| Left: | US Core Vital Signs Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs) |
| Right: | Comorbidities Elixhauser Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser) |
| Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs' vs 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser' |
| Error | StructureDefinition.version | Values for version differ: '6.0.0-ballot' vs '2.1.0' |
| Information | StructureDefinition.name | Values for name differ: 'USCoreVitalSignsProfile' vs 'ComorbiditiesElixhauser' |
| Information | StructureDefinition.title | Values for title differ: 'US Core Vital Signs Profile' vs 'Comorbidities Elixhauser Profile' |
| Information | StructureDefinition.date | Values for date differ: '2020-11-17' vs '2023-03-21T04:50:14+11:00' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - Cross-Group Projects' vs 'HL7 International Clinical Interoperability Council' |
| Error | StructureDefinition.baseDefinition | Values for baseDefinition differ: 'http://hl7.org/fhir/StructureDefinition/vitalsigns' vs 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-parent' |
| Warning | Observation | Elements differ in short: 'US Core Vital Signs Profile' vs 'Measurements and simple assertions' |
| Warning | Observation | Elements differ in definition: '\-' vs 'Measurements and simple assertions made about a patient, device or other subject.' |
| Warning | Observation | 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.' |
| Warning | Observation.category | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Information | Observation.category | Element minimum cardinalities differ: '1' vs '0' |
| Warning | Observation.code | Elements differ in short: 'Coded Responses from C-CDA Vital Sign Results' vs 'Type of observation (code / type)' |
| Warning | Observation.code | Elements differ in definition: 'Coded Responses from C-CDA Vital Sign Results.' vs 'Describes what was observed. Sometimes this is called the observation 'name'.' |
| Warning | Observation.code | 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.' |
| Warning | Observation.code | 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.' |
| Warning | Observation.subject | 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.' |
| Information | Observation.subject | Element minimum cardinalities differ: '1' vs '0' |
| Warning | Observation.focus | Elements differ in short: 'What the observation is about, when it is not about the subject of record' vs 'The Index Condition' |
| Warning | Observation.focus | 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.' |
| Warning | Observation.focus | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Warning | Observation.effective[x] | Elements differ in short: 'Often just a dateTime for Vital Signs' vs 'Clinically relevant time/time-period for observation' |
| Warning | Observation.effective[x] | 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'. 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.' |
| Information | Observation.effective[x] | Element minimum cardinalities differ: '1' vs '0' |
| Warning | Observation.value[x] | Elements differ in short: 'Vital Signs Value' vs 'Actual result' |
| Warning | Observation.value[x] | 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.' |
| Warning | Observation.value[x] | 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.' |
| Warning | Observation.dataAbsentReason | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Warning | Observation.bodySite | Elements differ in short: 'Observed body part' vs 'Not used in this profile' |
| Warning | Observation.bodySite | 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' |
| Warning | Observation.specimen | Elements differ in short: 'Specimen used for this observation' vs 'Not used in this profile' |
| Warning | Observation.specimen | Elements differ in definition: 'The specimen that was used when this observation was made.' vs 'Not used in this profile' |
| Warning | Observation.device | Elements differ in short: '(Measurement) Device' vs 'Not used in this profile' |
| Warning | Observation.device | Elements differ in definition: 'The device used to generate the observation data.' vs 'Not used in this profile' |
| Warning | Observation.hasMember | Elements differ in short: 'Used when reporting vital signs panel components' vs 'Related resource that belongs to the Observation group' |
| Warning | Observation.hasMember | Elements differ in definition: 'Used when reporting vital signs panel components.' 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.' |
| Error | Observation.hasMember | 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/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) |
| Warning | Observation.component | Elements differ in short: 'Component observations' vs 'Component results' |
| Warning | Observation.component | Elements differ in definition: 'Used when reporting component observation such as systolic and diastolic blood pressure.' vs 'Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).' |
| Warning | Observation.component.extension | Elements differ in short: 'Additional content defined by implementations' vs 'Extensions to capture specific conditions that fall into the given category.' |
| Warning | Observation.component.extension | 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.' |
| Warning | Observation.component.modifierExtension | Elements differ in short: 'Extensions that cannot be ignored even if unrecognized' vs 'Extension' |
| Warning | Observation.component.modifierExtension | 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' |
| Information | Observation.component.modifierExtension | Element maximum cardinalities differ: '2147483647' vs '0' |
| Warning | Observation.component.code | Elements differ in short: 'Type of component observation (code / type)' vs 'Code representing the comorbidity category' |
| Warning | Observation.component.code | 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.' |
| Warning | Observation.component.code | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Warning | Observation.component.code | 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.' |
| Warning | Observation.component.value[x] | Elements differ in short: 'Vital Sign Component Value' vs 'Actual component result' |
| Warning | Observation.component.value[x] | 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.' |
| Warning | Observation.component.value[x] | 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.' |
| Warning | Observation.component.value[x] | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Warning | Observation.component.dataAbsentReason | Elements differ in definition for mustSupport: 'true' vs 'false' |
| Name | Value | Comments | |
|---|---|---|---|
 abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/vitalsigns | http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-parent |
|
| copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |
| |
| date | 2020-11-17 | 2023-03-21T04:50:14+11:00 |
|
| description | To promote interoperability and adoption through common implementation, this profile is based on the base [FHIR Vital Signs Profile](http://hl7.org/fhir/R4/observation-vitalsigns.html) and defines *additional* constraints on the Observation resource to represent vital signs observations. 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. This US Core profiles that are derived from this profile are listed below. | 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). |
|
| experimental | false |
| |
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
 jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | USCoreVitalSignsProfile | ComorbiditiesElixhauser |
|
| publisher | HL7 International - Cross-Group Projects | HL7 International Clinical Interoperability Council |
|
| purpose | |||
| status | active | ||
| title | US Core Vital Signs Profile | Comorbidities Elixhauser Profile |
|
| type | Observation | ||
| url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs | http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser |
|
| version | 6.0.0-ballot | 2.1.0 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 Observation | C | 0..* | observation-vitalsigns | US Core Vital Signs Profile | C | 0..* | ComorbiditiesParent | Measurements and simple assertions |
| ||||||||
 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.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| 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. | 0..* | CodeableConcept | Classification of type of observation Binding: ?? (preferred): Codes for high level observation categories. |
| |||||||||
| code | SΣ | 1..1 | CodeableConcept | Coded Responses from C-CDA Vital Sign Results Binding: ?? (extensible): The vital sign codes from the base FHIR and US Core Vital Signs. | 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"}]} |
| ||||||||
| 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 |
| ||||||||
| 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 |
| ||||||||
| 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 | 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, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | Vital Signs Value Binding: ?? (extensible): Common UCUM units for recording Vital Signs. | SΣC | 0..1 | integer | Actual result |
| ||||||||
| 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. |
| ||||||||
| 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. |
| ||||||||||
| 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 |
| ||||||||||
| device | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device | 0..1 | Reference(Device | DeviceMetric) | 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(QuestionnaireResponse | MolecularSequence | Vital Signs Profile) | Used when reporting vital signs panel components | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group |
| ||||||||
| derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) | Related measurements the observation is made from | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | |||||||||
 component | SΣC | 0..* | BackboneElement | Component observations | SΣ | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code |
| ||||||||
 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 |
| ||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..0 |
| ||||||||||
| 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 | Code representing the comorbidity category Binding: ?? (example): 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 | CodeableConcept | Actual component result Binding: ?? (required) |
| ||||||||
| 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. |
| ||||||||
| 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 | |||||||||||||||||