The Patient-Reported Outcome Measure (PROM) score observation records a person's responses to questions contained in a PROM instrument. For example, PHQ-9 for depressions assessment, GAD-7 for anxiety assessment, or one of the PROMIS instruments. When tracking a person's outcomes or performing a digital quality measure, we are usually interested only in the score that is calculated from a person's anwers. This profile specifies how that PROM score is recorded in the value of a single FHIR Observation resource.

The standardized approach for capturing assessment results, including PROM instruments, is well documented in the US Core implementation guide. This PROM score observation profile inherits from the US Core Observation Screening Assessment Profile; refer to it for scope and usage guidance. The US Core profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) Health Status Assessments Data Class. It sets the minimum expectations for the Observation Resource to record, search, and fetch observations representing the questions and responses to surveys and screening and assessment tools.

Example Usage Scenarios:

The following are example usage scenarios for this Profile:

• Record or update observations related to a person's assessment from a PROM instrument. These observations may be extracted from a QuestionnaireResponse that inludes panel(s) of question/answer responses about importance or confidence, or observations created from a dedicated assessment application without use of a Questionnaire.
• Query for observations representing a patient's PROM assessment score.

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 PROM Score Observation must have:

1. a status
2. a category code of "survey"
3. a code identifying the type of PROM score
4. a patient

Each PROM Score Observation must support:

1. additional categories that further specify the assessment or screening
2. a time or period indicating when the assessment was taken
3. who answered the questions
4. a focus referring to a Goal that was assessed for progress
5. a value for the Quantity containing the PROM score

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present us-core-3: SHALL use UCUM for coded quantity units.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Screening Assessment Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Code for PROM score observation Binding: PROM Target Measure Scores (extensible) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	SΣ	0..1	Reference(Person-Centered PROM Goal)	The goal whose progress was scored ele-1: All FHIR elements must have a @value or children
effective[x]	SΣC	1..1		When the score was assessed ele-1: All FHIR elements must have a @value or children 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)	(USCDI) Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	1..1	Quantity	(USCDI) Actual result ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
hasMember	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile)	(USCDI) Reference to panel members or multi-select responses or multi-select responses ele-1: All FHIR elements must have a @value or children
derivedFrom	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile | US Core QuestionnaireResponse Profile)	(USCDI) Related Observation(s) or other resource the observation is made from ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:survey	preferred	Pattern: survey http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category
Observation.code	extensible	PROMTargetMeasures http://hl7.org/fhir/us/pco/ValueSet/prom-target-measures from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

This structure is derived from USCoreObservationScreeningAssessmentProfile

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
code		1..1	CodeableConcept	Code for PROM score observation Binding: PROM Target Measure Scores (extensible)
focus	S	0..1	Reference(Person-Centered PROM Goal)	The goal whose progress was scored
effective[x]		1..1		When the score was assessed
effectiveDateTime			dateTime
effectivePeriod			Period
value[x]		1..1	Quantity	(USCDI) Actual result
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	extensible	PROMTargetMeasures http://hl7.org/fhir/us/pco/ValueSet/prom-target-measures from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present us-core-3: SHALL use UCUM for coded quantity units.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	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
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Screening Assessment Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	Code for PROM score observation Binding: PROM Target Measure Scores (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
focus	SΣ	0..1	Reference(Person-Centered PROM Goal)	The goal whose progress was scored
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		When the score was assessed us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime S
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
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)	(USCDI) Who is responsible for the observation
value[x]	SΣC	1..1	Quantity S	(USCDI) Actual result
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile S | QuestionnaireResponse | MolecularSequence)	(USCDI) Reference to panel members or multi-select responses or multi-select responses
derivedFrom	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile S | US Core QuestionnaireResponse Profile S | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence)	(USCDI) Related Observation(s) or other resource the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:survey	preferred	Pattern: survey http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category
Observation.code	extensible	PROMTargetMeasures http://hl7.org/fhir/us/pco/ValueSet/prom-target-measures from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present us-core-3: SHALL use UCUM for coded quantity units.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Screening Assessment Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Code for PROM score observation Binding: PROM Target Measure Scores (extensible) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	SΣ	0..1	Reference(Person-Centered PROM Goal)	The goal whose progress was scored ele-1: All FHIR elements must have a @value or children
effective[x]	SΣC	1..1		When the score was assessed ele-1: All FHIR elements must have a @value or children 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)	(USCDI) Who is responsible for the observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	1..1	Quantity	(USCDI) Actual result ele-1: All FHIR elements must have a @value or children
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
hasMember	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile)	(USCDI) Reference to panel members or multi-select responses or multi-select responses ele-1: All FHIR elements must have a @value or children
derivedFrom	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile | US Core QuestionnaireResponse Profile)	(USCDI) Related Observation(s) or other resource the observation is made from ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:survey	preferred	Pattern: survey http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category
Observation.code	extensible	PROMTargetMeasures http://hl7.org/fhir/us/pco/ValueSet/prom-target-measures from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard

Differential View

This structure is derived from USCoreObservationScreeningAssessmentProfile

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
code		1..1	CodeableConcept	Code for PROM score observation Binding: PROM Target Measure Scores (extensible)
focus	S	0..1	Reference(Person-Centered PROM Goal)	The goal whose progress was scored
effective[x]		1..1		When the score was assessed
effectiveDateTime			dateTime
effectivePeriod			Period
value[x]		1..1	Quantity	(USCDI) Actual result
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	extensible	PROMTargetMeasures http://hl7.org/fhir/us/pco/ValueSet/prom-target-measures from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present us-core-3: SHALL use UCUM for coded quantity units.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	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
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: US Core Screening Assessment Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	Code for PROM score observation Binding: PROM Target Measure Scores (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who and/or what the observation is about
focus	SΣ	0..1	Reference(Person-Centered PROM Goal)	The goal whose progress was scored
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		When the score was assessed us-core-1: Datetime must be at least to day.
effectiveDateTime			dateTime S
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
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)	(USCDI) Who is responsible for the observation
value[x]	SΣC	1..1	Quantity S	(USCDI) Actual result
dataAbsentReason	SC	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile S | QuestionnaireResponse | MolecularSequence)	(USCDI) Reference to panel members or multi-select responses or multi-select responses
derivedFrom	SΣ	0..*	Reference(US Core Observation Screening Assessment Profile S | US Core QuestionnaireResponse Profile S | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence)	(USCDI) Related Observation(s) or other resource the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:survey	preferred	Pattern: survey http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-observation-category
Observation.code	extensible	PROMTargetMeasures http://hl7.org/fhir/us/pco/ValueSet/prom-target-measures from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from USCoreObservationScreeningAssessmentProfile

Summary

Mandatory: 2 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• Person-Centered PROM Goal (http://hl7.org/fhir/us/pco/StructureDefinition/pco-prom-goal-profile)

Maturity: 2