FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

10.1.9 Resource Observation - Mappings

Orders and Observations Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Mappings:

RIM Mapping

SNOMED CT Attribute Binding

SNOMED CT Concept Domain Binding

HL7 v2 Mapping

Workflow Mapping

Mappings for the observation resource.

10.1.9.1 Mappings for RIM Mapping (http://hl7.org/v3)

ObservationObservation[classCode=OBS, moodCode=EVN]
    identifierid
    basedOn.outboundRelationship[typeCode=FLFS].target
    statusstatus 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
    codecode
    subjectparticipation[typeCode=SBJ]
    contextinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
    effective[x]effectiveTime
    issuedparticipation[typeCode=AUT].time
    performerparticipation[typeCode=PRF]
    value[x]value
    dataAbsentReasonvalue.nullFlavor
    interpretationinterpretationCode
    commentsubjectOf.observationEvent[code="annotation"].value
    bodySitetargetSiteCode
    methodmethodCode
    specimenparticipation[typeCode=SPC].specimen
    deviceparticipation[typeCode=DEV]
    referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
        lowvalue:IVL_PQ.low
        highvalue:IVL_PQ.high
        typeinterpretationCode
        appliesTointerpretationCode
        ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
        textvalue:ST
    relatedoutBoundRelationship
        type.typeCode
        target.targetObservation
    componentoutBoundRelationship[typeCode=COMP]
        codecode
        value[x]value
        dataAbsentReasonvalue.nullFlavor
        interpretationinterpretationCode
        referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

10.1.9.2 Mappings for SNOMED CT Attribute Binding (http://snomed.info/sct)

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
Observation
    identifier
    basedOn
    status
    category
    code116680003 |Is a|
    subject
    context
    effective[x]
    issued
    performer
    value[x]363714003 |Interprets|
    dataAbsentReason
    interpretation363713009 |Has interpretation|
    comment
    bodySite718497002 |Inherent location|
    method
    specimen704319004 |Inherent in|
    device424226004 |Using device|
    referenceRange
        low
        high
        type
        appliesTo
        age
        text
    related
        type
        target
    component
        code
        value[x]363714003 |Interprets|
        dataAbsentReason
        interpretation363713009 |Has interpretation|
        referenceRange

10.1.9.3 Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

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
Observation< 363787002 |Observable entity|
    identifier
    basedOn
    status< 445584004 |Report by finality status|
    category
    code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
    subject
    context
    effective[x]
    issued
    performer
    value[x]< 441742003 |Evaluation finding|
    dataAbsentReason
    interpretation< 260245000 |Findings values|
    comment
    bodySite< 123037004 |Body structure|
    method
    specimen< 123038009 |Specimen|
    device< 49062001 |Device|
    referenceRange
        low
        high
        type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
        appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
        age
        text
    related
        type
        target
    component
        code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
        value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
        dataAbsentReason
        interpretation< 260245000 |Findings values|
        referenceRange

10.1.9.4 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

ObservationOBX
    identifierOBX.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 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
    basedOnORC
    statusOBX-11
    category
    codeOBX-3
    subjectPID-3
    contextPV1
    effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
    issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
    performerOBX.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
    dataAbsentReasonN/A
    interpretationOBX-8
    commentNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
    bodySiteOBX-20
    methodOBX-17
    specimenSPM segment
    deviceOBX-17 / PRT -10
    referenceRangeOBX.7
        lowOBX-7
        highOBX-7
        typeOBX-10
        appliesToOBX-10
        age
        textOBX-7
    relatedRelationships established by OBX-4 usage
        typeN/A
        target
    componentcontainment by OBX-4?
        codeOBX-3
        value[x]OBX.2, OBX.5, OBX.6
        dataAbsentReasonN/A
        interpretationOBX-8
        referenceRangeOBX.7

10.1.9.5 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)

ObservationEvent
    identifierEvent.identifier
    basedOnEvent.basedOn
    statusEvent.status
    category
    codeEvent.code
    subjectEvent.subject
    contextEvent.context
    effective[x]Event.occurrence[x]
    issued
    performerEvent.performer
    value[x]Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
    dataAbsentReasonEvent.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
    interpretation
    commentEvent.note
    bodySite
    method
    specimen
    device
    referenceRange
        low
        high
        type
        appliesTo
        age
        text
    related
        type
        target
    component
        code
        value[x]
        dataAbsentReason
        interpretation
        referenceRange