Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate vs http://hl7.org/fhir/us/home-lab-report/StructureDefinition/Observation-patient-question-answer

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey	Values Differ
copyright	Used 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'
date	2022-04-20	2023-03-25T16:46:40+00:00	Values Differ
description	To promote interoperability and adoption through common implementation, this profile sets minimum expectations for the Observation resource to record, search, and fetch respiratory rate observations with a standard LOINC code and UCUM units of measure. It is based on the US Core Vital Signs Profile and identifies the *additional* mandatory 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 use cases.	This profile constrains the FHIR Observation Resource to represent an answer given to a question asked of the patient by the app when recording or uploading their test results.	Values Differ
experimental	false		Removed the item 'false'
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreRespiratoryRateProfile	ObservationPatientQuestionAnswer	Values Differ
publisher	HL7 International - Cross-Group Projects	Orders and Observations	Values Differ
purpose
status	active
title	US Core Respiratory Rate Profile	Observation - Patient Question Answer	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate	http://hl7.org/fhir/us/home-lab-report/StructureDefinition/Observation-patient-question-answer	Values Differ
version	6.0.0-ballot	1.0.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
Observation	C	0..*	USCoreVitalSignsProfile	US Core Respiratory Rate Profile	C	0..*	USCoreObservationSurveyProfile	Survey Observation	Elements differ in short: 'US Core Respiratory Rate Profile' vs 'Survey Observation'
id	Σ	0..1	id	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ?? (required)	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ?? (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ?? (preferred): Codes for high level observation categories.	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ?? (preferred): Codes for high level observation categories.	Elements differ in requirements: 'Used for filtering what observations are retrieved and displayed.' vs 'To identify that observation is derived from a questionnaire.'
code	SΣ	1..1	CodeableConcept	Respiratory Rate Binding: ?? (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. Required Pattern: {"coding":[{"system":"http://loinc.org","code":"9279-1"}]}	SΣ	1..1	CodeableConcept	Questions asked of the patient by the app when recording or uploading their at-home in-vitro test results. Binding: ?? (extensible): Clinical Focus Clinical FocusThis set of values contains concepts representing questions asked of the patient by the app when recording or uploading their at-home in-vitro test results.	Elements differ in short: 'Respiratory Rate' vs 'Questions asked of the patient by the app when recording or uploading their at-home in-vitro test results.' Elements differ in definition: 'Coded Responses from C-CDA Vital Sign Results.' vs 'Describes what was observed. Sometimes this is called the observation "name".' Elements differ in requirements: '5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).' vs 'Knowing what kind of observation is being made is essential to understanding the observation.' Elements differ in description: 'The vital sign codes from the base FHIR and US Core Vital Signs.' vs 'Clinical Focus Clinical FocusThis set of values contains concepts representing questions asked of the patient by the app when recording or uploading their at-home in-vitro test results.' Elements differ in description: 'The vital sign codes from the base FHIR and US Core Vital Signs.' vs 'Clinical Focus Clinical FocusThis set of values contains concepts representing questions asked of the patient by the app when recording or uploading their at-home in-vitro test results.' Unable to resolve right value set http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.55 at Observation.code
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1	dateTime S, Period	Often just a dateTime for Vital Signs	SΣC	0..1	dateTime S, Period, Timing, instant	Clinically relevant time/time-period for observation	Elements differ in short: 'Often just a dateTime for Vital Signs' vs 'Clinically relevant time/time-period for observation' Elements differ in definition: 'Often just a dateTime for Vital Signs.' 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".' Elements differ in comments: '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.' vs 'At least a date should be present unless this observation is a historical report.' Element minimum cardinalities differ: '1' vs '0'
issued	Σ	0..1	instant	Date/Time this version was made available	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation	SΣ	0..*	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	Elements differ in definition for mustSupport: 'false' vs 'true'
Slices for value[x]	SΣC	0..1	Quantity S, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Vital Signs Value Slice: Unordered, Open by type:$this Binding: ?? (extensible): Common UCUM units for recording Vital Signs.	SΣC	1..1	Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Answer given to a question asked of the patient by the app when recording or uploading their test results.	Elements differ in short: 'Vital Signs Value' vs 'Answer given to a question asked of the patient by the app when recording or uploading their test results.' Elements differ in definition: 'Vital Signs value are typically recorded using the Quantity data type.' vs 'The information determined as a result of making the observation, if the information has a simple value.' Elements differ in comments: '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.' vs '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.' Elements differ in requirements: '9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).' vs 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.' Element minimum cardinalities differ: '0' vs '1'
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	SC	0..1	CodeableConcept	Why the result is missing Binding: ?? (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. 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.' 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. 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.'
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality.		0..1	CodeableConcept	Observed body part Binding: ?? (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ?? (example): Methods for simple observations.		0..1	CodeableConcept	How it was done Binding: ?? (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	??	Low Range, if relevant	C	0..1	??	Low Range, if relevant
high	C	0..1	??	High Range, if relevant	C	0..1	??	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.		0..1	CodeableConcept	Reference range qualifier Binding: ?? (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.		0..*	CodeableConcept	Reference range population Binding: ?? (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components	SΣ	0..*	Reference(US Core Observation Survey Profile S | US Core QuestionnaireResponse Profile | MolecularSequence)	Reference to panel or multi-select responses	Elements differ in short: 'Used when reporting vital signs panel components' vs 'Reference to panel or multi-select responses' Elements differ in definition: 'Used when reporting vital signs panel components.' vs 'Aggregate set of Observations that represent question answer pairs for both multi-question surveys and multi-select questions.' Elements differ in comments: '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.' vs '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.' Elements differ in definition for mustSupport: 'false' vs 'true' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence], CanonicalType[http://hl7.org/fhir/StructureDefinition/vitalsigns]]) vs 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/StructureDefinition/MolecularSequence]])
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from	SΣ	0..*	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	Elements differ in short: 'Related measurements the observation is made from' vs 'Related Observations or QuestionnaireResponses that the observation is made from' Elements differ in definition: '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.' vs 'Observations or QuestionnaireResponses from which this observation value is derived.' Elements differ in definition for mustSupport: 'false' vs 'true' Type Mismatch: 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/MolecularSequence], CanonicalType[http://hl7.org/fhir/StructureDefinition/vitalsigns]]) vs 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]])
component	SΣC	0..*	BackboneElement	Component observations	Σ	0..*	BackboneElement	Component results	Elements differ in short: 'Component observations' vs 'Component results' Elements differ in definition: 'Used when reporting component observation such as systolic and diastolic blood pressure.' vs 'Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.' Elements differ in definition for mustSupport: 'true' vs 'false'
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations.	Elements differ in definition for mustSupport: 'true' vs 'false' Elements differ in binding.description: 'The vital sign codes from the base FHIR and US Core Vital Signs.' vs 'Codes identifying names of simple observations.'
value[x]	SΣC	0..1	Quantity S, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Vital Sign Component Value Binding: ?? (extensible): Common UCUM units for recording Vital Signs.	Σ	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result	Elements differ in short: 'Vital Sign Component Value' vs 'Actual component result' Elements differ in definition: 'Vital Signs value are typically recorded using the Quantity data type. For supporting observations such as cuff size could use other datatypes such as CodeableConcept.' vs 'The information determined as a result of making the observation, if the information has a simple value.' Elements differ in requirements: '9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).' vs 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.' Elements differ in definition for mustSupport: 'true' vs 'false'
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	C	0..1	CodeableConcept	Why the component result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	Elements differ in definition for mustSupport: 'true' vs 'false'
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ?? (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
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