PACIO Personal Functioning and Engagement Implementation Guide
1.0.0-ballot - ballot1 US

This page is part of the PACIO Personal Functioning and Engagement 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: Personal Functioning and Engagement Collection

Official URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-collection Version: 1.0.0-ballot
Active as of 2022-08-05 Computable Name: PFECollection

A point in time collection of post-acute care observations for a patient. This profile is used for exchanging a set of observation data collected through the use of a structured resource (e.g. assessment tool, instrument, or screen) with multiple questions. The specific questions within the structured tool are captured as child observations.

Example Usage Scenarios:

The following are example usage scenarios for this Profile:

  • Query for the documentation of a formal, or informal, assessment of a patient’s functioning and engagement.
  • Record or update assessment observations for a Patient.

Mandatory and Must Support Data Elements

The following data elements must always be present or must be supported if the data is present in the sending system (Must Support definition). They are presented below with a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Personal Functioning and Engagement Collection must have:

  1. a status
  2. a category code of “survey” and “functioning”
  3. a LOINC or SNOMED CT code, if available, which tells you which tool was used
  4. a patient
  5. the point in time or period when the observation was made
  6. who made the observation

Each Personal Functioning and Engagement Collection must support:

  1. the location the observation was made
  2. any devices the patient used
  3. an additional category value or values specifying the specific health or health-related domain that this observation is related to***
  4. the answer or a reason why the data is absent*
  5. related questionnaire responses that this observation is made from
  6. references to observations that contain the specific questions and answers that make up the represented tool.**

* ** *** see guidance below

Profile specific implementation guidance:

  • **These observations represent structured instruments with multiple questions, so the Observation.value element should be empty and the individual survey questions represented as distinct Personal Functioning and Engagement Observations and referenced using Observation.hasMember. Summary scores should be represented as child observations (e.g., a BIMS Assessment collection and its summary score observation).
  • ***When a health or health-related domain is specified as an additional category value, Observation.code should be drawn from the corresponding value set specified within the supplemental guide. The additional categories on the parent collection should include any and all additional categories indicated on its children.
  • *An Observation without a value, SHALL include a reason why the data is absent unless there are 1) component observations, or 2) reporting panel observations using Observation.hasMember.
  • Systems that never provide an observation without a value are not required to support Observation.dataAbsentReason.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreObservationSurveyProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*USCoreObservationSurveyProfileSurvey Observation
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... event-location S0..1Reference(US Core Location Profile)An extension to indicate where the observation event occurred.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/event-location
... device-use S0..*Reference(Personal Functioning and Engagement Use of Device)An extension to indicate a record of assistive device usage by a patient during an assessment.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/device-patient-used
... category 2..*CodeableConceptClassification of type of observation
... category:functioning S1..1CodeableConceptClassification of type of observation
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-functioning-cs
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: functioning
..... display1..1stringRepresentation defined by the system
Fixed Value: Functioning
... category:PFEDomain S0..*CodeableConceptClassification of type of observation
Binding: Personal Functioning and Engagement Category Value Set (required)
... code 1..1CodeableConceptFor a Post-Acute Care structured assessment resource such as an instrument or screen, use a LOINC code to identify the instrument/screen name or panel/section title to indicate the kind of assessment.
Binding: Personal Functioning and Engagement ValueSet LOINC SNOMED (extensible)
... effective[x] 1..1Clinical relevant time for an assessment such as post-acute care observations performed with structured evaluation tools is the time the evaluation occurs, i.e., when the clinician obtains the answers entered in the tool. However, the only timing available may be when then tool is completed by the clinician. That timing is generally documented as a point in time (dateTime).
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer 1..*Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
... value[x] 0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodIf used, should use the CodeableConcept datatype whenever possible to provide a suitable code to define the concept for the observation data. When capturing a collection of related observations, typically this field is not used. If the outcome of an assessment includes one or more summary scores, leave this field unused and use the 'hasMember' field to point to one or more Observation resources with each of which has a score provided in the 'value' field.
... hasMember 0..*Reference(Personal Functioning and Engagement Observation)Each post-acute care observation in the collection. May also be another collection to support nested sections.
... derivedFrom 0..*Reference(US Core QuestionnaireResponse Profile)Should point back to the QuestionnaireResponse that this resource is derived from.

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*USCoreObservationSurveyProfileSurvey Observation
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!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
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... event-location S0..1Reference(US Core Location Profile)An extension to indicate where the observation event occurred.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/event-location
... device-use S0..*Reference(Personal Functioning and Engagement Use of Device)An extension to indicate a record of assistive device usage by a patient during an assessment.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/device-patient-used
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn 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
... status ?!SΣ1..1codeShould have the value 'final' when all the observatons are complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used.
Binding: ObservationStatus (required): Codes providing the status of an observation.

... Slices for category S2..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:survey S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: survey
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
.... category:functioning S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-functioning-cs
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: functioning
...... display1..1stringRepresentation defined by the system
Fixed Value: Functioning
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
.... category:PFEDomain S0..*CodeableConceptClassification of type of observation
Binding: Personal Functioning and Engagement Category Value Set (required)
... code SΣ1..1CodeableConceptFor a Post-Acute Care structured assessment resource such as an instrument or screen, use a LOINC code to identify the instrument/screen name or panel/section title to indicate the kind of assessment.
Binding: Personal Functioning and Engagement ValueSet LOINC SNOMED (extensible)
... subject SΣ1..1Reference(US Core Patient Profile)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
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Clinical relevant time for an assessment such as post-acute care observations performed with structured evaluation tools is the time the evaluation occurs, i.e., when the clinician obtains the answers entered in the tool. However, the only timing available may be when then tool is completed by the clinician. That timing is generally documented as a point in time (dateTime).
.... effectiveDateTimedateTime S
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer SΣ1..*Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
... value[x] SΣI0..1If used, should use the CodeableConcept datatype whenever possible to provide a suitable code to define the concept for the observation data. When capturing a collection of related observations, typically this field is not used. If the outcome of an assessment includes one or more summary scores, leave this field unused and use the 'hasMember' field to point to one or more Observation resources with each of which has a score provided in the 'value' field.
.... valueQuantityQuantity S
.... valueCodeableConceptCodeableConcept S
.... valueStringstring S
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
... dataAbsentReason SI0..1CodeableConceptWhy the 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.


... note 0..*AnnotationComments about the observation
... bodySite 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.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type 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.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember SΣ0..*Reference(Personal Functioning and Engagement Observation)Each post-acute care observation in the collection. May also be another collection to support nested sections.
... derivedFrom SΣ0..*Reference(US Core QuestionnaireResponse Profile)Should point back to the QuestionnaireResponse that this resource is derived from.
... component Σ0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!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.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason 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.


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

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*USCoreObservationSurveyProfileSurvey Observation
... event-location 0..1Reference(US Core Location Profile)An extension to indicate where the observation event occurred.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/event-location
... device-use 0..*Reference(Personal Functioning and Engagement Use of Device)An extension to indicate a record of assistive device usage by a patient during an assessment.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/device-patient-used
... status ?!Σ1..1codeShould have the value 'final' when all the observatons are complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used.
Binding: ObservationStatus (required): Codes providing the status of an observation.

.... category:survey 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: survey
.... category:functioning 1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-functioning-cs
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: functioning
...... display1..1stringRepresentation defined by the system
Fixed Value: Functioning
.... category:PFEDomain 0..*CodeableConceptClassification of type of observation
Binding: Personal Functioning and Engagement Category Value Set (required)
... code Σ1..1CodeableConceptFor a Post-Acute Care structured assessment resource such as an instrument or screen, use a LOINC code to identify the instrument/screen name or panel/section title to indicate the kind of assessment.
Binding: Personal Functioning and Engagement ValueSet LOINC SNOMED (extensible)
... subject Σ1..1Reference(US Core Patient Profile)Who and/or what the observation is about
... effective[x] ΣI1..1Clinical relevant time for an assessment such as post-acute care observations performed with structured evaluation tools is the time the evaluation occurs, i.e., when the clinician obtains the answers entered in the tool. However, the only timing available may be when then tool is completed by the clinician. That timing is generally documented as a point in time (dateTime).
.... effectiveDateTimedateTime
... performer Σ1..*Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
... value[x] ΣI0..1If used, should use the CodeableConcept datatype whenever possible to provide a suitable code to define the concept for the observation data. When capturing a collection of related observations, typically this field is not used. If the outcome of an assessment includes one or more summary scores, leave this field unused and use the 'hasMember' field to point to one or more Observation resources with each of which has a score provided in the 'value' field.
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... hasMember Σ0..*Reference(Personal Functioning and Engagement Observation)Each post-acute care observation in the collection. May also be another collection to support nested sections.
... derivedFrom Σ0..*Reference(US Core QuestionnaireResponse Profile)Should point back to the QuestionnaireResponse that this resource is derived from.

doco Documentation for this format

Differential View

This structure is derived from USCoreObservationSurveyProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*USCoreObservationSurveyProfileSurvey Observation
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... event-location S0..1Reference(US Core Location Profile)An extension to indicate where the observation event occurred.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/event-location
... device-use S0..*Reference(Personal Functioning and Engagement Use of Device)An extension to indicate a record of assistive device usage by a patient during an assessment.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/device-patient-used
... category 2..*CodeableConceptClassification of type of observation
... category:functioning S1..1CodeableConceptClassification of type of observation
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-functioning-cs
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: functioning
..... display1..1stringRepresentation defined by the system
Fixed Value: Functioning
... category:PFEDomain S0..*CodeableConceptClassification of type of observation
Binding: Personal Functioning and Engagement Category Value Set (required)
... code 1..1CodeableConceptFor a Post-Acute Care structured assessment resource such as an instrument or screen, use a LOINC code to identify the instrument/screen name or panel/section title to indicate the kind of assessment.
Binding: Personal Functioning and Engagement ValueSet LOINC SNOMED (extensible)
... effective[x] 1..1Clinical relevant time for an assessment such as post-acute care observations performed with structured evaluation tools is the time the evaluation occurs, i.e., when the clinician obtains the answers entered in the tool. However, the only timing available may be when then tool is completed by the clinician. That timing is generally documented as a point in time (dateTime).
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer 1..*Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
... value[x] 0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodIf used, should use the CodeableConcept datatype whenever possible to provide a suitable code to define the concept for the observation data. When capturing a collection of related observations, typically this field is not used. If the outcome of an assessment includes one or more summary scores, leave this field unused and use the 'hasMember' field to point to one or more Observation resources with each of which has a score provided in the 'value' field.
... hasMember 0..*Reference(Personal Functioning and Engagement Observation)Each post-acute care observation in the collection. May also be another collection to support nested sections.
... derivedFrom 0..*Reference(US Core QuestionnaireResponse Profile)Should point back to the QuestionnaireResponse that this resource is derived from.

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*USCoreObservationSurveyProfileSurvey Observation
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!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
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... event-location S0..1Reference(US Core Location Profile)An extension to indicate where the observation event occurred.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/event-location
... device-use S0..*Reference(Personal Functioning and Engagement Use of Device)An extension to indicate a record of assistive device usage by a patient during an assessment.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/device-patient-used
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn 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
... status ?!SΣ1..1codeShould have the value 'final' when all the observatons are complete and there are no further actions needed. Otherwise, another value from the value set may appropriately be used.
Binding: ObservationStatus (required): Codes providing the status of an observation.

... Slices for category S2..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:survey S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: survey
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
.... category:functioning S1..1CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-functioning-cs
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: functioning
...... display1..1stringRepresentation defined by the system
Fixed Value: Functioning
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
.... category:PFEDomain S0..*CodeableConceptClassification of type of observation
Binding: Personal Functioning and Engagement Category Value Set (required)
... code SΣ1..1CodeableConceptFor a Post-Acute Care structured assessment resource such as an instrument or screen, use a LOINC code to identify the instrument/screen name or panel/section title to indicate the kind of assessment.
Binding: Personal Functioning and Engagement ValueSet LOINC SNOMED (extensible)
... subject SΣ1..1Reference(US Core Patient Profile)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
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI1..1Clinical relevant time for an assessment such as post-acute care observations performed with structured evaluation tools is the time the evaluation occurs, i.e., when the clinician obtains the answers entered in the tool. However, the only timing available may be when then tool is completed by the clinician. That timing is generally documented as a point in time (dateTime).
.... effectiveDateTimedateTime S
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this version was made available
... performer SΣ1..*Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)The person who performed the assessment. The preferred way to specify the performer is to use the PractitionerRole resource to provide both the practitioner and organization.
... value[x] SΣI0..1If used, should use the CodeableConcept datatype whenever possible to provide a suitable code to define the concept for the observation data. When capturing a collection of related observations, typically this field is not used. If the outcome of an assessment includes one or more summary scores, leave this field unused and use the 'hasMember' field to point to one or more Observation resources with each of which has a score provided in the 'value' field.
.... valueQuantityQuantity S
.... valueCodeableConceptCodeableConcept S
.... valueStringstring S
.... valueBooleanboolean
.... valueIntegerinteger
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
... dataAbsentReason SI0..1CodeableConceptWhy the 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.


... note 0..*AnnotationComments about the observation
... bodySite 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.

... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type 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.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember SΣ0..*Reference(Personal Functioning and Engagement Observation)Each post-acute care observation in the collection. May also be another collection to support nested sections.
... derivedFrom SΣ0..*Reference(US Core QuestionnaireResponse Profile)Should point back to the QuestionnaireResponse that this resource is derived from.
... component Σ0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!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.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason 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.


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

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Max Binding: AllLanguages
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.category:surveypreferredPattern: survey
Observation.category:functioningpreferredPattern: functioning("Functioning")
Observation.category:PFEDomainrequiredPFECategoryVS
Observation.codeextensiblePFELoincSnomedVS
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodexampleObservationMethods
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Notes:

The syntax used to describe the interactions below is described here.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support searching using the combination of the patient and category search parameters:

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]

    Example:

    1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|survey
    2. GET [base]/Observation?patient=1134281&category=http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-category-cs|mental_functions

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = survey or mental_functions respectively (how to search by reference and how to search by token)

  2. SHALL support searching using the combination of the patient and code search parameters:
    • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)

    GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=1134281&code=http://loinc.org|72133-2
    2. GET [base]/Observation?patient=1134281&code=http://loinc.org|72133-2,http://loinc.org|72107-6,http://loinc.org|54635-8

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). SHOULD support search by multiple report codes. The Observation code parameter searches `Observation.code only. (how to search by reference and how to search by token)

  3. SHALL support searching using the combination of the patient and category and date search parameters:
    • including support for these date comparators: gt,lt,ge,le
    • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]Observation?patient=555580&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date=ge2018-03-14T00:00:00Z
    2. GET [base]Observation?patient=555580&category=http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-category-cs|mental_functions&date=ge2018-03-14T00:00:00Z

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = survey or mental_functions respectively (how to search by reference and how to search by token and how to search by date)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

  1. SHOULD support searching using the combination of the patient and category and status search parameters:
    • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final
    2. GET [base]/Observation?patient=1134281&category=http://hl7.org/fhir/us/pacio-pfe/CodeSystem/pfe-category-cs|mental_functions&status=final

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category = survey or mental_functions respectively and status final (how to search by reference and how to search by token)

  2. SHOULD support searching using the combination of the patient and code and date search parameters:
    • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
    • including support for these date comparators: gt,lt,ge,le
    • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

    GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]Observation?patient=555580&code=http://loinc.org|72133-2&date=ge2019-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and report code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token and how to search by date)