SDOH Clinical Care
2.3.0 - STU 2.3 United States of America flag

This page is part of the SDOH Clinical Care for Multiple Domains (v2.3.0: STU 2.3) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: SDOHCC Observation Personal Characteristic ( Abstract )

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationPersonalCharacteristic Version: 2.3.0
Standards status: Trial-use Maturity Level: 2 Computable Name: SDOHCCObservationPersonalCharacteristic

Defines constraints that represent the minimum requirement for personal characteristic observations which are observations that are usually self-attested but may be attested to on behalf of the subject and are generally only verifiable by the source of attestation (e.g., race, ethnicity, sexual orientation, gender identity and personal pronouns), but may sometimes be verifiable by someone other than the source of attestation (e.g., recorded sex). This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreSimpleObservationProfile(7.0.0) This is an abstract profile. Child profiles: SDOHCCObservationEthnicityOMB, SDOHCCObservationGenderIdentity, SDOHCCObservationPersonalPronouns, SDOHCCObservationRaceOMB, SDOHCCObservationRecordedSexGender, SDOHCCObservationSexualOrientation
Personal characteristic observation
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: 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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
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
SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both
SDOH-Obs-2: Focus is only allowed if subject is present
SDOH-Obs-3: Must have either performer or derivedFrom
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


ele-1: All FHIR elements must have a @value or children
.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


ele-1: All FHIR elements must have a @value or children
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


ele-1: All FHIR elements must have a @value or children

Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.


ele-1: All FHIR elements must have a @value or children
... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children
... focus ΣC 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
ele-1: All FHIR elements must have a @value or children
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
ele-1: All FHIR elements must have a @value or children
.... effectiveDateTime dateTime
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
ele-1: All FHIR elements must have a @value or children
... value[x] SΣC 0..1 CodeableConcept Actual result
ele-1: All FHIR elements must have a @value or children
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredSDOHCCValueSetObservationStatus
http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus
from this IG
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:us-corerequiredUSCoreSimpleObservationCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristicpreferredPattern: personal-characteristic
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
SDOH-Obs-1errorObservationEither subject or extension-Observation.subject must exist but not both
: subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2errorObservationFocus is only allowed if subject is present
: focus.exists() implies subject.exists()
SDOH-Obs-3errorObservationMust have either performer or derivedFrom
: performer.exists() or derivedFrom.exists()
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()

This structure is derived from USCoreSimpleObservationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreSimpleObservationProfile(7.0.0) This is an abstract profile. Child profiles: SDOHCCObservationEthnicityOMB, SDOHCCObservationGenderIdentity, SDOHCCObservationPersonalPronouns, SDOHCCObservationRaceOMB, SDOHCCObservationRecordedSexGender, SDOHCCObservationSexualOrientation
Personal characteristic observation
SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both
SDOH-Obs-2: Focus is only allowed if subject is present
SDOH-Obs-3: Must have either performer or derivedFrom
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... status 1..1 code final | corrected | entered-in-error | unknown
Binding: SDOHCC ValueSet Observation Status (required)
... Slices for category Content/Rules for all slices
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
... subject C 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus C 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
... effective[x] 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer C 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] 0..1 CodeableConcept Actual result
... interpretation 0..0
... bodySite 0..0
... specimen 0..0
... referenceRange 0..0
... derivedFrom SC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.statusrequiredSDOHCCValueSetObservationStatus
http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus
from this IG
Observation.codepreferredLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
SDOH-Obs-1errorObservationEither subject or extension-Observation.subject must exist but not both
: subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2errorObservationFocus is only allowed if subject is present
: focus.exists() implies subject.exists()
SDOH-Obs-3errorObservationMust have either performer or derivedFrom
: performer.exists() or derivedFrom.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreSimpleObservationProfile(7.0.0) This is an abstract profile. Child profiles: SDOHCCObservationEthnicityOMB, SDOHCCObservationGenderIdentity, SDOHCCObservationPersonalPronouns, SDOHCCObservationRaceOMB, SDOHCCObservationRecordedSexGender, SDOHCCObservationSexualOrientation
Personal characteristic observation
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
SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both
SDOH-Obs-2: Focus is only allowed if subject is present
SDOH-Obs-3: Must have either performer or derivedFrom
... 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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... 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 final | corrected | entered-in-error | unknown
Binding: SDOHCC ValueSet Observation Status (required)
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.

... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus ΣC 0..1 Reference(RelatedPerson) 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] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] SΣC 0..1 CodeableConcept S Actual result
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... note 0..* Annotation Comments about the observation
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.

... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource 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
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredSDOHCCValueSetObservationStatus
http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus
from this IG
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:us-corerequiredUSCoreSimpleObservationCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristicpreferredPattern: personal-characteristic
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
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
SDOH-Obs-1errorObservationEither subject or extension-Observation.subject must exist but not both
: subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2errorObservationFocus is only allowed if subject is present
: focus.exists() implies subject.exists()
SDOH-Obs-3errorObservationMust have either performer or derivedFrom
: performer.exists() or derivedFrom.exists()
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()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreSimpleObservationProfile(7.0.0) This is an abstract profile. Child profiles: SDOHCCObservationEthnicityOMB, SDOHCCObservationGenderIdentity, SDOHCCObservationPersonalPronouns, SDOHCCObservationRaceOMB, SDOHCCObservationRecordedSexGender, SDOHCCObservationSexualOrientation
Personal characteristic observation
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: 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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
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
SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both
SDOH-Obs-2: Focus is only allowed if subject is present
SDOH-Obs-3: Must have either performer or derivedFrom
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


ele-1: All FHIR elements must have a @value or children
.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


ele-1: All FHIR elements must have a @value or children
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


ele-1: All FHIR elements must have a @value or children

Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.


ele-1: All FHIR elements must have a @value or children
... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children
... focus ΣC 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
ele-1: All FHIR elements must have a @value or children
... effective[x] SΣ 0..1 Clinically relevant time/time-period for observation
ele-1: All FHIR elements must have a @value or children
.... effectiveDateTime dateTime
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
ele-1: All FHIR elements must have a @value or children
... value[x] SΣC 0..1 CodeableConcept Actual result
ele-1: All FHIR elements must have a @value or children
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredSDOHCCValueSetObservationStatus
http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus
from this IG
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:us-corerequiredUSCoreSimpleObservationCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristicpreferredPattern: personal-characteristic
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
SDOH-Obs-1errorObservationEither subject or extension-Observation.subject must exist but not both
: subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2errorObservationFocus is only allowed if subject is present
: focus.exists() implies subject.exists()
SDOH-Obs-3errorObservationMust have either performer or derivedFrom
: performer.exists() or derivedFrom.exists()
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()

Differential View

This structure is derived from USCoreSimpleObservationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreSimpleObservationProfile(7.0.0) This is an abstract profile. Child profiles: SDOHCCObservationEthnicityOMB, SDOHCCObservationGenderIdentity, SDOHCCObservationPersonalPronouns, SDOHCCObservationRaceOMB, SDOHCCObservationRecordedSexGender, SDOHCCObservationSexualOrientation
Personal characteristic observation
SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both
SDOH-Obs-2: Focus is only allowed if subject is present
SDOH-Obs-3: Must have either performer or derivedFrom
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... status 1..1 code final | corrected | entered-in-error | unknown
Binding: SDOHCC ValueSet Observation Status (required)
... Slices for category Content/Rules for all slices
.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
... subject C 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus C 0..1 Reference(RelatedPerson) What the observation is about, when it is not about the subject of record
... effective[x] 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer C 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] 0..1 CodeableConcept Actual result
... interpretation 0..0
... bodySite 0..0
... specimen 0..0
... referenceRange 0..0
... derivedFrom SC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource the observation is made from

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.statusrequiredSDOHCCValueSetObservationStatus
http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus
from this IG
Observation.codepreferredLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
SDOH-Obs-1errorObservationEither subject or extension-Observation.subject must exist but not both
: subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2errorObservationFocus is only allowed if subject is present
: focus.exists() implies subject.exists()
SDOH-Obs-3errorObservationMust have either performer or derivedFrom
: performer.exists() or derivedFrom.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* USCoreSimpleObservationProfile(7.0.0) This is an abstract profile. Child profiles: SDOHCCObservationEthnicityOMB, SDOHCCObservationGenderIdentity, SDOHCCObservationPersonalPronouns, SDOHCCObservationRaceOMB, SDOHCCObservationRecordedSexGender, SDOHCCObservationSexualOrientation
Personal characteristic observation
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
SDOH-Obs-1: Either subject or extension-Observation.subject must exist but not both
SDOH-Obs-2: Focus is only allowed if subject is present
SDOH-Obs-3: Must have either performer or derivedFrom
... 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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:OtherSubject SC 0..1 (Complex) Optional Extensions Element
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject"
..... value[x] 1..1 Reference(US Core Practitioner Profile(7.0.0)) Value of extension
... 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 final | corrected | entered-in-error | unknown
Binding: SDOHCC ValueSet Observation Status (required)
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


.... category:us-core S 0..* CodeableConcept Classification of type of observation
Binding: USCoreSimpleObservationCategory (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


.... category:PersonalCharacteristic S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: personal-characteristic
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (preferred): Codes identifying names of simple observations.

... subject SΣC 1..1 Reference(US Core Patient Profile(7.0.0)) Who and/or what the observation is about
... focus ΣC 0..1 Reference(RelatedPerson) 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] SΣ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime S
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer SΣC 0..* Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | PractitionerRole | US Core CareTeam Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) Who is responsible for the observation
... value[x] SΣC 0..1 CodeableConcept S Actual result
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... note 0..* Annotation Comments about the observation
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.

... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom SΣC 0..* Reference(US Core DocumentReference Profile(7.0.0) | US Core QuestionnaireResponse Profile(7.0.0) | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profiles or other resource 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
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredSDOHCCValueSetObservationStatus
http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetObservationStatus
from this IG
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:us-corerequiredUSCoreSimpleObservationCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category|7.0.0
Observation.category:PersonalCharacteristicpreferredPattern: personal-characteristic
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
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
SDOH-Obs-1errorObservationEither subject or extension-Observation.subject must exist but not both
: subject.exists() xor extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.subject').exists()
SDOH-Obs-2errorObservationFocus is only allowed if subject is present
: focus.exists() implies subject.exists()
SDOH-Obs-3errorObservationMust have either performer or derivedFrom
: performer.exists() or derivedFrom.exists()
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()

 

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