HL7.FHIR.US.MCC\Multiple Chronic Condition Care Plan Simple Observation

MCC eCare Plan Implementation Guide
1.0.0-ballot - Comment only US

This page is part of the MCC eCare Plan Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: Multiple Chronic Condition Care Plan Simple Observation

Official URL: http://hl7.org/fhir/us/mcc/StructureDefinition/MCCSimpleObservation				Version: 1.0.0-ballot
Active as of 2022-12-04				Computable Name: MCCSimpleObservation
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

This profile constrains FHIR R4.0.1 Observation for use in the MCC FHIR Care Plan or other FHIR Care Plans. It is using Observation resource to record, search, and fetch Observations on issues or items that are not appropriate for the other MCC FHIR Observation profiles.

This profile sets expectations to record, search, and fetch Observations on issues or items that are not appropriate for the other MCC FHIR Observation profiles. In addition to the requirements set in the the observation resource, this derived profile is designed to add requirements to the following elements:

Observation.extension:resource-pertainsToGoal (Must Support)

This profile can be bound with any of the value sets found on the MCC Simple Observation Value Set library page to query for, fetch or record basic clinical observations as defined in the scope of each value set.

Usage:

Examples for this Resource Profile: Observation/simple-observation-example

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
pertainsToGoal	S	0..*	Reference(Goal)	The pertains To Goal extension allows any resource to reference a related goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
status	S	1..1	code	registered \| preliminary \| final \| amended +
category		0..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this
code	S	1..1	CodeableConcept	Code
subject	S	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
effective[x]	SC	0..1		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
performer	S	0..*	Reference(US Core Practitioner Profile \| US Core Organization Profile \| US Core Patient Profile \| PractitionerRole \| US Core CareTeam Profile \| US Core RelatedPerson Profile)	Who is responsible for the observation
value[x]	SC	0..1		Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing
derivedFrom	S	0..*	Reference(US Core Observation Survey Profile \| US Core QuestionnaireResponse Profile \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence \| Multiple Chronic Condition Care Plan Questionnaire Response)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
pertainsToGoal	S	0..*	Reference(Goal)	The pertains To Goal extension allows any resource to reference a related goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered \| preliminary \| final \| amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Code Binding: LOINCCodes (example): Codes identifying names of simple observations.
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
effective[x]	SΣC	0..1		Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime
performer	SΣ	0..*	Reference(US Core Practitioner Profile \| US Core Organization Profile \| US Core Patient Profile \| PractitionerRole \| US Core CareTeam Profile \| US Core RelatedPerson Profile)	Who is responsible for the observation
value[x]	SΣC	0..1		Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
derivedFrom	SΣ	0..*	Reference(US Core Observation Survey Profile \| US Core QuestionnaireResponse Profile \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence \| Multiple Chronic Condition Care Plan Questionnaire Response)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	example	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.code

example

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: 1 element
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
pertainsToGoal	S	0..*	Reference(Goal)	The pertains To Goal extension allows any resource to reference a related goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
status	S	1..1	code	registered \| preliminary \| final \| amended +
category		0..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this
code	S	1..1	CodeableConcept	Code
subject	S	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
effective[x]	SC	0..1		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
performer	S	0..*	Reference(US Core Practitioner Profile \| US Core Organization Profile \| US Core Patient Profile \| PractitionerRole \| US Core CareTeam Profile \| US Core RelatedPerson Profile)	Who is responsible for the observation
value[x]	SC	0..1		Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing
derivedFrom	S	0..*	Reference(US Core Observation Survey Profile \| US Core QuestionnaireResponse Profile \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence \| Multiple Chronic Condition Care Plan Questionnaire Response)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
pertainsToGoal	S	0..*	Reference(Goal)	The pertains To Goal extension allows any resource to reference a related goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered \| preliminary \| final \| amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Code Binding: LOINCCodes (example): Codes identifying names of simple observations.
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
effective[x]	SΣC	0..1		Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime
performer	SΣ	0..*	Reference(US Core Practitioner Profile \| US Core Organization Profile \| US Core Patient Profile \| PractitionerRole \| US Core CareTeam Profile \| US Core RelatedPerson Profile)	Who is responsible for the observation
value[x]	SΣC	0..1		Result Value us-core-3: SHALL use UCUM for coded quantity units.
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
derivedFrom	SΣ	0..*	Reference(US Core Observation Survey Profile \| US Core QuestionnaireResponse Profile \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence \| Multiple Chronic Condition Care Plan Questionnaire Response)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	example	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.code

example

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'