| Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus' vs 'http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse' |
| Error | StructureDefinition.version | Values for version differ: '4.0.0' vs '1.0.0' |
| Information | StructureDefinition.name | Values for name differ: 'USCoreSmokingStatusProfile' vs 'SDOHCCObservationScreeningResponse' |
| Information | StructureDefinition.title | Values for title differ: 'US Core Smoking Status Observation Profile' vs 'SDOHCC Observation Screening Response' |
| Information | StructureDefinition.status | Values for status differ: 'active' vs 'draft' |
| Information | StructureDefinition.date | Values for date differ: '2019-05-21T00:00:00+00:00' vs '2021-08-05T20:07:39+00:00' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - US Realm Steering Committee' vs 'HL7 International - Patient Care WG' |
| Warning | Observation | Elements differ in short:
'Measurements and simple assertions'
'SDOH screening questionnaire observations' |
| Warning | Observation | Elements differ in definition:
'The US Core Smoking Status Observation Profile is based upon the core FHIR Observation Resource and created to meet the USCDI Data Set 'Smoking status' requirements.'
'For Observations derived from SDOH screening surveys/questionnaires.' |
| Warning | Observation | Elements differ in comments:
'Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.'
'Used for simple observations such as education status, food insecurity observations, etc.
This profile allows the representation of SDOH observations based on SDOH screening questionnaire responses (which can also be represented using SDC QuestionnaireResponse).
Many of the SDOHCC profiles reference one another. One flow supported by this IG is that QuestionnaireResponses result in Observations that can be used as evidence for Conditions that can lead to Goals, ServiceRequests and Procedures. However, alternatives paths are also possible.' |
| Warning | Observation.status | Elements differ in short:
'registered | preliminary | final | amended +'
'final | corrected | entered-in-error | unknown' |
| Warning | Observation.status | Elements differ in definition:
'The status of the result value.'
'The status of the observation value.' |
| Warning | Observation.status | Elements differ in requirements:
'Need to track the status of individual results. Some results are finalized before the whole report is finalized.'
'Further constrained to values that are relevant for SDOH.' |
| Warning | Observation.category | Elements differ in requirements:
'Used for filtering what observations are retrieved and displayed.'
'To identify that an SDOH screening response observation is derived from an SDOH questionnaire, the “social-history” and “survey” codes are required.' |
| Error | Observation.category | Elements differ in definition for mustSupport:
'true'
'false' |
| Warning | Observation.code | Elements differ in short:
'Smoking Status'
'Type of observation (code / type)' |
| Warning | Observation.code | Elements differ in comments:
'*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
'*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
For SDOH questions represented in LOINC that specify “check all that apply”, the LOINC question should be used for Observation.code and for Observation.component.code. For “check all that apply” questions, the answers (regardless of whether one or more are selected) should only be represented using Observation.component.value and Observation.value should be empty.
As the Gravity Project continues to refine content for the SDOH categories (e.g., food, housing, transportation, etc.), this value set will be refined to codes that pertain to SDOH categories.' |
| Warning | Observation.code | Elements differ in requirements:
'Knowing what kind of observation is being made is essential to understanding the observation.'
'Knowing what kind of observation is being made is essential to understanding the observation.
The Gravity implemenation guide restricts questionnaire/survey observations to LOINC to move the industry to the use of LOINC panels/surveys (structures that are not available in other terminology systems) to standardize the coding of SDOH related risk assessment instruments. In addition, USCDI and US Core have standardized on the use of LOINC to represent Observations in general.' |
| Warning | Observation.subject | Elements differ in comments:
'One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.'
'Cardinality is 1..1.' |
| Warning | Observation.effective[x] | Elements differ in definition:
'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'. This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.'
'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'.' |
| Warning | Observation.effective[x] | Elements differ in comments:
'At least a date should be present unless this observation is a historical report. For recording imprecise or 'fuzzy' times (For example, a blood glucose measurement taken 'after breakfast') use the [Timing] datatype which allow the measurement to be tied to regular life events.'
'At least a date should be present unless this observation is a historical report.' |
| Error | Observation.effective[x] | Elements differ in definition for mustSupport:
'false'
'true' |
| Warning | Observation.performer | Elements differ in requirements:
'May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.'
'Some questions on an SDOH screening questionnaire are not answered directly (e.g., asserted) by the individual completing the questionnaire. Rather, the answer to some questions (e.g., the Hunger Vital Sign 88124-3 “Food insecurity risk”) may be derived from answers to one or more other questions. For a Screening Response Observation that is derived, as opposed to answered directly, Observation.performer should not be specified and Observation.derivedFrom should reference the relevant Screening Response Observation(s).' |
| Error | Observation.performer | Elements differ in definition for mustSupport:
'false'
'true' |
| Error | Observation.performer | Type Mismatch:
Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Practitioner], CanonicalType[http://hl7.org/fhir/StructureDefinition/PractitionerRole], CanonicalType[http://hl7.org/fhir/StructureDefinition/Organization], CanonicalType[http://hl7.org/fhir/StructureDefinition/CareTeam], CanonicalType[http://hl7.org/fhir/StructureDefinition/Patient], CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson]])
Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam]]) |
| Error | Observation.value[x] | Elements differ in definition for mustSupport:
'false'
'true' |
| Warning | Observation.dataAbsentReason | Elements differ in comments:
'Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be 'detected', 'not detected', 'inconclusive', or 'specimen unsatisfactory'.
The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code 'error' could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.'
''Null' or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.value. Where these concepts are not part of the value set for Observation.value, the Observation.dataAbsentReason can be used if necessary and appropriate.' |
| Error | Observation.dataAbsentReason | Elements differ in definition for mustSupport:
'false'
'true' |
| Warning | Observation.hasMember | Elements differ in definition:
'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.'
'Used when an observation is a group observation (e.g., the LOINC 88121-9 Hunger Vital Sign [HVS] panel) that includes the target as a member of the group.' |
| Error | Observation.derivedFrom | Elements differ in definition for mustSupport:
'false'
'true' |
| Warning | Observation.component | Elements differ in definition:
'Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.'
'Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples:
1) Individuals may be multiracial. Component is used to capture one or more races.
2) “Material hardship” can be assessed based on a number of factors (adequate food, clothing, utilities, etc.). One, or all, of which can be captured using Component.' |
| Warning | Observation.component | Elements differ in comments:
'For a discussion on the ways Observations can be assembled in groups together see [Notes] below.'
'For a discussion on the ways Observations can be assembled in groups together see [Notes] below.
For SDOH questions represented in LOINC that specify “check all that apply”, the LOINC question should be used for Observation.code and for Observation.component.code. For “check all that apply” questions, the answers (regardless of whether one or more are selected) should only be represented using Observation.component.value and Observation.value should be empty.' |
| Warning | Observation.component.code | Elements differ in comments:
'*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
'*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
As the Gravity Project continues to refine content for the SDOH categories (e.g., food, housing, transportation, etc.), this value set will be refined to codes that pertain to SDOH categories.' |
| Warning | Observation.component.code | Elements differ in requirements:
'Knowing what kind of observation is being made is essential to understanding the observation.'
'Knowing what kind of observation is being made is essential to understanding the observation.
LOINC codes are required because Gravity intends to use only LOINC encoded Questionnaires to generate QuestionnaireResponses which, in turn, will generate Screening Response Observations.' |
| Error | Observation.component.code | Elements differ in definition for mustSupport:
'false'
'true' |
| Error | Observation.component.value[x] | Elements differ in definition for mustSupport:
'false'
'true' |
| Warning | Observation.component.dataAbsentReason | Elements differ in comments:
''Null' or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be 'detected', 'not detected', 'inconclusive', or 'test not done'.
The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code 'error' could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.'
''Null' or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given 'check all that apply' LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.component.value. Where these concepts are not part of the value set for Observation.component.value, the Observation.component.dataAbsentReason can be used if necessary and appropriate.' |
| Error | Observation.component.dataAbsentReason | Elements differ in definition for mustSupport:
'false'
'true' |
abstract
jurisdiction[0]
Observation 
extension 
modifierExtension 
referenceRange