Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment vs http://hl7.org/fhir/us/vitals/StructureDefinition/twenty-four-hour-blood-pressure

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey	http://hl7.org/fhir/StructureDefinition/vitalsigns	Values Differ
copyright	Used by permission of HL7 International, all rights reserved Creative Commons License	Logica Health, all rights reserved Creative Commons License	Values Differ
date	2022-03-18	2022-09-12T00:45:08+00:00	Values Differ
description	The US Core Observation SDOH Assessment Profile meets the U.S. Core Data for Interoperability (USCDI) v2 'SDOH Assessments' requirements. This profile is based on the US Core Observation Survey Profile and sets minimum expectations for representing responses to assessment tools such as the *Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) Survey*. It can be used to represent individual responses, panels of multi-question surveys, and multi-select responses to “check all that apply” questions. It identifies the *additional* core elements, extensions, vocabularies and value sets which SHALL be present in the Observation resource when using this profile. It provides the floor for standards development for specific uses cases.	An average blood pressure (systolic and diastolic) over a twenty four hour period.	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreObservationSDOHAssessment	TwentyFourHourBloodPressure	Values Differ
publisher	HL7 International - Cross-Group Projects	HL7 International - Clinical Information Modeling Initiative	Values Differ
purpose
status	active
title	US Core Observation SDOH Assessment Profile	Twenty Four Hour Blood Pressure	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment	http://hl7.org/fhir/us/vitals/StructureDefinition/twenty-four-hour-blood-pressure	Values Differ
version	5.0.1	1.0.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
Observation	C	0..*	USCoreObservationSurveyProfile	SDOH Assessment Panel Observation	C	0..*	observation-vitalsigns	FHIR Vital Signs Profile	Elements differ in short: 'SDOH Assessment Panel Observation' vs 'FHIR Vital Signs Profile' Elements differ in definition: '\-' vs 'The FHIR Vitals Signs profile sets minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient.' Elements differ in comments: '\-' vs '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.'
id	Σ	0..1	string	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Extension Slice: Unordered, Open by value:url	Elements differ in short: 'Additional content defined by implementations' vs 'Extension' Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order	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	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (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.	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:coding.code, value:coding.system Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.	Elements differ in requirements: 'To identify that observation is derived from a questionnaire.' vs 'Used for filtering what observations are retrieved and displayed.'
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: US Core Common SDOH Assessments (preferred)	SΣ	1..1	CodeableConcept	Blood pressure panel 24 hour mean Binding: VitalSigns (extensible): This identifies the vital sign result type. Required Pattern: {"coding":[{"system":"http://loinc.org","code":"97844-5"}]}	Elements differ in short: 'Type of observation (code / type)' vs 'Blood pressure panel 24 hour mean' Elements differ in definition: 'Describes what was observed. Sometimes this is called the observation "name".' vs 'Coded Responses from C-CDA Vital Sign Results.' Elements differ in requirements: 'Knowing what kind of observation is being made is essential to understanding the observation.' vs '5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).'
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	SΣ	1..1	Reference(US Core Patient Profile)	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	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	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	0..1	dateTime S, Period, Timing, instant	Clinically relevant time/time-period for observation	SΣC	1..1	Period	The dates and times over which the 24 hour period falls.	Elements differ in short: 'Clinically relevant time/time-period for observation' vs 'The dates and times over which the 24 hour period falls.' 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".' vs 'Often just a dateTime for Vital Signs.' Elements differ in comments: 'At least a date should be present unless this observation is a historical report.' vs '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.' Element minimum cardinalities differ: '0' vs '1'
issued	Σ	0..1	instant	Date/Time this version was made available	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Who is responsible for the observation	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation	Elements differ in definition for mustSupport: 'true' vs 'false'
value[x]	SΣC	0..1	Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result	SΣC	0..0			Elements differ in short: 'Actual result' vs 'Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.' Elements differ in definition: 'The information determined as a result of making the observation, if the information has a simple value.' vs 'Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.' Elements differ in comments: 'An observation may have a value if it represents an individual survey question and answer pair. An observation should not have a value if it represents a multi-question survey or multi-select “check all that apply” question. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.' vs 'An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section] below.' Elements differ in requirements: 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.' vs '9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).' Element maximum cardinalities differ: '1' vs '0'
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	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. 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.' vs '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.'
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.	S	0..1	CodeableConcept	Observed body part Binding: Blood Pressure Measurement Body Location Precoordinated value set (extensible): A set of codes that describe where on/in the body an observation or procedure took place	Elements differ in definition for mustSupport: 'false' vs 'true' Elements differ in binding.description: 'Codes describing anatomical locations. May include laterality.' vs 'A set of codes that describe where on/in the body an observation or procedure took place'
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.	S	0..1	CodeableConcept	How it was done Binding: Blood Pressure Measurement Method value set (extensible): A set of codes that describe the method used to measure a blood pressure	Elements differ in definition for mustSupport: 'false' vs 'true' Elements differ in binding.description: 'Methods for simple observations.' vs 'A set of codes that describe the method used to measure a blood pressure'
specimen		0..1	Reference(Specimen)	Specimen used for this observation		0..0			Element maximum cardinalities differ: '1' vs '0'
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device	S	0..1	Reference(Blood Pressure Device)	Blood Pressure Device	Elements differ in short: '(Measurement) Device' vs 'Blood Pressure Device' Elements differ in definition for mustSupport: 'false' vs 'true'
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant	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.		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.		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		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation		0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(US Core Observation SDOH Assessment Profile S)	Individual Observations that belong to an SDOH multi-question sruvey or multi-select question.	Σ	0..*	Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Used when reporting vital signs panel components	Elements differ in short: 'Individual Observations that belong to an SDOH multi-question sruvey or multi-select question.' vs 'Used when reporting vital signs panel components' Elements differ in definition: 'Aggregate set of Observations that represent question answer pairs for both multi-question surveys and multi-select questions.' vs 'Used when reporting vital signs panel components.' Elements differ in comments: 'This grouping element is used to represent surveys that group several questions together or individual questions with “check all that apply” responses. For example in the simplest case a flat multi-question survey where the "panel" observation is the survey instrument itself and instead of an `Observation.value` the `hasMember` element references other Observation that represent the individual questions answer pairs. In a survey that has a heirarchical grouping of questions, the observation "panels" can be nested. Because surveys can be arbitrarily complex structurally, not all survey structures can be represented using this Observation grouping pattern.' vs 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes] below. Note that a system may calculate results from [QuestionnaireResponse] into a final score and represent the score as an Observation.' Elements differ in definition for mustSupport: 'true' vs 'false' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sdoh-assessment]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence], CanonicalType[http://hl7.org/fhir/StructureDefinition/vitalsigns]])
derivedFrom	SΣ	0..*	Reference(US Core Observation Survey Profile S | US Core QuestionnaireResponse Profile S | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence)	Related Observations or QuestionnaireResponses that the observation is made from	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile)	Related measurements the observation is made from	Elements differ in short: 'Related Observations or QuestionnaireResponses that the observation is made from' vs 'Related measurements the observation is made from' Elements differ in definition: 'Observations or QuestionnaireResponses from which this observation value is derived.' vs 'The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.' Elements differ in definition for mustSupport: 'true' vs 'false' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-survey], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence], CanonicalType[http://hl7.org/fhir/StructureDefinition/vitalsigns]])
component	Σ	0..*	BackboneElement	Component results	SΣC	1..*	BackboneElement	Blood pressure components Slice: Unordered, Open by pattern:code	Elements differ in short: 'Component results' vs 'Blood pressure components' 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.' vs 'Used when reporting systolic and diastolic blood pressure.' Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!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.	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: VitalSigns (extensible): This identifies the vital sign result type.	Elements differ in definition for mustSupport: 'false' vs 'true' Elements differ in binding.description: 'Codes identifying names of simple observations.' vs 'This identifies the vital sign result type.'
value[x]	Σ	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result	SΣC	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Vital Sign Value recorded with UCUM Binding: VitalSignsUnits (required): Common UCUM units for recording Vital Signs.	Elements differ in short: 'Actual component result' vs 'Vital Sign Value recorded with UCUM' Elements differ in definition: 'The information determined as a result of making the observation, if the information has a simple value.' vs 'Vital Sign Value recorded with UCUM.' Elements differ in requirements: 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.' vs '9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).' Elements differ in definition for mustSupport: 'false' vs 'true'
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	Elements differ in definition for mustSupport: 'false' vs 'true'
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.		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		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
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