QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.0.0. 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: 7.0.0-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.

QI Elements:
  • notDoneReason: (QI) Extension
  • status: (QI) registered | preliminary | final | amended +
  • category: (QI) Classification of type of observation
  • code: (QI) Type of observation (code / type)
  • notDoneValueSet: (QI) What was not done
  • subject: (QI) Who and/or what the observation is about
  • effective[x]: (QI) Clinically relevant time/time-period for observation
  • issued: (QI) Date/Time this version was made available
  • value[x]: (QI) Actual result
  • value[x]: (QI) Actual result
  • interpretation: (QI) High, low, normal, etc.
Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

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

For a more complete discussion of representation of negation within QI-Core 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.

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... Slices for extension Content/Rules for all slices
.... event-statusReason 1..1 CodeableConcept (QI) Event Status Reason
URL: http://hl7.org/fhir/StructureDefinition/event-statusReason
Binding: (unbound) (example): Codes identifying the reason for the current state of an event.

... status 1..1 code (QI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): SNOMED CT for coded results


Fixed Value: cancelled
... category 1..* CodeableConcept (QI) Classification of type of observation
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not done
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... subject 1..1 Reference(QICore Patient) (QI) Who and/or what the observation is about
... effective[x] 0..1 dateTime, Period, Timing, instant (QI) Clinically relevant time/time-period for observation
... issued 1..1 instant (QI) 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] Σ 0..1 (QI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept 0..1 CodeableConcept (QI) Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) . (preferred): SNOMED CT for coded results

... interpretation 0..* CodeableConcept (QI) 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

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet / CodeURI
Observation.extension:event-statusReason
[CanonicalType[http://hl7.org/fhir/StructureDefinition/event-statusReason]]		extensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
Observation.statusrequiredFixed Value: cancelled
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.value[x]:valueCodeableConceptpreferredUSCoreObservationValueCodes . (a valid code from SNOMED CT)
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ond-1errorObservationto 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/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
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
.... event-statusReason 1..1 CodeableConcept (QI) Event Status Reason
URL: http://hl7.org/fhir/StructureDefinition/event-statusReason
Binding: (unbound) (example): Codes identifying the reason for the current state of an event.


... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category 1..* CodeableConcept (QI) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept (QI) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not done
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... subject Σ 1..1 Reference(QICore Patient) (QI) Who and/or what the observation is about
... effective[x] Σ 0..1 (QI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant (QI) 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] ΣC 0..1 (QI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept (QI) Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) . (preferred): SNOMED CT for coded results

... interpretation 0..* CodeableConcept (QI) 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredFixed Value: cancelled
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x]:valueCodeableConceptpreferredUSCoreObservationValueCodes . (a valid code from SNOMED CT)
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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-1errorObservationto 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/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
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
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... event-statusReason 1..1 CodeableConcept (QI) Event Status Reason
URL: http://hl7.org/fhir/StructureDefinition/event-statusReason
Binding: (unbound) (example): Codes identifying the reason for the current state of an event.


... 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 ?!Σ 1..1 code (QI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): SNOMED CT for coded results


Fixed Value: cancelled
... category 1..* CodeableConcept (QI) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept (QI) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not done
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(QICore Patient) (QI) Who and/or what the observation is about
... focus Σ 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] Σ 0..1 (QI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant (QI) 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] ΣC 0..1 (QI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept (QI) Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) . (preferred): SNOMED CT for coded results

... 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 (QI) High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(QICore Simple Observation | QICore QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.statusrequiredFixed Value: cancelled
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x]:valueCodeableConceptpreferredUSCoreObservationValueCodes . (a valid code from SNOMED CT)
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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-1errorObservationto 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/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... Slices for extension Content/Rules for all slices
.... event-statusReason 1..1 CodeableConcept (QI) Event Status Reason
URL: http://hl7.org/fhir/StructureDefinition/event-statusReason
Binding: (unbound) (example): Codes identifying the reason for the current state of an event.

... status 1..1 code (QI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): SNOMED CT for coded results


Fixed Value: cancelled
... category 1..* CodeableConcept (QI) Classification of type of observation
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not done
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... subject 1..1 Reference(QICore Patient) (QI) Who and/or what the observation is about
... effective[x] 0..1 dateTime, Period, Timing, instant (QI) Clinically relevant time/time-period for observation
... issued 1..1 instant (QI) 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] Σ 0..1 (QI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept 0..1 CodeableConcept (QI) Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) . (preferred): SNOMED CT for coded results

... interpretation 0..* CodeableConcept (QI) 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

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet / CodeURI
Observation.extension:event-statusReason
[CanonicalType[http://hl7.org/fhir/StructureDefinition/event-statusReason]]		extensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
Observation.statusrequiredFixed Value: cancelled
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.value[x]:valueCodeableConceptpreferredUSCoreObservationValueCodes . (a valid code from SNOMED CT)
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ond-1errorObservationto 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/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
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
.... event-statusReason 1..1 CodeableConcept (QI) Event Status Reason
URL: http://hl7.org/fhir/StructureDefinition/event-statusReason
Binding: (unbound) (example): Codes identifying the reason for the current state of an event.


... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category 1..* CodeableConcept (QI) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept (QI) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not done
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... subject Σ 1..1 Reference(QICore Patient) (QI) Who and/or what the observation is about
... effective[x] Σ 0..1 (QI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant (QI) 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] ΣC 0..1 (QI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept (QI) Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) . (preferred): SNOMED CT for coded results

... interpretation 0..* CodeableConcept (QI) 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredFixed Value: cancelled
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x]:valueCodeableConceptpreferredUSCoreObservationValueCodes . (a valid code from SNOMED CT)
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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-1errorObservationto 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/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
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
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... event-statusReason 1..1 CodeableConcept (QI) Event Status Reason
URL: http://hl7.org/fhir/StructureDefinition/event-statusReason
Binding: (unbound) (example): Codes identifying the reason for the current state of an event.


... 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 ?!Σ 1..1 code (QI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): SNOMED CT for coded results


Fixed Value: cancelled
... category 1..* CodeableConcept (QI) Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code Σ 1..1 CodeableConcept (QI) Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not done
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(QICore Patient) (QI) Who and/or what the observation is about
... focus Σ 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] Σ 0..1 (QI) Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 1..1 instant (QI) 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] ΣC 0..1 (QI) Actual result
Slice: Unordered, Open by type:$this
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... value[x]:valueCodeableConcept ΣC 0..1 CodeableConcept (QI) Actual result
Binding: US Core Observation Value Codes (SNOMED-CT) . (preferred): SNOMED CT for coded results

... 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 (QI) High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.

... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(QICore Simple Observation | QICore QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.statusrequiredFixed Value: cancelled
http://hl7.org/fhir/ValueSet/observation-status
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x]:valueCodeableConceptpreferredUSCoreObservationValueCodes . (a valid code from SNOMED CT)
http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Observation.methodexampleObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf 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-4errorObservationIf 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-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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-1errorObservationto 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/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

 

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