HL7.FHIR.US.CORE\US Core Observation Clinical Result Profile

US Core Implementation Guide
6.1.0-snapshot1 - STU6 United States of America flag

This page is part of the US Core (v6.1.0-snapshot1: STU6 Update) based on FHIR R4. The current version which supercedes this version is 6.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: US Core Observation Clinical Result Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result				Version: 6.1.0-snapshot1
Active as of 2022-04-20				Computable Name: USCoreObservationClinicalResultProfile
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Observation Clinical Result Profile is based upon the core FHIR Observation Resource and, along with the US Core DiagnosticReport Profile, meets the US Core Data for Interoperability (USCDI) requirements for Diagnostic Imaging and Clinical Tests Data Classes. This profile sets minimum expectations for the Observation resource to record and search non-laboratory clinical test results (e.g., radiology and other clinical observations generated from procedures). An example would be when a gastroenterologist reports the size of a polyp observed during a colonoscopy. This profile is the basis for the US Core Laboratory Result Observation Profile, which defines additional data elements to record and search laboratory test results.

The US Core Observation Clinical Result Profile sets minimum expectations to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

Query for clinical tests or diagnostic imaging results for a patient.
Record or update clinical tests or diagnostic imaging results belonging to a Patient

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) 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 Views below provides the formal summary, definitions, and terminology requirements.

Each Observation Must Have:

a status
a category code
a LOINC code, if available, which tells you what is being measured
a patient

Each Observation Must Support:

a time indicating when the measurement was taken
a result value
- if the result value is a numeric quantity, a standard UCUM unit
a reason why the data is absent*

* see guidance below

Profile Specific Implementation Guidance:

ServersSHOULD use the base FHIR Observation Category Codes. The Observation.category element provides an efficient way of restricting search on observations to a given context such as procedure, exam or laboratory observations. Example searches are shown in the Quick Start section below. However, clients need to understand that data categorization is somewhat subjective. The categorization applied by the source may not align with the client’s expectations. Clients may find it more useful to use queries based on a specific code or set of codes or to perform additional client side filtering of query results.
Additional codes that translate or map to the Observation code or category codes are allowed. For example:
- providing both a local code and LOINC code
- providing a more specific code, a SNOMED CT concept, or a system specific code.
Systems SHOULD support Observation.effectivePeriod to accurately represent procedure tests that are collected over a period of time .
*An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
- For further guidance see the Observation Grouping section in FHIR Specification.
- Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.
*An Observation.component without a value, SHALL include a reason why the data is absent.
- Systems that never provide a component observation without a component value are not required to support Observation.component.dataAbsentReason.
See the General Guidance page for further guidance on using SNOMED and UCUM.
See the LOINC scale type to FHIR data type mapping for guidance on which Observation.value[x] data type to use based on the LOINC Type of Scale.

For a starter set of example clinical test LOINC codes, see Appendix B in U.S. Core Data for Interoperability (USCDI) Task Force 2021 HITAC Phase 3 Recommendations Report Letter.
For representing laboratory test results, see the US Core Laboratory Result Observation Profile.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

Differential Table
Key Elements Table
Snapshot Table
Statistics/References
All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
status	S	1..1	code	(USCDI) registered \| preliminary \| final \| amended +
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	S	1..1	CodeableConcept	(USCDI) Clinical Test or Procedure Name Binding: LOINCCodes (extensible)
subject	S	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
effective[x]	SC	0..1		(USCDI) Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
value[x]	SC	0..1		(USCDI) Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.category:us-core	required	USCoreClinicalResultObservationCategory
Observation.code	extensible	LOINCCodes (a valid code from LOINC)

Constraints

Id	Grade	Path(s)	Details	Requirements
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3	error	Observation.value[x]	SHALL use UCUM for coded quantity units. : valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) registered \| preliminary \| final \| amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Clinical Test or Procedure Name Binding: LOINCCodes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
effective[x]	SΣC	0..1		(USCDI) Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime
value[x]	SΣC	0..1		(USCDI) Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:us-core	required	USCoreClinicalResultObservationCategory
Observation.code	extensible	LOINCCodes (a valid code from LOINC)
Observation.dataAbsentReason	extensible	DataAbsentReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3	error	Observation.value[x]	SHALL use UCUM for coded quantity units. : valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path

Conformance

ValueSet

Observation.language

preferred

CommonLanguages

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

ObservationStatus

Observation.category

preferred

ObservationCategoryCodes

Observation.category:us-core

required

USCoreClinicalResultObservationCategory

Observation.code

extensible

LOINCCodes (a valid code from LOINC)

Observation.dataAbsentReason

extensible

DataAbsentReason

Observation.interpretation

extensible

ObservationInterpretationCodes

Observation.bodySite

example

SNOMEDCTBodyStructures

Observation.method

example

ObservationMethods

Observation.referenceRange.type

preferred

ObservationReferenceRangeMeaningCodes

Observation.referenceRange.appliesTo

example

ObservationReferenceRangeAppliesToCodes

Observation.component.code

example

LOINCCodes (a valid code from LOINC)

Observation.component.dataAbsentReason

extensible

DataAbsentReason

Observation.component.interpretation

extensible

ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-3	error	Observation.value[x]	SHALL use UCUM for coded quantity units. : valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Slices

This structure defines the following Slices:

The element Observation.category is sliced based on the value of pattern:$this

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
status	S	1..1	code	(USCDI) registered \| preliminary \| final \| amended +
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	S	1..1	CodeableConcept	(USCDI) Clinical Test or Procedure Name Binding: LOINCCodes (extensible)
subject	S	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
effective[x]	SC	0..1		(USCDI) Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
value[x]	SC	0..1		(USCDI) Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.category:us-core	required	USCoreClinicalResultObservationCategory
Observation.code	extensible	LOINCCodes (a valid code from LOINC)

Constraints

Id	Grade	Path(s)	Details	Requirements
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3	error	Observation.value[x]	SHALL use UCUM for coded quantity units. : valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) registered \| preliminary \| final \| amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Clinical Test or Procedure Name Binding: LOINCCodes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
effective[x]	SΣC	0..1		(USCDI) Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime
value[x]	SΣC	0..1		(USCDI) Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:us-core	required	USCoreClinicalResultObservationCategory
Observation.code	extensible	LOINCCodes (a valid code from LOINC)
Observation.dataAbsentReason	extensible	DataAbsentReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3	error	Observation.value[x]	SHALL use UCUM for coded quantity units. : valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'

Snapshot View

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path

Conformance

ValueSet

Observation.language

preferred

CommonLanguages

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

ObservationStatus

Observation.category

preferred

ObservationCategoryCodes

Observation.category:us-core

required

USCoreClinicalResultObservationCategory

Observation.code

extensible

LOINCCodes (a valid code from LOINC)

Observation.dataAbsentReason

extensible

DataAbsentReason

Observation.interpretation

extensible

ObservationInterpretationCodes

Observation.bodySite

example

SNOMEDCTBodyStructures

Observation.method

example

ObservationMethods

Observation.referenceRange.type

preferred

ObservationReferenceRangeMeaningCodes

Observation.referenceRange.appliesTo

example

ObservationReferenceRangeAppliesToCodes

Observation.component.code

example

LOINCCodes (a valid code from LOINC)

Observation.component.dataAbsentReason

extensible

DataAbsentReason

Observation.component.interpretation

extensible

ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-3	error	Observation.value[x]	SHALL use UCUM for coded quantity units. : valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Slices

This structure defines the following Slices:

The element Observation.category is sliced based on the value of pattern:$this

Other representations of profile: CSV, Excel, Schematron

Notes:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

The syntax used to describe the interactions is described here.
Servers providing access to clinical results data can use US Core SMART Scopes for:
- resource level scopes (for example, patient/Observation.rs)
- granular scopes (for example, patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|imaging and patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|procedure and patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory).
See the General Requirements 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 and category search parameters:

GET [base]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}procedure

Example:
1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|procedure
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = procedure (how to search by reference and how to search by token)
SHALL support searching using the combination of the patient and code search parameters:
- including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

Example:
1. GET [base]/Observation?patient=1134281&code=http://loinc.org|44974-4
2. GET [base]/Observation?patient=1134281&code=http://loinc.org|44974-4,http://loinc.org|44963-7,http://loinc.org|8601-7
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). SHOULD support search by multiple report codes. The Observation code parameter searches `Observation.code only. (how to search by reference and how to search by token)
SHALL support searching using the combination of the patient and category and date search parameters:
- including support for these date comparators: gt,lt,ge,le
- including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)
GET [base]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}procedure&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

Example:
1. GET [base]Observation?patient=555580&category=http://terminology.hl7.org/CodeSystem/observation-category|procedure&date=ge2018-03-14T00:00:00Z
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = procedure (how to search by reference and how to search by token and how to search by date)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

SHOULD support searching using the combination of the patient and category and status search parameters:
- including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)
GET [base]/Observation?patient={Type/}[id]&category={http://terminology.hl7.org/CodeSystem/observation-category|}procedure&status={system|}[code]{,{system|}[code],...}

Example:
1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|procedure&status=final
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category = procedure and status (how to search by reference and how to search by token)
SHOULD support searching using the combination of the patient and code and date search parameters:
- including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
- including support for these date comparators: gt,lt,ge,le
- including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)
GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

Example:
1. GET [base]Observation?patient=555580&code=http://loinc.org|44974-4&date=ge2019-01-01T00:00:00Z
Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and report code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token and how to search by date)

IG © 2023+ HL7 International - Cross-Group Projects. Package hl7.fhir.us.core#6.1.0-snapshot1 based on FHIR 4.0.1. Generated 2023-05-27
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