This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR v3.5.0. . For a full list of available versions, see the Directory of published versions

This is a pre-release version (Ballot 1) of Coverage Requirements Discovery (CRD) R1/STU. There is no current official version.
For a full list of available versions, see the Directory of published versions .

## StructureDefinition: CRD Observation

The official URL for this profile is:

    http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-observation-r4

### Formal Views of Profile Content

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

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 7 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-r4

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* |  |
status | S | 1..1 | code |
category | S | 1..* | CodeableConcept |
code | S | 1..1 | CodeableConcept |
subject | S | 1..1 | Reference(CRD Patient) |
effective[x] | S | 0..1 | dateTime, Period, Timing, instant |
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period |
dataAbsentReason | S | 0..1 | CodeableConcept |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | I | 0..* |  | Measurements and simple assertions
id | Î£ | 0..1 | id | Logical id of this artifact
meta | Î£ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Î£ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (preferred)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Î£ | 0..* | Identifier | Business Identifier for observation
basedOn | Î£ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Î£ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!S Î£ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required)
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred)
code | S Î£ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example)
subject | S Î£ | 1..1 | Reference(CRD Patient) | Who and/or what the observation is about
focus | Î£ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Î£ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | S Î£ | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation
issued | Î£ | 0..1 | instant | Date/Time this version was made available
performer | Î£ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S Î£I | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result
dataAbsentReason | S I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible)
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
comment |  | 0..1 | string | Comments about the test result value
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example)
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example)
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 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 | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Î£ | 0..* | Extension | Extensions that cannot be ignored if unrecognized
low | I | 0..1 | SimpleQuantity | Low Range, if relevant
high | I | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred)
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example)
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Î£ | 0..* | Reference(Observation | QuestionnaireResponse | Sequence) | Related resource that belongs to the Observation group
derivedFrom | Î£ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | Sequence) | Related measurements the observation is made from
component | Î£I | 0..* | BackboneElement | Component results
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Î£ | 0..* | Extension | Extensions that cannot be ignored if unrecognized
code | Î£ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example)
value[x] | Î£ | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result
dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible)
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
referenceRange |  | 0..* |  | Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result
Documentation for this format

This structure is derived from Observation

Summary

Mandatory: 2 elements
Must-Support: 7 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-r4

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* |  |
status | S | 1..1 | code |
category | S | 1..* | CodeableConcept |
code | S | 1..1 | CodeableConcept |
subject | S | 1..1 | Reference(CRD Patient) |
effective[x] | S | 0..1 | dateTime, Period, Timing, instant |
value[x] | S | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period |
dataAbsentReason | S | 0..1 | CodeableConcept |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | I | 0..* |  | Measurements and simple assertions
id | Î£ | 0..1 | id | Logical id of this artifact
meta | Î£ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Î£ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (preferred)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Î£ | 0..* | Identifier | Business Identifier for observation
basedOn | Î£ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Î£ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!S Î£ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required)
category | S | 1..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred)
code | S Î£ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example)
subject | S Î£ | 1..1 | Reference(CRD Patient) | Who and/or what the observation is about
focus | Î£ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Î£ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | S Î£ | 0..1 | dateTime, Period, Timing, instant | Clinically relevant time/time-period for observation
issued | Î£ | 0..1 | instant | Date/Time this version was made available
performer | Î£ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | S Î£I | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual result
dataAbsentReason | S I | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible)
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
comment |  | 0..1 | string | Comments about the test result value
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example)
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example)
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 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 | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Î£ | 0..* | Extension | Extensions that cannot be ignored if unrecognized
low | I | 0..1 | SimpleQuantity | Low Range, if relevant
high | I | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred)
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example)
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Î£ | 0..* | Reference(Observation | QuestionnaireResponse | Sequence) | Related resource that belongs to the Observation group
derivedFrom | Î£ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | Sequence) | Related measurements the observation is made from
component | Î£I | 0..* | BackboneElement | Component results
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Î£ | 0..* | Extension | Extensions that cannot be ignored if unrecognized
code | Î£ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example)
value[x] | Î£ | 0..1 | Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Actual component result
dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible)
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
referenceRange |  | 0..* |  | Unknown reference to #Observation.referenceRange Provides guide for interpretation of component result
Documentation for this format

Other representations of profile: Schematron

### Terminology Bindings

Path | Name | Conformance | ValueSet
Observation.language | Language | preferred | Common Languages
Observation.status | ObservationStatus | required | ObservationStatus
Observation.category | Observation Category Codes | preferred | ObservationCategoryCodes
Observation.code | LOINC Codes | example | LOINCCodes
Observation.dataAbsentReason | DataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | Observation Interpretation Codes | extensible | ObservationInterpretationCodes
Observation.bodySite | SNOMED CT Body Structures | example | SNOMEDCTBodyStructures
Observation.method | Observation Methods | example | ObservationMethods
Observation.referenceRange.type | Observation Reference Range Meaning Codes | preferred | ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo | Observation Reference Range Applies To Codes | example | ObservationReferenceRangeAppliesToCodes
Observation.component.code | LOINC Codes | example | LOINCCodes
Observation.component.dataAbsentReason | DataAbsentReason | extensible | DataAbsentReason
Observation.component.interpretation | Observation Interpretation Codes | extensible | ObservationInterpretationCodes

### Constraints

Id | Path | Details | Requirements
dom-2 | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-4 | 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-3 | 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-6 | Observation | A resource should have narrative for robust management : text.div.exists() |
dom-5 | Observation | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
obs-7 | Observation | If Observation.code is the same as a Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty() |
obs-6 | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty() |
ele-1 | Observation.referenceRange | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
obs-3 | Observation.referenceRange | Must have at least a low or a high or text : low.exists() or high.exists() or text.exists() |
ele-1 | Observation.component | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |