This page is part of the US Core (v3.1.0: STU3) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions
StructureDefinition-us-core-smokingstatus
This profile sets minimum expectations for the Observation resource to record, search, and fetch smoking status data associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.
Example Usage Scenarios:
The following are example usage scenarios for the US Core-SmokingStatus profile:
- Query for the Smoking Status of a patient
- Record or update the Smoking Status of a patient
Mandatory and Must Support Data Elements
The following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.
Each Observation must have:
- a status
- a code for smoking observation
- a patient
- a date representing when the smoking status was recorded
- a result value code for smoking status
Profile specific implementation guidance:
- Smoking observation LOINC = 72166-2 Tobacco smoking status NHIS
Examples
Formal Views of Profile Content
Description of Profiles, Differentials, and Snapshots.
The official URL for this profile is:
http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus
Published on Tue May 21 00:00:00 AEST 2019 as active by the HL7 US Realm Steering Committee.
This profile builds on Observation
Observation
Summary of the Mandatory Requirements
- A code in
Observation.status
with a required binding to US Core Status for Smoking Status Observation - A CodeableConcept in
Observation.code
with an extensible binding to US Core Smoking Status Observation Codes - A Patient Reference in
Observation.subject
- An instant in
Observation.issued
- A CodeableConcept in
Observation.valueCodeableConcept
with an extensible binding to US Core Smoking Status
Summary of Constraints
- If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
- dataAbsentReason SHALL only be present if Observation.value[x] is not present
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | 0..* | |||
status | S | 1..1 | code | Binding: US Core Status for Smoking Status Observation (required) |
code | S | 1..1 | CodeableConcept | Smoking Status Binding: US Core Smoking Status Observation Codes (extensible) |
subject | S | 1..1 | Reference(US Core Patient Profile) | |
issued | S | 1..1 | instant | |
valueCodeableConcept | S | 1..1 | CodeableConcept | Coded Responses from Smoking Status Value Set Binding: US Core Smoking Status (extensible) |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | I | 0..* | Measurements and simple assertions | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | ΣI | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
contained | 0..* | Resource | Contained, inline Resources | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
identifier | ΣI | 0..* | Identifier | Business Identifier for observation |
basedOn | ΣI | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order |
partOf | ΣI | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event |
status | ?!SΣI | 1..1 | code | registered | preliminary | final | amended + Binding: US Core Status for Smoking Status Observation (required) |
category | I | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred) |
code | SΣI | 1..1 | CodeableConcept | Smoking Status Binding: US Core Smoking Status Observation Codes (extensible) |
subject | SΣI | 1..1 | Reference(US Core Patient Profile) | Who and/or what the observation is about |
focus | ΣI | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record |
encounter | ΣI | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made |
effective[x] | ΣI | 0..1 | Clinically relevant time/time-period for observation | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
effectiveTiming | Timing | |||
effectiveInstant | instant | |||
issued | SΣI | 1..1 | instant | Date/Time this version was made available |
performer | ΣI | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation |
value[x] | ΣI | 0..1 | (Slice Definition) | Actual result Slice: Unordered, Closed by type:$this |
value[x]:valueCodeableConcept | SΣI | 1..1 | CodeableConcept | Coded Responses from Smoking Status Value Set Binding: US Core Smoking Status (extensible) |
dataAbsentReason | I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
note | I | 0..* | Annotation | Comments about the observation |
bodySite | I | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example) |
method | I | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example) |
specimen | I | 0..1 | Reference(Specimen) | Specimen used for this observation |
device | I | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device |
referenceRange | I | 0..* | 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 | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
low | I | 0..1 | SimpleQuantity | Low Range, if relevant |
high | I | 0..1 | SimpleQuantity | High Range, if relevant |
type | I | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred) |
appliesTo | I | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example) |
age | I | 0..1 | Range | Applicable age range, if relevant |
text | I | 0..1 | string | Text based reference range in an observation |
hasMember | ΣI | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group |
derivedFrom | ΣI | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from |
component | ΣI | 0..* | BackboneElement | Component results |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | ΣI | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example) |
value[x] | ΣI | 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 | |||
dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
referenceRange | I | 0..* | Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result | |
Documentation for this format |
Observation
Summary of the Mandatory Requirements
- A code in
Observation.status
with a required binding to US Core Status for Smoking Status Observation - A CodeableConcept in
Observation.code
with an extensible binding to US Core Smoking Status Observation Codes - A Patient Reference in
Observation.subject
- An instant in
Observation.issued
- A CodeableConcept in
Observation.valueCodeableConcept
with an extensible binding to US Core Smoking Status
Summary of Constraints
- If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
- dataAbsentReason SHALL only be present if Observation.value[x] is not present
Differential View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | 0..* | |||
status | S | 1..1 | code | Binding: US Core Status for Smoking Status Observation (required) |
code | S | 1..1 | CodeableConcept | Smoking Status Binding: US Core Smoking Status Observation Codes (extensible) |
subject | S | 1..1 | Reference(US Core Patient Profile) | |
issued | S | 1..1 | instant | |
valueCodeableConcept | S | 1..1 | CodeableConcept | Coded Responses from Smoking Status Value Set Binding: US Core Smoking Status (extensible) |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | I | 0..* | Measurements and simple assertions | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | ΣI | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
contained | 0..* | Resource | Contained, inline Resources | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
identifier | ΣI | 0..* | Identifier | Business Identifier for observation |
basedOn | ΣI | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order |
partOf | ΣI | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event |
status | ?!SΣI | 1..1 | code | registered | preliminary | final | amended + Binding: US Core Status for Smoking Status Observation (required) |
category | I | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred) |
code | SΣI | 1..1 | CodeableConcept | Smoking Status Binding: US Core Smoking Status Observation Codes (extensible) |
subject | SΣI | 1..1 | Reference(US Core Patient Profile) | Who and/or what the observation is about |
focus | ΣI | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record |
encounter | ΣI | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made |
effective[x] | ΣI | 0..1 | Clinically relevant time/time-period for observation | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
effectiveTiming | Timing | |||
effectiveInstant | instant | |||
issued | SΣI | 1..1 | instant | Date/Time this version was made available |
performer | ΣI | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation |
value[x] | ΣI | 0..1 | (Slice Definition) | Actual result Slice: Unordered, Closed by type:$this |
value[x]:valueCodeableConcept | SΣI | 1..1 | CodeableConcept | Coded Responses from Smoking Status Value Set Binding: US Core Smoking Status (extensible) |
dataAbsentReason | I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
note | I | 0..* | Annotation | Comments about the observation |
bodySite | I | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example) |
method | I | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example) |
specimen | I | 0..1 | Reference(Specimen) | Specimen used for this observation |
device | I | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device |
referenceRange | I | 0..* | 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 | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
low | I | 0..1 | SimpleQuantity | Low Range, if relevant |
high | I | 0..1 | SimpleQuantity | High Range, if relevant |
type | I | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred) |
appliesTo | I | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example) |
age | I | 0..1 | Range | Applicable age range, if relevant |
text | I | 0..1 | string | Text based reference range in an observation |
hasMember | ΣI | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group |
derivedFrom | ΣI | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from |
component | ΣI | 0..* | BackboneElement | Component results |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | ΣI | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example) |
value[x] | ΣI | 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 | |||
dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible) |
interpretation | I | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible) |
referenceRange | I | 0..* | Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result | |
Documentation for this format |
Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron
Quick Start
Below is an overview of the required set of RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.
- See the General Guidance section for additional rules and expectations when a server requires status parameters.
- See the General Guidance section for additional guidance on searching for multiple patients.
Mandatory Search Parameters:
The following search parameters and search parameter combinations SHALL be supported.:
- SHALL support searching using the combination of the
patient
andcode
search parameters:- including optional support for composite OR search on
code
(e.g.code={[system]}|[code],{[system]}|[code],...
)
GET [base]/Observation?patient=[reference]&code=http://loinc.org|72166-2
Example:
- GET [base]/Observation?patient=1032702&code=http://loinc.org|72166-2
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code. (how to search by reference and how to search by token)
- including optional support for composite OR search on