Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	This is an abstract profile. Child profiles: Observation, Observation, Observation, Observation Measurements and simple assertions
implicitRules		0..0
modifierExtension		0..0
status	S	1..1	code	final | amended | corrected | entered-in-error Binding: ObservationStatus (required)
Slices for category		2..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this
category:Activity	S	1..1	CodeableConcept	Activity (Required for U.S. Core) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: activity
category:PhysicalActivity	S	1..1	CodeableConcept	Physical Activity Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PhysicalActivity
code	S	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred)
subject	S	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
focus		0..0
Slices for effective[x]	S	1..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectiveDateTime		0..1	dateTime	Clinically relevant time/time-period for observation
effective[x]:effectivePeriod		0..1	Period	Clinically relevant time/time-period for observation
start	S	1..1	dateTime	Starting time with inclusive boundary
end	S	1..1	dateTime	End time with inclusive boundary, if not ongoing
performer	S	0..*	Reference(US Core Patient Profile S | US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	S	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual result
value[x]:valueQuantity		0..1	SimpleQuantity	A fixed quantity (no comparator)
value	S	1..1	decimal	Numerical value (with implicit precision)
system		1..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	S	1..1	code	Coded form of the unit
note	S	0..*	Annotation	Comments about the observation
author[x]	S	1..1	Reference(Practitioner S | Patient S | RelatedPerson)	Individual responsible for the annotation
time	S	1..1	dateTime	When the annotation was made
text	S	1..1	markdown	The annotation - text content (as markdown)
specimen		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	preferred	LOINCCodes (a valid code from LOINC)

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: Observation, Observation, Observation, Observation Measurements and simple assertions
status	?!SΣ	1..1	code	final | amended | corrected | entered-in-error Binding: ObservationStatus (required)
Slices for category		2..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:Activity	S	1..1	CodeableConcept	Activity (Required for U.S. Core) Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: activity
category:PhysicalActivity	S	1..1	CodeableConcept	Physical Activity Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PhysicalActivity
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
Slices for effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Clinically relevant time/time-period for observation
effective[x]:effectivePeriod	Σ	0..1	Period	Clinically relevant time/time-period for observation
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	1..1	dateTime	End time with inclusive boundary, if not ongoing
performer	SΣ	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result
value[x]:valueQuantity	C	0..1	SimpleQuantity	A fixed quantity (no comparator)
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
system	ΣC	1..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit
note	S	0..*	Annotation	Comments about the observation
author[x]	SΣ	1..1	Reference(Practitioner | Patient)	Individual responsible for the annotation
time	SΣ	1..1	dateTime	When the annotation was made
text	SΣ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:Activity	preferred	Pattern: activity
Observation.category:PhysicalActivity	preferred	Pattern: PhysicalActivity
Observation.code	preferred	LOINCCodes (a valid code from LOINC)

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
qty-3	error	Observation.value[x]:valueQuantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	Observation.value[x]:valueQuantity	The comparator is not used on a SimpleQuantity : comparator.empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: Observation, Observation, Observation, Observation Measurements and simple assertions
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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
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	final | amended | corrected | entered-in-error Binding: ObservationStatus (required)
Slices for category		2..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:Activity	S	1..1	CodeableConcept	Activity (Required for U.S. Core) 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: activity
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:PhysicalActivity	S	1..1	CodeableConcept	Physical Activity 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://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PhysicalActivity
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
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Clinically relevant time/time-period for observation
effective[x]:effectivePeriod	Σ	0..1	Period	Clinically relevant time/time-period for observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	1..1	dateTime	End time with inclusive boundary, if not ongoing
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Patient Profile S | US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result
value[x]:valueQuantity	C	0..1	SimpleQuantity	A fixed quantity (no comparator)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	1..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	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	S	0..*	Annotation	Comments about the observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
author[x]	SΣ	1..1	Reference(Practitioner S | Patient S | RelatedPerson)	Individual responsible for the annotation
time	SΣ	1..1	dateTime	When the annotation was made
text	SΣ	1..1	markdown	The annotation - text content (as markdown)
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.
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
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	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
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
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:Activity	preferred	Pattern: activity
Observation.category:PhysicalActivity	preferred	Pattern: PhysicalActivity
Observation.code	preferred	LOINCCodes (a valid code from LOINC)
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
qty-3	error	Observation.value[x]:valueQuantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	Observation.value[x]:valueQuantity	The comparator is not used on a SimpleQuantity : comparator.empty()

Summary

Mandatory: 4 elements (7 nested mandatory elements)
Must-Support: 16 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• Reference - RESTful (http://hl7.org/fhir/us/physical-activity/StructureDefinition/reference-rest)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• Reference - RESTful or Logical (http://hl7.org/fhir/us/physical-activity/StructureDefinition/reference-rest-or-logical)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this
• The element Observation.effective[x] is sliced based on the value of type:$this
• The element Observation.value[x] is sliced based on the value of type:$this

Maturity: 2

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	This is an abstract profile. Child profiles: Observation, Observation, Observation, Observation Measurements and simple assertions
implicitRules		0..0
modifierExtension		0..0
status	S	1..1	code	final | amended | corrected | entered-in-error Binding: ObservationStatus (required)
Slices for category		2..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this
category:Activity	S	1..1	CodeableConcept	Activity (Required for U.S. Core) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: activity
category:PhysicalActivity	S	1..1	CodeableConcept	Physical Activity Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PhysicalActivity
code	S	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred)
subject	S	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
focus		0..0
Slices for effective[x]	S	1..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectiveDateTime		0..1	dateTime	Clinically relevant time/time-period for observation
effective[x]:effectivePeriod		0..1	Period	Clinically relevant time/time-period for observation
start	S	1..1	dateTime	Starting time with inclusive boundary
end	S	1..1	dateTime	End time with inclusive boundary, if not ongoing
performer	S	0..*	Reference(US Core Patient Profile S | US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	S	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual result
value[x]:valueQuantity		0..1	SimpleQuantity	A fixed quantity (no comparator)
value	S	1..1	decimal	Numerical value (with implicit precision)
system		1..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	S	1..1	code	Coded form of the unit
note	S	0..*	Annotation	Comments about the observation
author[x]	S	1..1	Reference(Practitioner S | Patient S | RelatedPerson)	Individual responsible for the annotation
time	S	1..1	dateTime	When the annotation was made
text	S	1..1	markdown	The annotation - text content (as markdown)
specimen		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	preferred	LOINCCodes (a valid code from LOINC)

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: Observation, Observation, Observation, Observation Measurements and simple assertions
status	?!SΣ	1..1	code	final | amended | corrected | entered-in-error Binding: ObservationStatus (required)
Slices for category		2..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:Activity	S	1..1	CodeableConcept	Activity (Required for U.S. Core) Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: activity
category:PhysicalActivity	S	1..1	CodeableConcept	Physical Activity Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PhysicalActivity
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
Slices for effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Clinically relevant time/time-period for observation
effective[x]:effectivePeriod	Σ	0..1	Period	Clinically relevant time/time-period for observation
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	1..1	dateTime	End time with inclusive boundary, if not ongoing
performer	SΣ	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result
value[x]:valueQuantity	C	0..1	SimpleQuantity	A fixed quantity (no comparator)
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
system	ΣC	1..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit
note	S	0..*	Annotation	Comments about the observation
author[x]	SΣ	1..1	Reference(Practitioner | Patient)	Individual responsible for the annotation
time	SΣ	1..1	dateTime	When the annotation was made
text	SΣ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:Activity	preferred	Pattern: activity
Observation.category:PhysicalActivity	preferred	Pattern: PhysicalActivity
Observation.code	preferred	LOINCCodes (a valid code from LOINC)

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
qty-3	error	Observation.value[x]:valueQuantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	Observation.value[x]:valueQuantity	The comparator is not used on a SimpleQuantity : comparator.empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: Observation, Observation, Observation, Observation Measurements and simple assertions
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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
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	final | amended | corrected | entered-in-error Binding: ObservationStatus (required)
Slices for category		2..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:Activity	S	1..1	CodeableConcept	Activity (Required for U.S. Core) 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: activity
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:PhysicalActivity	S	1..1	CodeableConcept	Physical Activity 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://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PhysicalActivity
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
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (preferred)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectiveDateTime	Σ	0..1	dateTime	Clinically relevant time/time-period for observation
effective[x]:effectivePeriod	Σ	0..1	Period	Clinically relevant time/time-period for observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	1..1	dateTime	End time with inclusive boundary, if not ongoing
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Patient Profile S | US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Actual result Slice: Unordered, Closed by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result
value[x]:valueQuantity	C	0..1	SimpleQuantity	A fixed quantity (no comparator)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	1..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	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	S	0..*	Annotation	Comments about the observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
author[x]	SΣ	1..1	Reference(Practitioner S | Patient S | RelatedPerson)	Individual responsible for the annotation
time	SΣ	1..1	dateTime	When the annotation was made
text	SΣ	1..1	markdown	The annotation - text content (as markdown)
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.
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
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	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
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
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:Activity	preferred	Pattern: activity
Observation.category:PhysicalActivity	preferred	Pattern: PhysicalActivity
Observation.code	preferred	LOINCCodes (a valid code from LOINC)
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
qty-3	error	Observation.value[x]:valueQuantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	Observation.value[x]:valueQuantity	The comparator is not used on a SimpleQuantity : comparator.empty()

Summary

Mandatory: 4 elements (7 nested mandatory elements)
Must-Support: 16 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• Reference - RESTful (http://hl7.org/fhir/us/physical-activity/StructureDefinition/reference-rest)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• Reference - RESTful or Logical (http://hl7.org/fhir/us/physical-activity/StructureDefinition/reference-rest-or-logical)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this
• The element Observation.effective[x] is sliced based on the value of type:$this
• The element Observation.value[x] is sliced based on the value of type:$this

Maturity: 2