Summary

10.1.19.74.2 Complete Summary of the Mandatory Requirements

1. One code in Observation.code which must have
   • a fixed Observation.code.coding.system='http ://loinc.org'
   • a fixed Observation.code.coding.code= 85354-9'
   • Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an 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'
   • Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an 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'
   • Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
4. fixedObservation.component.valueQuantity.code = 'mm[Hg]'

Fixed Value: 8 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

• The element Observation.code.coding is sliced based on the value of value:code
• The element Observation.component is sliced based on the value of value:code.coding.code
• The element Observation.component.code.coding is sliced based on the value of value:code

<!-- Vital Signs Profile -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- 0..1 Language of the resource content  -->
 <text><!-- 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan)|Reference(DeviceRequest)|Reference(ImmunizationRecommendation)|Reference(MedicationRequest)|
   Reference(NutritionOrder)|Reference(ProcedureRequest)|Reference(ReferralRequest) Fulfills plan, proposal or order --></basedOn>
 <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended +  -->
 <category><!--  1..* CodeableConcept Classification of  type of observation  --></category>
 <code> 1..1 CodeableConcept  <!-- 1..1 Blood Pressure -->
  <-- coding sliced by value:code  in the specified orderOpen-->
  <coding> 0..* Coding  <!-- 0..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- 0..1 Identity of the terminology system -->
   <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- 0..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- 1..1 Reference(Patient) Who and/or what this is about --></subject>
 <context><!-- 0..1 Reference(Encounter)|Reference(EpisodeOfCare) 
     Healthcare event during which this observation is made --></context>
 <effective[x]><!--  1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- 0..1 Date/Time this was made available -->
 <performer><!-- 0..* Reference(Practitioner)|Reference(Organization)|Reference(Patient)|Reference(RelatedPerson) 
     Who is responsible for the observation --></performer>
 <valueQuantity> 0..0 Quantity  <!-- 0..0 Vital Sign Value recorded with UCUM -->
 </valueQuantity>
 <dataAbsentReason><!-- 0..1 CodeableConcept Why the result is missing  --></dataAbsentReason>
 <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc.  --></interpretation>
 <comment value="[string]"/><!-- 0..1 Comments about result -->
 <bodySite><!-- 0..1 CodeableConcept Observed body part  --></bodySite>
 <method><!-- 0..1 CodeableConcept How it was done  --></method>
 <specimen><!-- 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- 0..1 Reference(Device)|Reference(DeviceMetric) (Measurement) Device --></device>
 <referenceRange>  0..* BackboneElement  <!--  0..* Provides guide for interpretation -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <low><!-- 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- 0..1 CodeableConcept Reference range qualifier  --></type>
  <appliesTo><!-- 0..* CodeableConcept Reference range population  --></appliesTo>
  <age><!-- 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- 0..1 Text based reference range in an observation -->
 </referenceRange>
 <related>  0..* BackboneElement  <!--  0..* Used when reporting vital signs panel components -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <type value="[code]"/><!-- 1..1 has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by  -->
  <target><!-- 1..1 Reference(Vital Signs Profile) 
      Resource that is related to this one --></target>
 </related>
 <-- component sliced by value:code.coding.code  in the specified orderOpen-->
 <component>  0..* BackboneElement  <!--  0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code  in the specified orderOpen-->
   <coding> 0..* Coding  <!-- 0..* Systolic Blood Pressure -->
    <system value="[uri]"/><!-- 0..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 0..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value  -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing  --></dataAbsentReason>
  <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc.  --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
 <component>  0..* BackboneElement  <!--  0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code  in the specified orderOpen-->
   <coding> 0..* Coding  <!-- 0..* Diastolic Blood Pressure -->
    <system value="[uri]"/><!-- 0..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 0..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value  -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing  --></dataAbsentReason>
  <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc.  --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

{ // Vital Signs Profile
  // from Element: extension
    "meta" : { Meta }, //Metadata about the resource
    "implicitRules" : "<uri>", //A set of rules under which this content was created
    "language" : "<code>", //Language of the resource content 
    "text" : { Narrative }, //Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
    "identifier" : [{ Identifier }], //Business Identifier for observation
// value[x]: Fulfills plan, proposal or order. One of these 7:
    "basedOn" : [{ Reference(CarePlan) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(DeviceRequest) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(ImmunizationRecommendation) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(MedicationRequest) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(NutritionOrder) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(ProcedureRequest) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(ReferralRequest) }], //Fulfills plan, proposal or order
    "status" : "<code>", // R! registered | preliminary | final | amended + 
    "category" : [{ CodeableConcept }], // C? R! Classification of  type of observation 
    "code" : { CodeableConcept }, // R! Blood Pressure 
    "subject" : { Reference(Patient) }, // R! Who and/or what this is about
// value[x]: Healthcare event during which this observation is made. One of these 2:
    "context" : { Reference(Encounter) }, //Healthcare event during which this observation is made
    "context" : { Reference(EpisodeOfCare) }, //Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", //Date/Time this was made available
// value[x]: Who is responsible for the observation. One of these 4:
    "performer" : [{ Reference(Practitioner) }], //Who is responsible for the observation
    "performer" : [{ Reference(Organization) }], //Who is responsible for the observation
    "performer" : [{ Reference(Patient) }], //Who is responsible for the observation
    "performer" : [{ Reference(RelatedPerson) }], //Who is responsible for the observation
    "dataAbsentReason" : { CodeableConcept } //Why the result is missing 
    "interpretation" : { CodeableConcept }, //High, low, normal, etc. 
    "comment" : "<string>", //Comments about result
    "bodySite" : { CodeableConcept }, //Observed body part 
    "method" : { CodeableConcept }, //How it was done 
    "specimen" : { Reference(Specimen) }, //Specimen used for this observation
// value[x]: (Measurement) Device. One of these 2:
    "device" : { Reference(Device) }, //(Measurement) Device
    "device" : { Reference(DeviceMetric) }, //(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "related" : [{ BackboneElement }], // C?Used when reporting vital signs panel components
    "component" : [ //  sliced by value:code.coding.code  in the specified orderOpen
      { // Used when reporting systolic and diastolic blood pressure. // C?
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
        "code" : { CodeableConcept }, // R! Type of component observation (code / type) 
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM 
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing 
        "interpretation" : { CodeableConcept }, //High, low, normal, etc. 
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C?
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
        "code" : { CodeableConcept }, // R! Type of component observation (code / type) 
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM 
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing 
        "interpretation" : { CodeableConcept }, //High, low, normal, etc. 
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }

Summary

10.1.19.74.3 Complete Summary of the Mandatory Requirements

1. One code in Observation.code which must have
   • a fixed Observation.code.coding.system='http ://loinc.org'
   • a fixed Observation.code.coding.code= 85354-9'
   • Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an 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'
   • Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an 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'
   • Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value
4. fixedObservation.component.valueQuantity.code = 'mm[Hg]'

Fixed Value: 8 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

• The element Observation.code.coding is sliced based on the value of value:code
• The element Observation.component is sliced based on the value of value:code.coding.code
• The element Observation.component.code.coding is sliced based on the value of value:code

<!-- Vital Signs Profile -->

<Observation xmlns="http://hl7.org/fhir"
>
  <!-- from Element: extension -->
 <id value="[id]"/><!-- 0..1 Logical id of this artifact -->
 <meta><!-- 0..1 Meta Metadata about the resource --></meta>
 <implicitRules value="[uri]"/><!-- 0..1 A set of rules under which this content was created -->
 <language value="[code]"/><!-- 0..1 Language of the resource content  -->
 <text><!-- 0..1 Narrative 
     Text summary of the resource, for human interpretation --></text>
 <contained><!-- 0..* Resource Contained, inline Resources --></contained>
 <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
 <identifier><!-- 0..* Identifier 
     Business Identifier for observation --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan)|Reference(DeviceRequest)|Reference(ImmunizationRecommendation)|Reference(MedicationRequest)|
   Reference(NutritionOrder)|Reference(ProcedureRequest)|Reference(ReferralRequest) Fulfills plan, proposal or order --></basedOn>
 <status value="[code]"/><!-- 1..1 registered | preliminary | final | amended +  -->
 <category><!--  1..* CodeableConcept Classification of  type of observation  --></category>
 <code> 1..1 CodeableConcept  <!-- 1..1 Blood Pressure -->
  <-- coding sliced by value:code  in the specified orderOpen-->
  <coding> 0..* Coding  <!-- 0..* Code defined by a terminology system -->
   <system value="[uri]"/><!-- 0..1 Identity of the terminology system -->
   <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
   <code value="[code]"/><!-- 0..1 Symbol in syntax defined by the system -->
   <display value="[string]"/><!-- 0..1 Representation defined by the system -->
   <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
  </coding>
  <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
 </code>
 <subject><!-- 1..1 Reference(Patient) Who and/or what this is about --></subject>
 <context><!-- 0..1 Reference(Encounter)|Reference(EpisodeOfCare) 
     Healthcare event during which this observation is made --></context>
 <effective[x]><!--  1..1 dateTime|Period 
     Often just a dateTime for Vital Signs --></effective[x]>
 <issued value="[instant]"/><!-- 0..1 Date/Time this was made available -->
 <performer><!-- 0..* Reference(Practitioner)|Reference(Organization)|Reference(Patient)|Reference(RelatedPerson) 
     Who is responsible for the observation --></performer>
 <valueQuantity> 0..0 Quantity  <!-- 0..0 Vital Sign Value recorded with UCUM -->
 </valueQuantity>
 <dataAbsentReason><!-- 0..1 CodeableConcept Why the result is missing  --></dataAbsentReason>
 <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc.  --></interpretation>
 <comment value="[string]"/><!-- 0..1 Comments about result -->
 <bodySite><!-- 0..1 CodeableConcept Observed body part  --></bodySite>
 <method><!-- 0..1 CodeableConcept How it was done  --></method>
 <specimen><!-- 0..1 Reference(Specimen) Specimen used for this observation --></specimen>
 <device><!-- 0..1 Reference(Device)|Reference(DeviceMetric) (Measurement) Device --></device>
 <referenceRange>  0..* BackboneElement  <!--  0..* Provides guide for interpretation -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <low><!-- 0..1 Quantity 
      Low Range, if relevant --></low>
  <high><!-- 0..1 Quantity 
      High Range, if relevant --></high>
  <type><!-- 0..1 CodeableConcept Reference range qualifier  --></type>
  <appliesTo><!-- 0..* CodeableConcept Reference range population  --></appliesTo>
  <age><!-- 0..1 Range 
      Applicable age range, if relevant --></age>
  <text value="[string]"/><!-- 0..1 Text based reference range in an observation -->
 </referenceRange>
 <related>  0..* BackboneElement  <!--  0..* Used when reporting vital signs panel components -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <type value="[code]"/><!-- 1..1 has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by  -->
  <target><!-- 1..1 Reference(Vital Signs Profile) 
      Resource that is related to this one --></target>
 </related>
 <-- component sliced by value:code.coding.code  in the specified orderOpen-->
 <component>  0..* BackboneElement  <!--  0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code  in the specified orderOpen-->
   <coding> 0..* Coding  <!-- 0..* Systolic Blood Pressure -->
    <system value="[uri]"/><!-- 0..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 0..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value  -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing  --></dataAbsentReason>
  <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc.  --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
 <component>  0..* BackboneElement  <!--  0..* Used when reporting systolic and diastolic blood pressure. -->
  <modifierExtension><!-- 0..* Extension  Extensions that cannot be ignored  --></modifierExtension>
  <code> 1..1 CodeableConcept  <!-- 1..1 Type of component observation (code / type) -->
   <-- coding sliced by value:code  in the specified orderOpen-->
   <coding> 0..* Coding  <!-- 0..* Diastolic Blood Pressure -->
    <system value="[uri]"/><!-- 0..1 Identity of the terminology system -->
    <version value="[string]"/><!-- 0..1 Version of the system - if relevant -->
    <code value="[code]"/><!-- 0..1 Symbol in syntax defined by the system -->
    <display value="[string]"/><!-- 0..1 Representation defined by the system -->
    <userSelected value="[boolean]"/><!-- 0..1 If this coding was chosen directly by the user -->
   </coding>
   <text value="[string]"/><!-- 0..1 Plain text representation of the concept -->
  </code>
  <valueQuantity> 0..1 Quantity  <!-- 0..1 Vital Sign Value recorded with UCUM -->
   <value value="[decimal]"/><!-- 1..1 Numerical value (with implicit precision) -->
   <comparator value="[code]"/><!-- 0..1 < | <= | >= | > - how to understand the value  -->
   <unit value="[string]"/><!-- 1..1 Unit representation -->
   <system value="[uri]"/><!-- 1..1 System that defines coded unit form -->
   <code value="[code]"/><!-- 1..1 
       Coded responses from the common UCUM units for vital signs value set. -->
  </valueQuantity>
  <dataAbsentReason><!-- 0..1 CodeableConcept Why the component result is missing  --></dataAbsentReason>
  <interpretation><!-- 0..1 CodeableConcept High, low, normal, etc.  --></interpretation>
  <referenceRange><!-- See #Observation.referenceRange  Provides guide for interpretation of component result --></referenceRange>
 </component>
</Observation>

{ // Vital Signs Profile
  // from Element: extension
    "meta" : { Meta }, //Metadata about the resource
    "implicitRules" : "<uri>", //A set of rules under which this content was created
    "language" : "<code>", //Language of the resource content 
    "text" : { Narrative }, //Text summary of the resource, for human interpretation
    "contained" : [{ Resource }], //Contained, inline Resources
    "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
    "identifier" : [{ Identifier }], //Business Identifier for observation
// value[x]: Fulfills plan, proposal or order. One of these 7:
    "basedOn" : [{ Reference(CarePlan) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(DeviceRequest) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(ImmunizationRecommendation) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(MedicationRequest) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(NutritionOrder) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(ProcedureRequest) }], //Fulfills plan, proposal or order
    "basedOn" : [{ Reference(ReferralRequest) }], //Fulfills plan, proposal or order
    "status" : "<code>", // R! registered | preliminary | final | amended + 
    "category" : [{ CodeableConcept }], // C? R! Classification of  type of observation 
    "code" : { CodeableConcept }, // R! Blood Pressure 
    "subject" : { Reference(Patient) }, // R! Who and/or what this is about
// value[x]: Healthcare event during which this observation is made. One of these 2:
    "context" : { Reference(Encounter) }, //Healthcare event during which this observation is made
    "context" : { Reference(EpisodeOfCare) }, //Healthcare event during which this observation is made
// value[x]: Often just a dateTime for Vital Signs. One of these 2:
    "effectiveDateTime" : "<dateTime>", // C? R! Often just a dateTime for Vital Signs
    "effectivePeriod" : { Period }, // C? R! Often just a dateTime for Vital Signs
    "issued" : "<instant>", //Date/Time this was made available
// value[x]: Who is responsible for the observation. One of these 4:
    "performer" : [{ Reference(Practitioner) }], //Who is responsible for the observation
    "performer" : [{ Reference(Organization) }], //Who is responsible for the observation
    "performer" : [{ Reference(Patient) }], //Who is responsible for the observation
    "performer" : [{ Reference(RelatedPerson) }], //Who is responsible for the observation
    "dataAbsentReason" : { CodeableConcept } //Why the result is missing 
    "interpretation" : { CodeableConcept }, //High, low, normal, etc. 
    "comment" : "<string>", //Comments about result
    "bodySite" : { CodeableConcept }, //Observed body part 
    "method" : { CodeableConcept }, //How it was done 
    "specimen" : { Reference(Specimen) }, //Specimen used for this observation
// value[x]: (Measurement) Device. One of these 2:
    "device" : { Reference(Device) }, //(Measurement) Device
    "device" : { Reference(DeviceMetric) }, //(Measurement) Device
    "referenceRange" : [{ BackboneElement }], // C?Provides guide for interpretation
    "related" : [{ BackboneElement }], // C?Used when reporting vital signs panel components
    "component" : [ //  sliced by value:code.coding.code  in the specified orderOpen
      { // Used when reporting systolic and diastolic blood pressure. // C?
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
        "code" : { CodeableConcept }, // R! Type of component observation (code / type) 
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM 
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing 
        "interpretation" : { CodeableConcept }, //High, low, normal, etc. 
// value[x]: Provides guide for interpretation of component result. One of these 0:
      },
      { // Used when reporting systolic and diastolic blood pressure. // C?
        // from Element: extension
        "modifierExtension" : [{ Extension }], //Extensions that cannot be ignored
        "code" : { CodeableConcept }, // R! Type of component observation (code / type) 
        "valueQuantity" : { Quantity }, //Vital Sign Value recorded with UCUM 
        "dataAbsentReason" : { CodeableConcept }, //Why the component result is missing 
        "interpretation" : { CodeableConcept }, //High, low, normal, etc. 
// value[x]: Provides guide for interpretation of component result. One of these 0:
      }
    ],
  }