Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result vs http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/Observation	http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-parent	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	2023-03-21T04:50:14+11:00	Values Differ
description	The US Core Observation Clinical Result Profile is based upon the core FHIR Observation Resource and, along with the US Core DiagnosticReport Profile, meets the US Core Data for Interoperability (USCDI) requirements for *Diagnostic Imaging* and *Clinical Tests* Data Classes. This profile sets minimum expectations for the Observation resource to record and search non-laboratory clinical test results (e.g., radiology and other clinical observations generated from procedures). An example would be when a gastroenterologist reports the size of a polyp observed during a colonoscopy. This profile is the basis for the US Core Laboratory Result Observation Profile, which defines additional data elements to record and search laboratory test results. The US Core Observation Clinical Result Profile sets minimum expectations to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource when using this profile. It provides the floor for standards development for specific use cases.	Comorbid condition checklist and optional risk score, using Elixhauser comorbidity categories as defined by the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (H-CUP).	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreObservationClinicalResultProfile	ComorbiditiesElixhauser	Values Differ
publisher	HL7 International - Cross-Group Projects	HL7 International Clinical Interoperability Council	Values Differ
purpose
status	active
title	US Core Observation Clinical Result Profile	Comorbidities Elixhauser Profile	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result	http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser	Values Differ
version	6.0.0-ballot	2.1.0	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..*	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	C	0..*	ComorbiditiesParent	Measurements and simple assertions	Elements differ in definition: '\-' vs 'Measurements and simple assertions made about a patient, device or other subject.' 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	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): Codes providing the status of an observation.	?!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 pattern:$this Binding: ?? (preferred): Codes for high level observation categories.		0..*	CodeableConcept	Classification of type of observation Binding: ?? (preferred): Codes for high level observation categories.	Elements differ in definition for mustSupport: 'true' vs 'false' Element minimum cardinalities differ: '1' vs '0'
code	SΣ	1..1	CodeableConcept	Clinical Test or Procedure Name Binding: ?? (extensible)	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: ?? (example): Codes identifying names of simple observations. Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs","code":"comorbidities-elixhauser","display":"Elixhauser Comorbidity Panel"}]}	Elements differ in short: 'Clinical Test or Procedure Name' vs 'Type of observation (code / type)' Elements differ in definition: 'The name of the clinical test or procedure performed on a patient. A LOINC **SHALL** be used if the concept is present in LOINC.' vs 'Describes what was observed. Sometimes this is called the observation "name".' Elements differ in comments: 'The typical patterns for codes are: 1) a LOINC code either as a translation from a "local" code or as a primary code, or 2) a local code only if no suitable LOINC exists, or 3) both the local and the LOINC translation. Systems SHALL be capable of sending the local code if one exists. When using LOINC , Use either the SHORTNAME or LONG_COMMON_NAME field for the display.' vs '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	SΣ	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about	Elements differ in definition: 'The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.' vs 'The patient whose comorbidities are recorded.' Element minimum cardinalities differ: '1' vs '0'
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record	SΣ	0..*	Reference(Primary Cancer Condition Profile)	The Index Condition	Elements differ in short: 'What the observation is about, when it is not about the subject of record' vs 'The Index Condition' 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 'A reference to the cancer condition that is the context for the current list of comorbid conditions.' Elements differ in definition for mustSupport: 'false' vs 'true'
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	0..1	dateTime S, Period, Timing, instant	Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.	SΣ	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation
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	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1	Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Result Value us-core-3: SHALL use UCUM for coded quantity units.	SΣC	0..1	integer	Actual result	Elements differ in short: 'Result Value' vs 'Actual result' Elements differ in definition: 'The clinical test or procedure result value. If a numeric value, valueQuantity.code **SHALL** be selected from [UCUM]. A FHIR [UCUM Codes value set] that defines all UCUM codes is in the FHIR specification.' vs 'The information determined as a result of making the observation, if the information has a simple value.'
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.	C	0..1	CodeableConcept	Why the 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.
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	Not used in this profile Binding: ?? (example): Codes describing anatomical locations. May include laterality.	Elements differ in short: 'Observed body part' vs 'Not used in this profile' Elements differ in definition: 'Indicates the site on the subject's body where the observation was made (i.e. the target site).' vs 'Not used in this profile'
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)	Not used in this profile	Elements differ in short: 'Specimen used for this observation' vs 'Not used in this profile' Elements differ in definition: 'The specimen that was used when this observation was made.' vs 'Not used in this profile'
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device		0..1	Reference(Device | DeviceMetric)	Not used in this profile	Elements differ in short: '(Measurement) Device' vs 'Not used in this profile' Elements differ in definition: 'The device used to generate the observation data.' vs 'Not used in this profile'
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(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Closed by pattern:code	Elements differ in definition: '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.' vs 'Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).' Elements differ in definition for mustSupport: 'false' vs 'true'
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	Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url	Elements differ in short: 'Additional content defined by implementations' vs 'Extensions to capture specific conditions that fall into the given category.' Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. 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 more detail about the comorbid condition is desired, elements in this extension can be populated with a specific condition code or a reference to a Condition resource. The extension elements SHALL be used only if the comorbidity category is present.'
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..0			Elements differ in short: 'Extensions that cannot be ignored even if unrecognized' vs 'Extension' Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).' vs 'An Extension' Element maximum cardinalities differ: '2147483647' vs '0'
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: ?? (example): Codes identifying names of simple observations.	Σ	1..1	CodeableConcept	Code representing the comorbidity category Binding: ?? (example): Codes identifying names of simple observations.	Elements differ in short: 'Type of component observation (code / type)' vs 'Code representing the comorbidity category' Elements differ in definition: 'Describes what was observed. Sometimes this is called the observation "code".' vs 'The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.'
value[x]	Σ	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result	Σ	0..1	CodeableConcept	Actual component result Binding: ?? (required)
dataAbsentReason	C	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.
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
Documentation for this format