..1 | Reference(Device | DeviceMetric) | A reference to the device that generates the measurements or the device settings for the device | |||||
|    referenceRange | SC  | 1..1 | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     high | C  | 1..1 | SimpleQuantity | High Range, if relevant Fixed Value: As shown | ||||
|      id | 0..0 | string | Unique id for inter-element referencing | |||||
|      extension | 0..0 | Extension | Additional content defined by implementations | |||||
|      value | 1..1 | decimal | Numerical value (with implicit precision) Fixed Value: 4.5 | |||||
|      comparator | 0..0 | code | < | <= | >= | > | ad - how to understand the value | |||||
|      unit | 0..0 | string | Unit representation | |||||
|      system | 0..0 | uri | System that defines coded unit form | |||||
|      code | 0..0 | code | Coded form of the unit | |||||
|     normalValue | 0..1 | CodeableConcept | Normal value, if relevant Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation. | |||||
|     text | C  | 0..1 | markdown | Text based reference range in an observation | ||||
|    component | ΣC  | 0..* | BackboneElement | Component results | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     code | ΣC  | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. | ||||
|     value[x] | ΣC  | 0..1 | Actual component result | |||||
|      valueQuantity | Quantity | |||||||
|      valueCodeableConcept | CodeableConcept | |||||||
|      valueString | string | |||||||
|      valueBoolean | boolean | |||||||
|      valueInteger | integer | |||||||
|      valueRange | Range | |||||||
|      valueRatio | Ratio | |||||||
|      valueSampledData | SampledData | |||||||
|      valueTime | time | |||||||
|      valueDateTime | dateTime | |||||||
|      valuePeriod | Period | |||||||
|      valueAttachment | Attachment | |||||||
|      valueReference | Reference(MolecularSequence) | |||||||
|     dataAbsentReason | C  | 0..1 | CodeableConcept | Why the component result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
|     interpretation | 0..* | CodeableConcept | High, low, normal, etc Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations. | |||||
|     referenceRange | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result value | |||||
|  | ||||||||
<!-- ExampleLipidProfile --><Observation xmlns="http://hl7.org/fhir" > <!-- from Element: extension --> <id value="[id]"/><!-- 0..1 Logical id of this artifact --> <meta><!-- I 0..1 Meta Metadata about the resource --></meta> <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created --> <language value="[code]"/><!-- I 0..1 Language of the resource content --> <text><!-- I 0..1 Narrative Text summary of the resource, for human interpretation --></text> <contained><!-- 0..* Resource Contained, inline Resources --></contained> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored --></modifierExtension> <identifier><!-- I 0..* Identifier Business Identifier for observation --></identifier> <instantiates[x]><!-- I 0..1 canonical|Reference(ObservationDefinition) Instantiates FHIR ObservationDefinition --></instantiates[x]> <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn> <triggeredBy> I 0..* BackboneElement <!-- I 0..* Triggering observation(s) --> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored even if unrecognized --></modifierExtension> <observation><!-- I 1..1 Reference(Observation) Triggering observation --></observation> <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run --> <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered --> </triggeredBy> <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf> <status value="[code]"/><!-- I 1..1 registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained --> <category><!-- I 0..* CodeableConcept Classification of type of observation --></category> <code><!-- I 1..1 CodeableConcept Cholesterol --></code> <subject><!-- I 0..1 Reference(Patient) Who and/or what the observation is about --></subject> <focus><!-- I 0..* Reference(Resource) What the observation is about, when it is not about the subject of record --></focus> <organizer value="[boolean]"/><!-- I 0..1 This observation organizes/groups a set of sub-observations --> <encounter><!-- I 0..1 Reference(Encounter) Healthcare event during which this observation is made --></encounter> <effective[x]><!-- I 0..1 dateTime|Period|Timing|instant Clinically relevant time/time-period for observation --></effective[x]> <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available --> <performer><!-- I 0..* Reference(Practitioner) Who is responsible for the observation --></performer> <-- valueQuantity sliced by type:$this in the specified orderClosed--> <valueQuantity> I 0..1 Quantity <!-- I 0..1 Cholesterol value --> <value value="[decimal]"/><!-- I 0..1 Actual numerical value --> <comparator value="[code]"/><!-- I 0..0 < | <= | >= | > | ad - how to understand the value --> <unit value="[string]"/><!-- I 1..1 Unit representation --> <system value="[uri]"/><!-- I 1..1 System that defines coded unit form --> <code value="[code]"/><!-- I 1..1 Coded form of the unit --> </valueQuantity> <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result value is missing --></dataAbsentReason> <interpretation><!-- I 0..1 CodeableConcept + | ++ | +++ | - | -- | --- --></interpretation> <note><!-- I 0..* Annotation Comments about result --></note> <bodySite><!-- I 0..1 CodeableConcept Observed body part --></bodySite> <bodyStructure><!-- I 0..1 Reference(BodyStructure) Observed body structure --></bodyStructure> <method><!-- I 0..1 CodeableConcept How it was done --></method> <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen> <device><!-- I 0..1 Reference(Device) A reference to the device that generates the measurements or the device settings for the device --></device> <referenceRange> I 1..1 BackboneElement <!-- I 1..1 Provides guide for interpretation --> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored even if unrecognized --></modifierExtension> <low><!-- I 0..0 Quantity Low Range, if relevant --></low> <high><!-- I 1..1 Quantity High Range, if relevant --></high> <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant --></normalValue> <type><!-- I 0..0 CodeableConcept Reference range qualifier --></type> <appliesTo><!-- I 0..0 CodeableConcept Reference range population --></appliesTo> <age><!-- I 0..0 Range Applicable age range, if relevant --></age> <text value="[markdown]"/><!-- I 0..1 Text based reference range in an observation --> </referenceRange> <hasMember><!-- I 0..0 Reference(Observation) Related resource that belongs to the Observation group --></hasMember> <derivedFrom><!-- I 0..0 Reference(DocumentReference) Related resource from which the observation is made --></derivedFrom> <component> I 0..* BackboneElement <!-- I 0..* Component results --> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored even if unrecognized --></modifierExtension> <code><!-- I 1..1 CodeableConcept Type of component observation (code / type) --></code> <value[x]><!-- I 0..1 Quantity|CodeableConcept|string| boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment| Reference(MolecularSequence) Actual component result --></value[x]> <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result value is missing --></dataAbsentReason> <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc --></interpretation> <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange Provides guide for interpretation of component result value --></referenceRange> </component> </Observation>
{ // ExampleLipidProfile
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
    "category" : [{ CodeableConcept }], // IClassification of  type of observation
    "code" : { CodeableConcept }, // I R! 
    "subject" : { Reference(Patient) }, // IWho and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "organizer" : <boolean>, // IThis observation organizes/groups a set of sub-observations
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Clinically relevant time/time-period for observation. One of these 4:
    "effectiveDateTime" : "<dateTime>", // IClinically relevant time/time-period for observation
    "effectivePeriod" : { Period }, // IClinically relevant time/time-period for observation
    "effectiveTiming" : { Timing }, // IClinically relevant time/time-period for observation
    "effectiveInstant" : "<instant>", // IClinically relevant time/time-period for observation
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Cholesterol value // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "value" : <decimal>, // IActual numerical value
        "unit" : "mmol/L", // I R! 
        "system" : "http://unitsofmeasure.org", // I R! 
        "code" : "mmol/L" // I R! 
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result value is missing
    "interpretation" : { CodeableConcept }, // I+ | ++ | +++ | - | -- | ---
    "note" : [{ Annotation }], // IComments about result
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // IA reference to the device that generates the measurements or the device settings for the device
    "referenceRange" : { BackboneElement }, // I R! Provides guide for interpretation
    "component" : [{ BackboneElement }], // IComponent results
  }
   This structure is derived from Observation.
Differential View
This indicates the differences between this profile and the base Observation structure.
| Name  | Flags  | Card.  | Type  | Description & Constraints   | 
|---|---|---|---|---|
|   Observation | 1..1 | Observation | Measurements and simple assertions | |
|    code | S | 1..1 | CodeableConcept | Cholesterol Fixed Value: As shown | 
|     coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
|      system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |
|      code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 35200-5 | |
|      display | 1..1 | string | Representation defined by the system Fixed Value: Cholesterol [Mass or Moles/volume] in Serum or Plasma | |
|    valueQuantity | S | 0..1 | Quantity | Cholesterol value | 
|     value | S | 0..1 | decimal | Actual numerical value | 
|     comparator | 0..0 | |||
|     unit | S | 1..1 | string | Unit representation Fixed Value: mmol/L | 
|     system | S | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org | 
|     code | S | 1..1 | code | Coded form of the unit Fixed Value: mmol/L | 
|    interpretation | S | 0..1 | CodeableConcept | + | ++ | +++ | - | -- | --- | 
|    note | S | 0..* | Annotation | Comments about result | 
|    referenceRange | S | 1..1 | BackboneElement | Provides guide for interpretation | 
|     low | 0..0 | |||
|     high | 1..1 | SimpleQuantity | High Range, if relevant Fixed Value: As shown | |
|      value | 1..1 | decimal | Numerical value (with implicit precision) Fixed Value: 4.5 | |
|     type | 0..0 | |||
|     appliesTo | 0..0 | |||
|     age | 0..0 | |||
|    hasMember | 0..0 | |||
|    derivedFrom | 0..0 | |||
|  | ||||
Snapshot View
This provides the consolidated view (aka snapshot) of the profile after applying the changes in this profile to the base Observation structure.
| Name  | Flags  | Card.  | Type  | Description & Constraints   | ||||
|---|---|---|---|---|---|---|---|---|
|   Observation | C  | 1..1 | Observation | Measurements and simple assertions obs-6: Observation.dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: 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). obs-8: bodyStructure SHALL only be present if Observation.bodySite is not present obs-10: Observation.component.dataAbsentReason SHALL only be present if Observation.component.value[x] is not present obs-11: if organizer exists and organizer = true, then value[x], dataAbsentReason and component SHALL NOT be present | ||||
|    id | Σ | 0..1 | id | Logical id of this artifact | ||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    language | 0..1 | code | Language of the resource content Binding: All Languages (required): IETF language tag for a human language 
 | |||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    extension | 0..* | Extension | Additional content defined by implementations | |||||
|    modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | Σ | 0..* | Identifier | Business Identifier for observation | ||||
|    instantiates[x] | Σ | 0..1 | canonical(ObservationDefinition), Reference(ObservationDefinition) | Instantiates FHIR ObservationDefinition | ||||
|    basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
|    triggeredBy | 0..* | BackboneElement | Triggering observation(s) | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     observation | Σ | 1..1 | Reference(Observation) | Triggering observation | ||||
|     type | Σ | 1..1 | code | reflex | repeat | re-run Binding: triggered Bytype (required): The type of TriggeredBy Observation. | ||||
|     reason | 0..1 | string | Reason that the observation was triggered | |||||
|    partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) | Part of referenced event | ||||
|    status | ?!Σ | 1..1 | code | registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained Binding: Observation Status (required): Codes providing the status of an observation. | ||||
|    category | 0..* | CodeableConcept | Classification of  type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories. | |||||
|    code | SΣC  | 1..1 | CodeableConcept | Cholesterol Binding: LOINC Codes (example): Codes identifying names of simple observations. Fixed Value: As shown | ||||
|     id | 0..0 | string | Unique id for inter-element referencing | |||||
|     extension | 0..0 | Extension | Additional content defined by implementations | |||||
|     coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
|      id | 0..0 | string | Unique id for inter-element referencing | |||||
|      extension | 0..0 | Extension | Additional content defined by implementations | |||||
|      system | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org | |||||
|      version | 0..0 | string | Version of the system - if relevant | |||||
|      code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 35200-5 | |||||
|      display | 1..1 | string | Representation defined by the system Fixed Value: Cholesterol [Mass or Moles/volume] in Serum or Plasma | |||||
|      userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |||||
|     text | 0..0 | string | Plain text representation of the concept | |||||
|    subject | Σ | 0..1 | Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct) | Who and/or what the observation is about | ||||
|    focus | ?!Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record | ||||
|    organizer | ΣC  | 0..1 | boolean | This observation organizes/groups a set of sub-observations | ||||
|    encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | ||||
|    effective[x] | Σ | 0..1 | Clinically relevant time/time-period for observation | |||||
|     effectiveDateTime | dateTime | |||||||
|     effectivePeriod | Period | |||||||
|     effectiveTiming | Timing | |||||||
|     effectiveInstant | instant | |||||||
|    issued | Σ | 0..1 | instant | Date/Time this version was made available | ||||
|    performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService) | Who is responsible for the observation | ||||
|    Slices for value[x] | ΣC  | 0..1 | Quantity | Actual result Slice: Unordered, Closed by type:$this | ||||
|     value[x]:valueQuantity | SΣC  | 0..1 | Quantity | Cholesterol value | ||||
|      id | 0..1 | id | Unique id for inter-element referencing | |||||
|      extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
|      value | S | 0..1 | decimal | Actual numerical value | ||||
|      unit | S | 1..1 | string | Unit representation Fixed Value: mmol/L | ||||
|      system | SC  | 1..1 | uri | System that defines coded unit form Fixed Value: http://unitsofmeasure.org | ||||
|      code | SC  | 1..1 | code | Coded form of the unit Fixed Value: mmol/L | ||||
|    dataAbsentReason | C  | 0..1 | CodeableConcept | Why the result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
|    interpretation | S | 0..1 | CodeableConcept | + | ++ | +++ | - | -- | --- Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations. | ||||
|    note | S | 0..* | Annotation | Comments about result | ||||
|    bodySite | C  | 0..1 | CodeableConcept | Observed body part Binding: SNOMED CT Body Structures (example): SNOMED CT Body site concepts | ||||
|    bodyStructure | C  | 0..1 | Reference(BodyStructure) | Observed body structure | ||||
|    method | 0..1 | CodeableConcept | How it was done Binding: Observation Methods (example): Methods for simple observations. | |||||
|    specimen | C  | 0..1 | Reference(Specimen | Group) | Specimen used for this observation obs-9: If Observation.specimen is a reference to Group, the group can only have specimens | ||||
|    device | 0..1 | Reference(Device | DeviceMetric) | A reference to the device that generates the measurements or the device settings for the device | |||||
|    referenceRange | SC  | 1..1 | BackboneElement | Provides guide for interpretation obs-3: Must have at least a low or a high or text | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     high | C  | 1..1 | SimpleQuantity | High Range, if relevant Fixed Value: As shown | ||||
|      id | 0..0 | string | Unique id for inter-element referencing | |||||
|      extension | 0..0 | Extension | Additional content defined by implementations | |||||
|      value | 1..1 | decimal | Numerical value (with implicit precision) Fixed Value: 4.5 | |||||
|      comparator | 0..0 | code | < | <= | >= | > | ad - how to understand the value | |||||
|      unit | 0..0 | string | Unit representation | |||||
|      system | 0..0 | uri | System that defines coded unit form | |||||
|      code | 0..0 | code | Coded form of the unit | |||||
|     normalValue | 0..1 | CodeableConcept | Normal value, if relevant Binding: Observation Reference Range Normal Value Codes (extensible): Codes identifying the normal value of the observation. | |||||
|     text | C  | 0..1 | markdown | Text based reference range in an observation | ||||
|    component | ΣC  | 0..* | BackboneElement | Component results | ||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     code | ΣC  | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. | ||||
|     value[x] | ΣC  | 0..1 | Actual component result | |||||
|      valueQuantity | Quantity | |||||||
|      valueCodeableConcept | CodeableConcept | |||||||
|      valueString | string | |||||||
|      valueBoolean | boolean | |||||||
|      valueInteger | integer | |||||||
|      valueRange | Range | |||||||
|      valueRatio | Ratio | |||||||
|      valueSampledData | SampledData | |||||||
|      valueTime | time | |||||||
|      valueDateTime | dateTime | |||||||
|      valuePeriod | Period | |||||||
|      valueAttachment | Attachment | |||||||
|      valueReference | Reference(MolecularSequence) | |||||||
|     dataAbsentReason | C  | 0..1 | CodeableConcept | Why the component result value is missing Binding: Data Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
|     interpretation | 0..* | CodeableConcept | High, low, normal, etc Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations. | |||||
|     referenceRange | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result value | |||||
|  | ||||||||
XML Template
<!-- ExampleLipidProfile --><Observation xmlns="http://hl7.org/fhir" > <!-- from Element: extension --> <id value="[id]"/><!-- 0..1 Logical id of this artifact --> <meta><!-- I 0..1 Meta Metadata about the resource --></meta> <implicitRules value="[uri]"/><!-- I 0..1 A set of rules under which this content was created --> <language value="[code]"/><!-- I 0..1 Language of the resource content --> <text><!-- I 0..1 Narrative Text summary of the resource, for human interpretation --></text> <contained><!-- 0..* Resource Contained, inline Resources --></contained> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored --></modifierExtension> <identifier><!-- I 0..* Identifier Business Identifier for observation --></identifier> <instantiates[x]><!-- I 0..1 canonical|Reference(ObservationDefinition) Instantiates FHIR ObservationDefinition --></instantiates[x]> <basedOn><!-- I 0..* Reference(CarePlan) Fulfills plan, proposal or order --></basedOn> <triggeredBy> I 0..* BackboneElement <!-- I 0..* Triggering observation(s) --> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored even if unrecognized --></modifierExtension> <observation><!-- I 1..1 Reference(Observation) Triggering observation --></observation> <type value="[code]"/><!-- I 1..1 reflex | repeat | re-run --> <reason value="[string]"/><!-- I 0..1 Reason that the observation was triggered --> </triggeredBy> <partOf><!-- I 0..* Reference(MedicationAdministration) Part of referenced event --></partOf> <status value="[code]"/><!-- I 1..1 registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained --> <category><!-- I 0..* CodeableConcept Classification of type of observation --></category> <code><!-- I 1..1 CodeableConcept Cholesterol --></code> <subject><!-- I 0..1 Reference(Patient) Who and/or what the observation is about --></subject> <focus><!-- I 0..* Reference(Resource) What the observation is about, when it is not about the subject of record --></focus> <organizer value="[boolean]"/><!-- I 0..1 This observation organizes/groups a set of sub-observations --> <encounter><!-- I 0..1 Reference(Encounter) Healthcare event during which this observation is made --></encounter> <effective[x]><!-- I 0..1 dateTime|Period|Timing|instant Clinically relevant time/time-period for observation --></effective[x]> <issued value="[instant]"/><!-- I 0..1 Date/Time this version was made available --> <performer><!-- I 0..* Reference(Practitioner) Who is responsible for the observation --></performer> <-- valueQuantity sliced by type:$this in the specified orderClosed--> <valueQuantity> I 0..1 Quantity <!-- I 0..1 Cholesterol value --> <value value="[decimal]"/><!-- I 0..1 Actual numerical value --> <comparator value="[code]"/><!-- I 0..0 < | <= | >= | > | ad - how to understand the value --> <unit value="[string]"/><!-- I 1..1 Unit representation --> <system value="[uri]"/><!-- I 1..1 System that defines coded unit form --> <code value="[code]"/><!-- I 1..1 Coded form of the unit --> </valueQuantity> <dataAbsentReason><!-- I 0..1 CodeableConcept Why the result value is missing --></dataAbsentReason> <interpretation><!-- I 0..1 CodeableConcept + | ++ | +++ | - | -- | --- --></interpretation> <note><!-- I 0..* Annotation Comments about result --></note> <bodySite><!-- I 0..1 CodeableConcept Observed body part --></bodySite> <bodyStructure><!-- I 0..1 Reference(BodyStructure) Observed body structure --></bodyStructure> <method><!-- I 0..1 CodeableConcept How it was done --></method> <specimen><!-- I 0..1 Reference(Specimen) Specimen used for this observation --></specimen> <device><!-- I 0..1 Reference(Device) A reference to the device that generates the measurements or the device settings for the device --></device> <referenceRange> I 1..1 BackboneElement <!-- I 1..1 Provides guide for interpretation --> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored even if unrecognized --></modifierExtension> <low><!-- I 0..0 Quantity Low Range, if relevant --></low> <high><!-- I 1..1 Quantity High Range, if relevant --></high> <normalValue><!-- I 0..1 CodeableConcept Normal value, if relevant --></normalValue> <type><!-- I 0..0 CodeableConcept Reference range qualifier --></type> <appliesTo><!-- I 0..0 CodeableConcept Reference range population --></appliesTo> <age><!-- I 0..0 Range Applicable age range, if relevant --></age> <text value="[markdown]"/><!-- I 0..1 Text based reference range in an observation --> </referenceRange> <hasMember><!-- I 0..0 Reference(Observation) Related resource that belongs to the Observation group --></hasMember> <derivedFrom><!-- I 0..0 Reference(DocumentReference) Related resource from which the observation is made --></derivedFrom> <component> I 0..* BackboneElement <!-- I 0..* Component results --> <modifierExtension><!-- I 0..* Extension Extensions that cannot be ignored even if unrecognized --></modifierExtension> <code><!-- I 1..1 CodeableConcept Type of component observation (code / type) --></code> <value[x]><!-- I 0..1 Quantity|CodeableConcept|string| boolean|integer|Range|Ratio|SampledData|time|dateTime|Period|Attachment| Reference(MolecularSequence) Actual component result --></value[x]> <dataAbsentReason><!-- I 0..1 CodeableConcept Why the component result value is missing --></dataAbsentReason> <interpretation><!-- I 0..* CodeableConcept High, low, normal, etc --></interpretation> <referenceRange><!-- See http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange Provides guide for interpretation of component result value --></referenceRange> </component> </Observation>
JSON Template
{ // ExampleLipidProfile
  // from Element: extension
    "meta" : { Meta }, // IMetadata about the resource
    "implicitRules" : "<uri>", // IA set of rules under which this content was created
    "language" : "<code>", // ILanguage of the resource content
    "text" : { Narrative }, // IText summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], // IExtensions that cannot be ignored
    "identifier" : [{ Identifier }], // IBusiness Identifier for observation
  // value[x]: Instantiates FHIR ObservationDefinition. One of these 2:
    "instantiatesCanonical" : "<canonical>", // IInstantiates FHIR ObservationDefinition
    "instantiatesReference" : { Reference(ObservationDefinition) }, // IInstantiates FHIR ObservationDefinition
    "basedOn" : [{ Reference(CarePlan) }], // IFulfills plan, proposal or order
    "triggeredBy" : [{ BackboneElement }], // ITriggering observation(s)
    "partOf" : [{ Reference(MedicationAdministration) }], // IPart of referenced event
    "status" : "<code>", // I R! registered | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
    "category" : [{ CodeableConcept }], // IClassification of  type of observation
    "code" : { CodeableConcept }, // I R! 
    "subject" : { Reference(Patient) }, // IWho and/or what the observation is about
    "focus" : [{ Reference(Resource) }], // IWhat the observation is about, when it is not about the subject of record
    "organizer" : <boolean>, // IThis observation organizes/groups a set of sub-observations
    "encounter" : { Reference(Encounter) }, // IHealthcare event during which this observation is made
  // value[x]: Clinically relevant time/time-period for observation. One of these 4:
    "effectiveDateTime" : "<dateTime>", // IClinically relevant time/time-period for observation
    "effectivePeriod" : { Period }, // IClinically relevant time/time-period for observation
    "effectiveTiming" : { Timing }, // IClinically relevant time/time-period for observation
    "effectiveInstant" : "<instant>", // IClinically relevant time/time-period for observation
    "issued" : "<instant>", // IDate/Time this version was made available
    "performer" : [{ Reference(Practitioner) }], // IWho is responsible for the observation
    "valueQuantity" : [ //  sliced by type:$this  in the specified order, Closed 
      { // Cholesterol value // I
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "value" : <decimal>, // IActual numerical value
        "unit" : "mmol/L", // I R! 
        "system" : "http://unitsofmeasure.org", // I R! 
        "code" : "mmol/L" // I R! 
      }
    ],
    "dataAbsentReason" : { CodeableConcept }, // IWhy the result value is missing
    "interpretation" : { CodeableConcept }, // I+ | ++ | +++ | - | -- | ---
    "note" : [{ Annotation }], // IComments about result
    "bodySite" : { CodeableConcept }, // IObserved body part
    "bodyStructure" : { Reference(BodyStructure) }, // IObserved body structure
    "method" : { CodeableConcept }, // IHow it was done
    "specimen" : { Reference(Specimen) }, // ISpecimen used for this observation
    "device" : { Reference(Device) }, // IA reference to the device that generates the measurements or the device settings for the device
    "referenceRange" : { BackboneElement }, // I R! Provides guide for interpretation
    "component" : [{ BackboneElement }], // IComponent results
  }
   
Alternate definitions: Master Definition (XML, JSON), Schematron
| Path | Name | Conformance | ValueSet | 
| Observation.language | All Languages | required | All Languages | 
| Observation.triggeredBy.type | triggered Bytype | required | triggered Bytype | 
| Observation.status | Observation Status | required | Observation Status | 
| Observation.category | Observation Category Codes | preferred | Observation Category Codes | 
| Observation.code | LOINC Codes | example | LOINC Codes | 
| Observation.dataAbsentReason | Data Absent Reason | extensible | Data Absent Reason | 
| Observation.interpretation | Observation Interpretation Codes | extensible | Observation Interpretation Codes | 
| Observation.bodySite | SNOMED CT Body Structures | example | SNOMED CT Body Structures | 
| Observation.method | Observation Methods | example | Observation Methods | 
| Observation.referenceRange.normalValue | Observation Reference Range Normal Value Codes | extensible | Observation Reference Range Normal Value Codes | 
| Observation.component.code | LOINC Codes | example | LOINC Codes | 
| Observation.component.dataAbsentReason | Data Absent Reason | extensible | Data Absent Reason | 
| Observation.component.interpretation | Observation Interpretation Codes | extensible | Observation Interpretation Codes |