The position of the body when the observation was done, e.g. standing, sitting. To be used only when the body position in not precoordinated in the observation code.

The qualitative change in the value relative to the previous measurement. Usually only recorded if the change is clinically significant.

The focus of an observation when not the patient of record (i.e. different from Observation.subject). For example, the focal subject may be a fetus, or a donor.

A specific offset time in milliseconds from the stated time in the Observation.appliesDateTime to allow for representation of sequential recording of sampled data from the same lead or data stream. For example, an ECG recorder may record sequentially 3 leads four time to receive 12-lead ECG, see ISO 22077 .

Regular life events the observation is tied to. This is useful for recording imprecise or "fuzzy" times when the observation occurred. For example, a blood glucose measurement "after breakfast". It is interpreted as relative to the effectiveTime element or the issued element if effectiveTime is absent. For example the blood glucose measurement could be reported that same day ("today after breakfast") or some other day ("yesterday after breakfast").