HL7.FHIR.US.QICORE\QICore Observation Cancelled

QI-Core Implementation Guide
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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

Resource Profile: QICore Observation Cancelled

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled				Version: 6.0.0-ballot
Active as of 2018-08-22				Computable Name: QICoreObservationCancelled

Profile of ObservationCancelled for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

The Simple Observation and ObservationCancelled profiles represent the positive and negative statements for an observation. To ensure instances retrieved meet negative intent, applications should check the status element as illustrated in this example:

define "Pap Test Refused":
  ["ObservationCancelled": "Pap Test"] PapTest
    where PapTest.notDoneReason in "Patient Refusal"

Note that when a more specific observation, such as a Blood Pressure, is negated, the resource instance should conform to both the specific observation profile AND the general negation profile.

Examples

Negation Example with valueset	Observation not indicated; indicates that none of the observations in the given not done value set were performed.
Negation Example with code	Observation not indicate; indicates that a specific observation, by code, was not done.

For a more complete discussion of representation of negation within QICore and quality improvement artifacts, see the Negation in QI Core topic.

Usage:

This Resource Profile is not used by any profiles in this Implementation Guide

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 Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions ond-1: to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided
notDoneReason	S	1..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneReason Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
status	S	1..1	code	registered \| preliminary \| final \| amended + Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation
code	S	1..1	CodeableConcept	Type of observation (code / type)
notDoneValueSet	S	0..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
subject	S	1..1	Reference(QICore Patient)	Who and/or what the observation is about
issued	S	1..1	instant	Date/Time this version was made available
performer		0..*	Reference(QICore Practitioner \| QICore Organization \| QICore Patient \| QICore RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣ	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer S
valueRange			Range S
valueRatio			Ratio S
valueSampledData			SampledData
valueTime			time S
valueDateTime			dateTime S
valuePeriod			Period S
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
derivedFrom		0..*	Reference(QICore Simple Observation \| QICore QuestionnaireResponse \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.value[x]:valueCodeableConcept	preferred	USCoreObservationValueCodes (a valid code from SNOMED CT)
Observation.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
ond-1	error	Observation	to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions ond-1: to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
notDoneReason	S	1..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneReason Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered \| preliminary \| final \| amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
notDoneValueSet	S	0..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
subject	SΣ	1..1	Reference(QICore Patient)	Who and/or what the observation is about
issued	SΣ	1..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(QICore Practitioner \| QICore Organization \| QICore Patient \| QICore RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
derivedFrom	Σ	0..*	Reference(QICore Simple Observation \| QICore QuestionnaireResponse \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	Fixed Value: cancelled
Observation.category	preferred	ObservationCategoryCodes
Observation.code	example	LOINCCodes (a valid code from LOINC)
Observation.value[x]:valueCodeableConcept	preferred	USCoreObservationValueCodes (a valid code from SNOMED CT)
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()
ond-1	error	Observation	to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
ond-1: to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path

Conformance

ValueSet / Code

Observation.language

preferred

CommonLanguages

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

Fixed Value: cancelled

Observation.category

preferred

ObservationCategoryCodes

Observation.code

example

LOINCCodes (a valid code from LOINC)

Observation.value[x]:valueCodeableConcept

preferred

USCoreObservationValueCodes (a valid code from SNOMED CT)

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()

This structure is derived from Observation

Summary

Mandatory: 6 elements
Must-Support: 10 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions ond-1: to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided
notDoneReason	S	1..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneReason Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
status	S	1..1	code	registered \| preliminary \| final \| amended + Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation
code	S	1..1	CodeableConcept	Type of observation (code / type)
notDoneValueSet	S	0..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
subject	S	1..1	Reference(QICore Patient)	Who and/or what the observation is about
issued	S	1..1	instant	Date/Time this version was made available
performer		0..*	Reference(QICore Practitioner \| QICore Organization \| QICore Patient \| QICore RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣ	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
valueBoolean			boolean S
valueInteger			integer S
valueRange			Range S
valueRatio			Ratio S
valueSampledData			SampledData
valueTime			time S
valueDateTime			dateTime S
valuePeriod			Period S
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
derivedFrom		0..*	Reference(QICore Simple Observation \| QICore QuestionnaireResponse \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.value[x]:valueCodeableConcept	preferred	USCoreObservationValueCodes (a valid code from SNOMED CT)
Observation.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
ond-1	error	Observation	to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions ond-1: to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
notDoneReason	S	1..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneReason Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered \| preliminary \| final \| amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: cancelled
category	S	1..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
notDoneValueSet	S	0..1	canonical(ValueSet)	What was not done URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
subject	SΣ	1..1	Reference(QICore Patient)	Who and/or what the observation is about
issued	SΣ	1..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(QICore Practitioner \| QICore Organization \| QICore Patient \| QICore RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Actual result Binding: US Core Observation Value Codes (SNOMED-CT) (preferred): SNOMED CT for coded results
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
derivedFrom	Σ	0..*	Reference(QICore Simple Observation \| QICore QuestionnaireResponse \| US Core DocumentReference Profile \| ImagingStudy \| Media \| MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	Fixed Value: cancelled
Observation.category	preferred	ObservationCategoryCodes
Observation.code	example	LOINCCodes (a valid code from LOINC)
Observation.value[x]:valueCodeableConcept	preferred	USCoreObservationValueCodes (a valid code from SNOMED CT)
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()
ond-1	error	Observation	to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided : code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()

Snapshot View

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
ond-1: to indicate what observation was not recorded, either at least one coding in the code or a notDoneValueSet extension shall be provided

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path

Conformance

ValueSet / Code

Observation.language

preferred

CommonLanguages

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

Fixed Value: cancelled

Observation.category

preferred

ObservationCategoryCodes

Observation.code

example

LOINCCodes (a valid code from LOINC)

Observation.value[x]:valueCodeableConcept

preferred

USCoreObservationValueCodes (a valid code from SNOMED CT)

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()

This structure is derived from Observation

Summary

Mandatory: 6 elements
Must-Support: 10 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

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

Other representations of profile: CSV, Excel, Schematron

IG © 2019+ http://www.hl7.org/Special/committees/cqi/index.cfm. Package hl7.fhir.us.qicore#6.0.0-ballot based on FHIR 4.0.1. Generated 2023-08-03
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