This page is part of the Quality Improvement Core Framework (v6.0.0-ballot: STU6 (v6.0.0) Ballot 1) based on FHIR R4. The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

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Resource Profile: QICore Observation Screening Assessment

The QI Core Observation Screening Assessment Profile is based upon the US Core Observation Screening Assessment Profile which can be used to represent individual responses, panels of multi-question surveys, and multi-select responses to “check all that apply” questions. The QI Core Observation Survey Profile sets minimum expectations for the Observation Resource to record, search, and fetch retrieve observations that represent the questions and responses to form/survey and and defines the core set of elements and extensions for quality rule and measure authors.

• Refer to this Resource Profile: QICore Observation Screening Assessment
• Examples for this Resource Profile: Observation/example-screening-assessment-10-minute-apgar-heart-rate

Formal Views of Profile Content

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

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

This structure is derived from USCoreObservationScreeningAssessmentProfile

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
status	S	1..1	code	registered | prliminary | final | amended | corrected | entered-in-error | unknown Binding: Non-Negative Observation Status (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (required): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (required): 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: 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
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: US Core Survey Codes (preferred)
subject	S	1..1	Reference(QICore Patient)	(USCDI) Who and/or what the observation is about
effective[x]	SΣ	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	S	0..*	Reference(QICore Practitioner S | QICore Organization S | QICore Patient S | QICore PractitionerRole S | QICore CareTeam | QICore RelatedPerson S)	(USCDI) Who is responsible for the observation
value[x]	S	0..1		(USCDI) Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer S
valueRange			Range S
valueRatio			Ratio S
valueTime			time S
valueDateTime			dateTime S
valuePeriod			Period S
dataAbsentReason	S	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
hasMember	S	0..*	Reference(QICore Observation Screening Assessment S | QICore QuestionnaireResponse)	Reference to panel or multi-select responses
derivedFrom	S	0..*	Reference(QICore Observation Screening Assessment S | QICore QuestionnaireResponse S)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code
Observation.status	required	NonNegativeObservationStatus
Observation.category	required	ObservationCategoryCodes
Observation.category:survey	required	Pattern: survey
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory
Observation.code	preferred	USCoreSurveyCodes
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | prliminary | final | amended | corrected | entered-in-error | unknown Binding: Non-Negative Observation Status (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (required): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (required): 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: 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
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: US Core Survey Codes (preferred)
subject	SΣ	1..1	Reference(QICore Patient)	(USCDI) Who and/or what the observation is about
effective[x]	SΣC	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
performer	SΣ	0..*	Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore RelatedPerson)	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1		(USCDI) Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
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	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
hasMember	SΣ	0..*	Reference(QICore Observation Screening Assessment)	Reference to panel or multi-select responses
derivedFrom	SΣ	0..*	Reference(QICore Observation Screening Assessment | QICore QuestionnaireResponse)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	NonNegativeObservationStatus
Observation.category	required	ObservationCategoryCodes
Observation.category:survey	required	Pattern: survey
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory
Observation.code	preferred	USCoreSurveyCodes
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.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-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()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3	error	Observation	SHALL use UCUM for coded quantity units. : value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
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	registered | prliminary | final | amended | corrected | entered-in-error | unknown Binding: Non-Negative Observation Status (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (required): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (required): 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	(USCDI) Type of observation (code / type) Binding: US Core Survey Codes (preferred)
subject	SΣ	1..1	Reference(QICore Patient)	(USCDI) Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(QICore Practitioner S | QICore Organization S | QICore Patient S | QICore PractitionerRole S | QICore CareTeam | QICore RelatedPerson S)	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1		(USCDI) Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer S
valueRange			Range S
valueRatio			Ratio S
valueTime			time S
valueDateTime			dateTime S
valuePeriod			Period S
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	S	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
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(QICore Observation Screening Assessment S | QICore QuestionnaireResponse)	Reference to panel or multi-select responses
derivedFrom	SΣ	0..*	Reference(QICore Observation Screening Assessment S | QICore QuestionnaireResponse S)	Related Observations or QuestionnaireResponses that 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	NonNegativeObservationStatus
Observation.category	required	ObservationCategoryCodes
Observation.category:survey	required	Pattern: survey
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory
Observation.code	preferred	USCoreSurveyCodes
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
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()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10

This structure is derived from USCoreObservationScreeningAssessmentProfile

Summary

Mandatory: 4 elements
Must-Support: 13 elements

Structures

This structure refers to these other structures:

• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
• QICore Organization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
• QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
• QICore CareTeam (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-careteam)
• QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
• QICore Observation Screening Assessment (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment)
• QICore QuestionnaireResponse (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-questionnaireresponse)

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this

Differential View

This structure is derived from USCoreObservationScreeningAssessmentProfile

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
status	S	1..1	code	registered | prliminary | final | amended | corrected | entered-in-error | unknown Binding: Non-Negative Observation Status (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (required): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (required): 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: 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
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: US Core Survey Codes (preferred)
subject	S	1..1	Reference(QICore Patient)	(USCDI) Who and/or what the observation is about
effective[x]	SΣ	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	S	0..*	Reference(QICore Practitioner S | QICore Organization S | QICore Patient S | QICore PractitionerRole S | QICore CareTeam | QICore RelatedPerson S)	(USCDI) Who is responsible for the observation
value[x]	S	0..1		(USCDI) Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer S
valueRange			Range S
valueRatio			Ratio S
valueTime			time S
valueDateTime			dateTime S
valuePeriod			Period S
dataAbsentReason	S	0..1	CodeableConcept	(USCDI) Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
hasMember	S	0..*	Reference(QICore Observation Screening Assessment S | QICore QuestionnaireResponse)	Reference to panel or multi-select responses
derivedFrom	S	0..*	Reference(QICore Observation Screening Assessment S | QICore QuestionnaireResponse S)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code
Observation.status	required	NonNegativeObservationStatus
Observation.category	required	ObservationCategoryCodes
Observation.category:survey	required	Pattern: survey
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory
Observation.code	preferred	USCoreSurveyCodes
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | prliminary | final | amended | corrected | entered-in-error | unknown Binding: Non-Negative Observation Status (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (required): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (required): 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: 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
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: US Core Survey Codes (preferred)
subject	SΣ	1..1	Reference(QICore Patient)	(USCDI) Who and/or what the observation is about
effective[x]	SΣC	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
performer	SΣ	0..*	Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore RelatedPerson)	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1		(USCDI) Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
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	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
hasMember	SΣ	0..*	Reference(QICore Observation Screening Assessment)	Reference to panel or multi-select responses
derivedFrom	SΣ	0..*	Reference(QICore Observation Screening Assessment | QICore QuestionnaireResponse)	Related Observations or QuestionnaireResponses that the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	NonNegativeObservationStatus
Observation.category	required	ObservationCategoryCodes
Observation.category:survey	required	Pattern: survey
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory
Observation.code	preferred	USCoreSurveyCodes
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.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-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()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10
us-core-2	error	Observation	If there is no component or hasMember element then either a value[x] or a data absent reason must be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3	error	Observation	SHALL use UCUM for coded quantity units. : value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	USCoreObservationScreeningAssessmentProfile	Survey Observation
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	registered | prliminary | final | amended | corrected | entered-in-error | unknown Binding: Non-Negative Observation Status (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (required): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	(USCDI) Classification of type of observation Binding: ObservationCategoryCodes (required): 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	(USCDI) Type of observation (code / type) Binding: US Core Survey Codes (preferred)
subject	SΣ	1..1	Reference(QICore Patient)	(USCDI) Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(QICore Practitioner S | QICore Organization S | QICore Patient S | QICore PractitionerRole S | QICore CareTeam | QICore RelatedPerson S)	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1		(USCDI) Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer S
valueRange			Range S
valueRatio			Ratio S
valueTime			time S
valueDateTime			dateTime S
valuePeriod			Period S
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	S	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
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(QICore Observation Screening Assessment S | QICore QuestionnaireResponse)	Reference to panel or multi-select responses
derivedFrom	SΣ	0..*	Reference(QICore Observation Screening Assessment S | QICore QuestionnaireResponse S)	Related Observations or QuestionnaireResponses that 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	NonNegativeObservationStatus
Observation.category	required	ObservationCategoryCodes
Observation.category:survey	required	Pattern: survey
Observation.category:screening-assessment	required	USCoreScreeningAssessmentObservationCategory
Observation.code	preferred	USCoreSurveyCodes
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
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()
us-core-1	error	Observation.effective[x]	Datetime must be at least to day. : $this is DateTime implies $this.toString().length() >= 10

This structure is derived from USCoreObservationScreeningAssessmentProfile

Summary

Mandatory: 4 elements
Must-Support: 13 elements

Structures

This structure refers to these other structures:

• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
• QICore Organization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
• QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
• QICore CareTeam (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-careteam)
• QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
• QICore Observation Screening Assessment (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment)
• QICore QuestionnaireResponse (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-questionnaireresponse)

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this

Other representations of profile: CSV, Excel, Schematron