Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment vs http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-exposure-contact-information

Left:US Core Observation SDOH Assessment Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment)
Right:US Public Health Exposure Contact Information (http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-exposure-contact-information)

Messages

ErrorStructureDefinition.urlValues for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment' vs 'http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-exposure-contact-information'
ErrorStructureDefinition.versionValues for version differ: '5.0.1' vs '2.1.0'
InformationStructureDefinition.nameValues for name differ: 'USCoreObservationSDOHAssessment' vs 'USPublicHealthExposureContactInformation'
InformationStructureDefinition.titleValues for title differ: 'US Core Observation SDOH Assessment Profile' vs 'US Public Health Exposure Contact Information'
InformationStructureDefinition.dateValues for date differ: '2022-03-18' vs '2022-08-31T17:40:18+00:00'
InformationStructureDefinition.publisherValues for publisher differ: 'HL7 International - Cross-Group Projects' vs 'HL7 Public Health Work Group (http://www.hl7.org/Special/committees/pher/index.cfm)'
ErrorStructureDefinition.baseDefinitionValues for baseDefinition differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey' vs 'http://hl7.org/fhir/StructureDefinition/Observation'
WarningObservationElements differ in short: 'SDOH Assessment Panel Observation' vs 'US Public Health Exposure Contact Information'
WarningObservationElements differ in definition: '\-' vs 'This profile represents patient exposure information.'
WarningObservationElements differ in comments: '\-' vs 'Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.'
WarningObservation.extensionElements differ in short: 'Additional content defined by implementations' vs 'Exposure/contact address'
WarningObservation.extensionElements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'If an address where the exposure/contact took place is known then it can be contained in the address-extension.'
WarningObservation.extensionElements differ in definition for mustSupport: 'false' vs 'true'
InformationObservation.extensionElement maximum cardinalities differ: '2147483647' vs '1'
WarningObservation.statusElements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.categoryElements differ in short: 'Classification of type of observation' vs 'Use AEXPOS for aquisition exposure, use TEXPOS for transmission exposure, or use EXPOS if the type of exposure is unknown'
WarningObservation.categoryElements differ in definition: 'A code that classifies the general type of observation being made.' vs 'Use AEXPOS for aquisition exposure, use TEXPOS for transmission exposure, or use EXPOS if the type of exposure is unknown'
WarningObservation.categoryElements differ in requirements: 'To identify that observation is derived from a questionnaire.' vs 'Used for filtering what observations are retrieved and displayed.'
InformationObservation.categoryElement maximum cardinalities differ: '2147483647' vs '1'
WarningObservation.categoryElements differ in binding.description: 'Codes for high level observation categories.' vs 'ActClassExposure'
WarningObservation.codeElements differ in short: 'Type of observation (code / type)' vs 'The type of exposure/contact (environmental, activity, event, location, person, animal, etc.).'
WarningObservation.codeElements differ in definition: 'Describes what was observed. Sometimes this is called the observation 'name'.' vs 'Suggested value sets: [Exposure Setting (COVID-19)], [Exposure Location], [Social History Type]'
InformationObservation.codeExample/preferred bindings differ at Observation.code using binding from USCoreObservationSDOHAssessment
WarningObservation.focusElements differ in short: 'What the observation is about, when it is not about the subject of record' vs 'Contains either the patient's contact with an entity (person, animal, or substance) or presence at a location where exposure to an agent could have occurred or the patient's contact with an entity (person, animal, or substance) or presence at a location where transmission from the patient could have occurred'
WarningObservation.focusElements differ in definition: 'The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.' vs 'Contact with an entity (person, animal) or at a location.'
WarningObservation.focusElements differ in definition for mustSupport: 'false' vs 'true'
WarningObservation.effective[x]Elements differ in short: 'Clinically relevant time/time-period for observation' vs 'Time or period the contact/exposure occurred.'
WarningObservation.effective[x]Elements differ in definition: 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'.' vs 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'. This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.'
WarningObservation.effective[x]Elements differ in comments: 'At least a date should be present unless this observation is a historical report.' vs 'At least a date should be present unless this observation is a historical report. For recording imprecise or 'fuzzy' times (For example, a blood glucose measurement taken 'after breakfast') use the [Timing] datatype which allow the measurement to be tied to regular life events.'
WarningObservation.performerElements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.value[x]Elements differ in short: 'Actual result' vs 'Specific exposure/contact'
WarningObservation.value[x]Elements differ in definition: 'The information determined as a result of making the observation, if the information has a simple value.' vs 'Specific exposure/contact'
WarningObservation.value[x]Elements differ in comments: 'An observation may have a value if it represents an individual survey question and answer pair. An observation should not have a value if it represents a multi-question survey or multi-select “check all that apply” question. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.' vs 'An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section] below.'
WarningObservation.dataAbsentReasonElements differ in comments: ''Null' or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.value. Where these concepts are not part of the value set for Observation.value, the Observation.dataAbsentReason can be used if necessary and appropriate.' vs 'Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be 'detected', 'not detected', 'inconclusive', or 'specimen unsatisfactory'. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code 'error' could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.'
WarningObservation.dataAbsentReasonElements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.hasMemberElements differ in short: 'Individual Observations that belong to an SDOH multi-question sruvey or multi-select question.' vs 'Related resource that belongs to the Observation group'
WarningObservation.hasMemberElements differ in definition: 'Aggregate set of Observations that represent question answer pairs for both multi-question surveys and multi-select questions.' vs 'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.'
WarningObservation.hasMemberElements differ in comments: 'This grouping element is used to represent surveys that group several questions together or individual questions with “check all that apply” responses. For example in the simplest case a flat multi-question survey where the 'panel' observation is the survey instrument itself and instead of an `Observation.value` the `hasMember` element references other Observation that represent the individual questions answer pairs. In a survey that has a heirarchical grouping of questions, the observation 'panels' can be nested. Because surveys can be arbitrarily complex structurally, not all survey structures can be represented using this Observation grouping pattern.' vs 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes] below. Note that a system may calculate results from [QuestionnaireResponse] into a final score and represent the score as an Observation.'
WarningObservation.hasMemberElements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.derivedFromElements differ in short: 'Related Observations or QuestionnaireResponses that the observation is made from' vs 'Related measurements the observation is made from'
WarningObservation.derivedFromElements differ in definition: 'Observations or QuestionnaireResponses from which this observation value is derived.' vs 'The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.'
WarningObservation.derivedFromElements differ in definition for mustSupport: 'true' vs 'false'
ErrorObservation.derivedFromType Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]])
WarningObservation.componentElements differ in short: 'Component results' vs 'Possible agent of concern in the exposure'
WarningObservation.componentElements differ in definition for mustSupport: 'false' vs 'true'
WarningObservation.component.codeElements differ in short: 'Type of component observation (code / type)' vs 'ExposureAgent'
WarningObservation.component.codeElements differ in definition: 'Describes what was observed. Sometimes this is called the observation 'code'.' vs ' The physical (including energy), chemical or biological substance that is participating in the exposure. For example in communicable diseases, the disease causing pathogen.'
WarningObservation.component.codeElements differ in definition for mustSupport: 'false' vs 'true'
WarningObservation.component.value[x]Elements differ in short: 'Actual component result' vs 'Possible agent of concern in the exposure'
WarningObservation.component.value[x]Elements differ in definition for mustSupport: 'false' vs 'true'
InformationObservation.component.value[x]Element minimum cardinalities differ: '0' vs '1'

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-surveyhttp://hl7.org/fhir/StructureDefinition/Observation
    • Values Differ
    .copyrightUsed by permission of HL7 International, all rights reserved Creative Commons License
    • Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
    .date2022-03-182022-08-31T17:40:18+00:00
    • Values Differ
    .descriptionThe US Core Observation SDOH Assessment Profile meets the U.S. Core Data for Interoperability (USCDI) v2 'SDOH Assessments' requirements. This profile is based on the US Core Observation Survey Profile and sets minimum expectations for representing responses to assessment tools such as the *Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) Survey*. It can be used to represent individual responses, panels of multi-question surveys, and multi-select responses to “check all that apply” questions. It identifies the *additional* core elements, extensions, vocabularies and value sets which SHALL be present in the Observation resource when using this profile. It provides the floor for standards development for specific uses cases.This Observation profile represents potential patient exposure and contact information and should be used to record information about the patient's exposure to an agent (exposure source) or to record information about those that the patient could have exposed to an agent (exposure target). Recording of this information could assist/support in contact tracing or other control measures.
    • Values Differ
    .experimentalfalse
    • Added the item 'false'
    .fhirVersion4.0.1
      .jurisdiction
        ..jurisdiction[0]urn:iso:std:iso:3166#US
          .kindresource
            .nameUSCoreObservationSDOHAssessmentUSPublicHealthExposureContactInformation
            • Values Differ
            .publisherHL7 International - Cross-Group ProjectsHL7 Public Health Work Group (http://www.hl7.org/Special/committees/pher/index.cfm)
            • Values Differ
            .purpose
              .statusactive
                .titleUS Core Observation SDOH Assessment ProfileUS Public Health Exposure Contact Information
                • Values Differ
                .typeObservation
                  .urlhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessmenthttp://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-exposure-contact-information
                  • Values Differ
                  .version5.0.12.1.0
                  • Values Differ

                  Structure

                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.L TypeL Description & ConstraintsCommentsdoco
                  .. Observation I0..*USCoreObservationSurveyProfileSDOH Assessment Panel Observation
                  I0..*ObservationUS Public Health Exposure Contact Information
                  • Elements differ in short: 'SDOH Assessment Panel Observation' vs 'US Public Health Exposure Contact Information'
                  • Elements differ in definition: '\-' vs 'This profile represents patient exposure information.'
                  • Elements differ in comments: '\-' vs 'Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.'
                  ... id Σ0..1stringLogical id of this artifactΣ0..1stringLogical id of this artifact
                    ... meta Σ0..1MetaMetadata about the resourceΣ0..1MetaMetadata about the resource
                      ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!Σ0..1uriA set of rules under which this content was created
                        ... language 0..1codeLanguage of the resource content
                        Binding: CommonLanguages (preferred): A human language.

                        Additional BindingsPurpose
                        AllLanguagesMax Binding
                        0..1codeLanguage of the resource content
                        Binding: CommonLanguages (preferred): A human language.

                        Additional BindingsPurpose
                        AllLanguagesMax Binding
                          ... text 0..1NarrativeText summary of the resource, for human interpretation0..1NarrativeText summary of the resource, for human interpretation
                            ... contained 0..*ResourceContained, inline Resources
                            0..*ResourceContained, inline Resources
                              ... us-ph-address-extension 0..*ExtensionAdditional content defined by implementations
                              S0..1AddressExposure/contact address
                              URL: http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-address-extension
                              • Elements differ in short: 'Additional content defined by implementations' vs 'Exposure/contact address'
                              • Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'If an address where the exposure/contact took place is known then it can be contained in the address-extension.'
                              • Elements differ in definition for mustSupport: 'false' vs 'true'
                              • Element maximum cardinalities differ: '2147483647' vs '1'
                              ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                              ?!0..*ExtensionExtensions that cannot be ignored
                                ... identifier Σ0..*IdentifierBusiness Identifier for observation
                                Σ0..*IdentifierBusiness Identifier for observation
                                  ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
                                  Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
                                    ... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
                                    Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
                                      ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
                                      Binding: ObservationStatus (required): Codes providing the status of an observation.

                                      ?!Σ1..1coderegistered | preliminary | final | amended +
                                      Binding: ObservationStatus (required): Codes providing the status of an observation.

                                      • Elements differ in definition for mustSupport: 'true' vs 'false'
                                      ... Slices for category S1..*CodeableConceptClassification of type of observation
                                      Slice: Unordered, Open by pattern:$this
                                      Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


                                      S1..1CodeableConceptUse AEXPOS for aquisition exposure, use TEXPOS for transmission exposure, or use EXPOS if the type of exposure is unknown
                                      Binding: ActClassExposure (required): ActClassExposure


                                      • Elements differ in short: 'Classification of type of observation' vs 'Use AEXPOS for aquisition exposure, use TEXPOS for transmission exposure, or use EXPOS if the type of exposure is unknown'
                                      • Elements differ in definition: 'A code that classifies the general type of observation being made.' vs 'Use AEXPOS for aquisition exposure, use TEXPOS for transmission exposure, or use EXPOS if the type of exposure is unknown'
                                      • Elements differ in requirements: 'To identify that observation is derived from a questionnaire.' vs 'Used for filtering what observations are retrieved and displayed.'
                                      • Element maximum cardinalities differ: '2147483647' vs '1'
                                      • Elements differ in binding.description: 'Codes for high level observation categories.' vs 'ActClassExposure'
                                      ... code SΣ1..1CodeableConceptType of observation (code / type)
                                      Binding: US Core Common SDOH Assessments (preferred)
                                      SΣ1..1CodeableConceptThe type of exposure/contact (environmental, activity, event, location, person, animal, etc.).
                                      Binding: LOINCCodes (example): Codes identifying names of simple observations.

                                      • Elements differ in short: 'Type of observation (code / type)' vs 'The type of exposure/contact (environmental, activity, event, location, person, animal, etc.).'
                                      • Elements differ in definition: 'Describes what was observed. Sometimes this is called the observation "name".' vs 'Suggested value sets: [Exposure Setting (COVID-19)], [Exposure Location], [Social History Type]'
                                      • Example/preferred bindings differ at Observation.code using binding from USCoreObservationSDOHAssessment
                                      ... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is aboutSΣ1..1Reference(US Public Health Patient)Who and/or what the observation is about
                                        ... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
                                        SΣ0..*Reference(US Public Health Patient | RelatedPerson | Group | US Core Location Profile)Contains either the patient's contact with an entity (person, animal, or substance) or presence at a location where exposure to an agent could have occurred or the patient's contact with an entity (person, animal, or substance) or presence at a location where transmission from the patient could have occurred
                                        • Elements differ in short: 'What the observation is about, when it is not about the subject of record' vs 'Contains either the patient's contact with an entity (person, animal, or substance) or presence at a location where exposure to an agent could have occurred or the patient's contact with an entity (person, animal, or substance) or presence at a location where transmission from the patient could have occurred'
                                        • Elements differ in definition: 'The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.' vs 'Contact with an entity (person, animal) or at a location.'
                                        • Elements differ in definition for mustSupport: 'false' vs 'true'
                                        ... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is madeΣ0..1Reference(Encounter)Healthcare event during which this observation is made
                                          ... effective[x] SΣI0..1dateTime S, Period, Timing, instantClinically relevant time/time-period for observationSΣ0..1dateTime, Period, Timing, instantTime or period the contact/exposure occurred.
                                          • Elements differ in short: 'Clinically relevant time/time-period for observation' vs 'Time or period the contact/exposure occurred.'
                                          • Elements differ in definition: 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time".' vs 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.'
                                          • Elements differ in comments: 'At least a date should be present unless this observation is a historical report.' vs 'At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing] datatype which allow the measurement to be tied to regular life events.'
                                          ... issued Σ0..1instantDate/Time this version was made availableΣ0..1instantDate/Time this version was made available
                                            ... performer SΣ0..*Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)Who is responsible for the observation
                                            Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                            ... value[x] SΣI0..1Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual resultSΣI0..1CodeableConcept, stringSpecific exposure/contact
                                            • Elements differ in short: 'Actual result' vs 'Specific exposure/contact'
                                            • Elements differ in definition: 'The information determined as a result of making the observation, if the information has a simple value.' vs 'Specific exposure/contact'
                                            • Elements differ in comments: 'An observation may have a value if it represents an individual survey question and answer pair. An observation should not have a value if it represents a multi-question survey or multi-select “check all that apply” question. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.' vs 'An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section] below.'
                                            ... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
                                            Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                            I0..1CodeableConceptWhy the result is missing
                                            Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                            • Elements differ in comments: '"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.value. Where these concepts are not part of the value set for Observation.value, the Observation.dataAbsentReason can be used if necessary and appropriate.' vs 'Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.'
                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                            ... interpretation 0..*CodeableConceptHigh, low, normal, etc.
                                            Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


                                            0..*CodeableConceptHigh, low, normal, etc.
                                            Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


                                              ... note 0..*AnnotationComments about the observation
                                              0..*AnnotationComments about the observation
                                                ... bodySite 0..1CodeableConceptObserved body part
                                                Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

                                                0..1CodeableConceptObserved body part
                                                Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

                                                  ... method 0..1CodeableConceptHow it was done
                                                  Binding: ObservationMethods (example): Methods for simple observations.

                                                  0..1CodeableConceptHow it was done
                                                  Binding: ObservationMethods (example): Methods for simple observations.

                                                    ... specimen 0..1Reference(Specimen)Specimen used for this observation0..1Reference(Specimen)Specimen used for this observation
                                                      ... device 0..1Reference(Device | DeviceMetric)(Measurement) Device0..1Reference(Device | DeviceMetric)(Measurement) Device
                                                        ... referenceRange I0..*BackboneElementProvides guide for interpretation
                                                        I0..*BackboneElementProvides guide for interpretation
                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                            0..*ExtensionAdditional content defined by implementations
                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                .... low I0..1SimpleQuantityLow Range, if relevantI0..1SimpleQuantityLow Range, if relevant
                                                                  .... high I0..1SimpleQuantityHigh Range, if relevantI0..1SimpleQuantityHigh Range, if relevant
                                                                    .... type 0..1CodeableConceptReference range qualifier
                                                                    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

                                                                    0..1CodeableConceptReference range qualifier
                                                                    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

                                                                      .... appliesTo 0..*CodeableConceptReference range population
                                                                      Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


                                                                      0..*CodeableConceptReference range population
                                                                      Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


                                                                        .... age 0..1RangeApplicable age range, if relevant0..1RangeApplicable age range, if relevant
                                                                          .... text 0..1stringText based reference range in an observation0..1stringText based reference range in an observation
                                                                            ... hasMember SΣ0..*Reference(US Core Observation SDOH Assessment Profile S)Individual Observations that belong to an SDOH multi-question sruvey or multi-select question.
                                                                            Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
                                                                            • Elements differ in short: 'Individual Observations that belong to an SDOH multi-question sruvey or multi-select question.' vs 'Related resource that belongs to the Observation group'
                                                                            • Elements differ in definition: 'Aggregate set of Observations that represent question answer pairs for both multi-question surveys and multi-select questions.' vs 'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.'
                                                                            • Elements differ in comments: 'This grouping element is used to represent surveys that group several questions together or individual questions with “check all that apply” responses. For example in the simplest case a flat multi-question survey where the "panel" observation is the survey instrument itself and instead of an `Observation.value` the `hasMember` element references other Observation that represent the individual questions answer pairs. In a survey that has a heirarchical grouping of questions, the observation "panels" can be nested. Because surveys can be arbitrarily complex structurally, not all survey structures can be represented using this Observation grouping pattern.' vs 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes] below. Note that a system may calculate results from [QuestionnaireResponse] into a final score and represent the score as an Observation.'
                                                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                            ... derivedFrom SΣ0..*Reference(US Core Observation Survey Profile S | US Core QuestionnaireResponse Profile S | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence)Related Observations or QuestionnaireResponses that the observation is made from
                                                                            Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
                                                                            • Elements differ in short: 'Related Observations or QuestionnaireResponses that the observation is made from' vs 'Related measurements the observation is made from'
                                                                            • Elements differ in definition: 'Observations or QuestionnaireResponses from which this observation value is derived.' vs 'The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.'
                                                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                            • Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]])
                                                                            ... component Σ0..*BackboneElementComponent results
                                                                            SΣ0..*BackboneElementPossible agent of concern in the exposure
                                                                            • Elements differ in short: 'Component results' vs 'Possible agent of concern in the exposure'
                                                                            • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                            .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                              .... extension 0..*ExtensionAdditional content defined by implementations
                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                  .... code Σ1..1CodeableConceptType of component observation (code / type)
                                                                                  Binding: LOINCCodes (example): Codes identifying names of simple observations.

                                                                                  SΣ1..1CodeableConceptExposureAgent
                                                                                  Binding: LOINCCodes (example): Codes identifying names of simple observations.


                                                                                  Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-ParticipationType","code":"EXPAGNT"}]}
                                                                                  • Elements differ in short: 'Type of component observation (code / type)' vs 'ExposureAgent'
                                                                                  • Elements differ in definition: 'Describes what was observed. Sometimes this is called the observation "code".' vs ' The physical (including energy), chemical or biological substance that is participating in the exposure. For example in communicable diseases, the disease causing pathogen.'
                                                                                  • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                                  .... value[x] Σ0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual component resultSΣ1..1CodeableConcept, stringPossible agent of concern in the exposure
                                                                                  • Elements differ in short: 'Actual component result' vs 'Possible agent of concern in the exposure'
                                                                                  • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                                  • Element minimum cardinalities differ: '0' vs '1'
                                                                                  .... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
                                                                                  Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  I0..1CodeableConceptWhy the component result is missing
                                                                                  Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                                                    .... interpretation 0..*CodeableConceptHigh, low, normal, etc.
                                                                                    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


                                                                                    0..*CodeableConceptHigh, low, normal, etc.
                                                                                    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


                                                                                      .... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result
                                                                                      0..*See referenceRange (Observation)Provides guide for interpretation of component result

                                                                                        doco Documentation for this format