Personal Health Device Implementation Guide
2.0.0-ballot - STU2 Ballot International flag

This page is part of the Personal Health Device FHIR IG (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) v4.3.0. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PhdBitsEnumerationObservation

Official URL: http://hl7.org/fhir/uv/phd/StructureDefinition/PhdBitsEnumerationObservation Version: 2.0.0-ballot
Draft as of 2017-06-02 Computable Name: PhdBitsEnumerationObservation

StructureDefinition for Observation Resources representing measurement data coming from a medical device where the measurement is an ASN1 BITS value.

The BITs Enumeration Observation Profile is used when the PHD Observation reports a bitstring where each bit represents an event or a state. PHDs typically send this kind of observation when more than one event or state can occur simultaneously. If the event or states are mutually exclusive, a Coded Enumeration Observation Profile is typically used instead.

Each bit in the bitstring may represent some state or event. The most common use of this type of observation is for reporting device status events that influence the observation. It is also used extensively in the Independent Living specialization to report states such as 'door open', 'door closed' or 'patient in room', 'patient out of room', etc. This type observation is generally used when there is the potential for more than one event or state to be set at the same time.

In IEEE 11073-10206 the information model only supports states as bitstrings. In the Generic Health Sensor Service Specification both states and events can be modelled using bitstrings.

Usage:

Formal Views of Profile Content

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

This structure is derived from PhdBaseObservation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* PhdBaseObservation Measurements and simple assertions
... Slices for value[x] 0..0
.... value[x]:valueCodeableConcept 0..0
... dataAbsentReason 0..1 CodeableConcept Why the result is missing
.... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:FhirDefault 1..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
...... code 1..1 code Symbol in syntax defined by the system
... Slices for component Content/Rules for all slices
.... component:bitsComponent 0..* BackboneElement BITs measurements entry components
..... code 1..1 CodeableConcept Type of component observation (code / type)
Binding: ANS1ToHL7 codes defined for measurement attributes (required)
...... coding 1..* Coding The ANS1 BITs code for the measurement
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7
....... code 1..1 code Symbol in syntax defined by the system
..... value[x] 0..1 CodeableConcept Actual component result
..... dataAbsentReason 0..1 CodeableConcept For the optional reporting of unsupported bits
...... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:FhirDefault 1..1 Coding FHIR default code system for reporting 'unsupported'
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: unsupported

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.component:bitsComponent.coderequiredASN1measurement
http://hl7.org/fhir/uv/phd/ValueSet/ASN1measurement
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* PhdBaseObservation 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
... meta Σ 1..1 Meta Metadata about the resource
.... Slices for security Σ 0..* Coding Security Labels applied to this resource
Slice: Unordered, Open by value:system, value:code
Binding: All Security Labels (extensible)
..... security:PhdHtest Σ 0..1 Coding Security value set to HTEST when measurement status indicates demo or test data
Binding: All Security Labels (extensible)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActReason
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: HTEST
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... GatewayDevice 0..1 Reference(Device) Gateway Device
URL: http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice
... Slices for identifier Σ 0..* Identifier Business Identifier for observation
Slice: Unordered, Open by exists:value, exists:system, exists:type
.... identifier:conditionalCreate Σ 0..1 Identifier Unique identifier of this measurement for a given patient and device
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... value Σ 1..1 string The value that is unique
Example General: 123456
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... Slices for category 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.


.... category:PHD-Observation 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... coding Σ 1..* Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: phd-observation
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:MDCType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
...... code Σ 1..1 code Symbol in syntax defined by the system
..... coding:LoincCoding Σ 0..1 Coding The LOINC code for the measurement
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
... subject Σ 1..1 Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance) Who and/or what the observation is about
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
... effective[x] Σ 1..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:FhirDefault Σ 1..1 Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
...... code Σ 1..1 code Symbol in syntax defined by the system
... device 1..1 Reference(Device | DeviceMetric) (Measurement) Device
.... reference ΣC 1..1 string Reference to the device responsible for the measurement
... Slices for component Σ 0..* BackboneElement Component results
Slice: Unordered, Open by value:code
.... component:All Slices Content/Rules for all slices
..... 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.

.... component:supplementalTypesComponent Σ 0..* BackboneElement Supplemental Type: A further description of the measurement type.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: CodeableConcept 11073 Attributes (required)
...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:MdcType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 68193
..... Slices for value[x] Σ 1..1 CodeableConcept Actual component result
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
....... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
........ coding:MDCType Σ 1..1 Coding Required MDC code entry.
......... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
......... code Σ 1..1 code Symbol in syntax defined by the system
.... component:bitsComponent Σ 0..* BackboneElement BITs measurements entry components
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: ANS1ToHL7 codes defined for measurement attributes (required)
...... coding Σ 1..* Coding The ANS1 BITs code for the measurement
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7
....... code Σ 1..1 code Symbol in syntax defined by the system
..... value[x] Σ 0..1 CodeableConcept Actual component result
..... dataAbsentReason C 0..1 CodeableConcept For the optional reporting of unsupported bits
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:FhirDefault Σ 1..1 Coding FHIR default code system for reporting 'unsupported'
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: unsupported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.security:PhdHtestextensibleFixed Value: HTEST
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.identifier:conditionalCreate.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.3.0
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.3.0
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:PHD-ObservationpreferredObservationCategoryCodes
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.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
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:supplementalTypesComponent.coderequiredCodeableConcept11073MDC
http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC
from this IG
Observation.component:bitsComponent.coderequiredASN1measurement
http://hl7.org/fhir/uv/phd/ValueSet/ASN1measurement
from this IG
Observation.component:bitsComponent.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
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.exists() and ('#'+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(uri) = '#').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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* PhdBaseObservation 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
... id Σ 0..1 id Logical id of this artifact
... meta Σ 1..1 Meta Metadata about the resource
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... Slices for security Σ 0..* Coding Security Labels applied to this resource
Slice: Unordered, Open by value:system, value:code
Binding: All Security Labels (extensible)
..... security:PhdHtest Σ 0..1 Coding Security value set to HTEST when measurement status indicates demo or test data
Binding: All Security Labels (extensible)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActReason
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: HTEST
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example)
... 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): IETF language tag

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... GatewayDevice 0..1 Reference(Device) Gateway Device
URL: http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business Identifier for observation
Slice: Unordered, Open by exists:value, exists:system, exists:type
.... identifier:conditionalCreate Σ 0..1 Identifier Unique identifier of this measurement for a given patient and device
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... 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 registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... Slices for category 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.


.... category:PHD-Observation 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 1..* Coding Code defined by a terminology system
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: phd-observation
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:MDCType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:LoincCoding Σ 0..1 Coding The LOINC code for the measurement
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string It is recommended to display at least the reference identifier for the MDC code
... subject Σ 1..1 Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance) Who and/or what the observation is about
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... 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 1..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:FhirDefault Σ 1..1 Coding Code defined by a terminology system
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:MsmtStatusInterpretation Σ 1..1 Coding Measurement status interpretation when questionable, calibration-ongoing, validated, early-indication, threshold exceeded, alarm inhibited
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/pocd/CodeSystem/measurement-status
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts

... 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 1..1 Reference(Device | DeviceMetric) (Measurement) Device
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to the device responsible for the measurement
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... 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(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Reference to the Coincident Time Stamp Observation and/or Source-Handle-Reference Observation
... Slices for component Σ 0..* BackboneElement Component results
Slice: Unordered, Open by value:code
.... component:All Slices Content/Rules for all slices
..... 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
.... component:supplementalTypesComponent Σ 0..* BackboneElement Supplemental Type: A further description of the measurement type.
..... 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: CodeableConcept 11073 Attributes (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:MdcType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
........ id 0..1 id Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 68193
........ display Σ 0..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... Slices for value[x] Σ 1..1 CodeableConcept Actual component result
Slice: Unordered, Closed by type:$this
..... Slices for value[x] Content/Rules for all slices
...... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
........ coding:MDCType Σ 1..1 Coding Required MDC code entry.
......... id 0..1 id Unique id for inter-element referencing
......... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
......... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
......... version Σ 0..1 string Version of the system - if relevant
......... code Σ 1..1 code Symbol in syntax defined by the system
......... display Σ 0..1 string Representation defined by the system
......... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
..... 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
.... component:bitsComponent Σ 0..* BackboneElement BITs measurements entry components
..... 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: ANS1ToHL7 codes defined for measurement attributes (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..* Coding The ANS1 BITs code for the measurement
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... value[x] Σ 0..1 CodeableConcept Actual component result
..... dataAbsentReason C 0..1 CodeableConcept For the optional reporting of unsupported bits
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:FhirDefault Σ 1..1 Coding FHIR default code system for reporting 'unsupported'
........ id 0..1 id Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: unsupported
........ display Σ 0..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... 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

PathConformanceValueSetURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.security:PhdHtestextensibleFixed Value: HTEST
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.identifier:conditionalCreate.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.3.0
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.3.0
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:PHD-ObservationpreferredObservationCategoryCodes
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.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
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.device.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
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
Observation.component:supplementalTypesComponent.coderequiredCodeableConcept11073MDC
http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC
from this IG
Observation.component:supplementalTypesComponent.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:bitsComponent.coderequiredASN1measurement
http://hl7.org/fhir/uv/phd/ValueSet/ASN1measurement
from this IG
Observation.component:bitsComponent.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:bitsComponent.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.exists() and ('#'+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(uri) = '#').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()
dom-r4bwarningObservation.containedContaining new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()

This structure is derived from PhdBaseObservation

Summary

Mandatory: 0 element(15 nested mandatory elements)
Fixed: 5 elements
Prohibited: 2 elements

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.value[x]
  • The element 1 is sliced based on the value of Observation.value[x].coding (ordered)
  • The element 1 is sliced based on the value of Observation.dataAbsentReason.coding
  • The element 1 is sliced based on the value of Observation.component.dataAbsentReason.coding

Differential View

This structure is derived from PhdBaseObservation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* PhdBaseObservation Measurements and simple assertions
... Slices for value[x] 0..0
.... value[x]:valueCodeableConcept 0..0
... dataAbsentReason 0..1 CodeableConcept Why the result is missing
.... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:FhirDefault 1..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
...... code 1..1 code Symbol in syntax defined by the system
... Slices for component Content/Rules for all slices
.... component:bitsComponent 0..* BackboneElement BITs measurements entry components
..... code 1..1 CodeableConcept Type of component observation (code / type)
Binding: ANS1ToHL7 codes defined for measurement attributes (required)
...... coding 1..* Coding The ANS1 BITs code for the measurement
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7
....... code 1..1 code Symbol in syntax defined by the system
..... value[x] 0..1 CodeableConcept Actual component result
..... dataAbsentReason 0..1 CodeableConcept For the optional reporting of unsupported bits
...... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:FhirDefault 1..1 Coding FHIR default code system for reporting 'unsupported'
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: unsupported

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.component:bitsComponent.coderequiredASN1measurement
http://hl7.org/fhir/uv/phd/ValueSet/ASN1measurement
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* PhdBaseObservation 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
... meta Σ 1..1 Meta Metadata about the resource
.... Slices for security Σ 0..* Coding Security Labels applied to this resource
Slice: Unordered, Open by value:system, value:code
Binding: All Security Labels (extensible)
..... security:PhdHtest Σ 0..1 Coding Security value set to HTEST when measurement status indicates demo or test data
Binding: All Security Labels (extensible)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActReason
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: HTEST
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... GatewayDevice 0..1 Reference(Device) Gateway Device
URL: http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice
... Slices for identifier Σ 0..* Identifier Business Identifier for observation
Slice: Unordered, Open by exists:value, exists:system, exists:type
.... identifier:conditionalCreate Σ 0..1 Identifier Unique identifier of this measurement for a given patient and device
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... value Σ 1..1 string The value that is unique
Example General: 123456
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... Slices for category 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.


.... category:PHD-Observation 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... coding Σ 1..* Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: phd-observation
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:MDCType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
...... code Σ 1..1 code Symbol in syntax defined by the system
..... coding:LoincCoding Σ 0..1 Coding The LOINC code for the measurement
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
... subject Σ 1..1 Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance) Who and/or what the observation is about
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
... effective[x] Σ 1..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:FhirDefault Σ 1..1 Coding Code defined by a terminology system
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
...... code Σ 1..1 code Symbol in syntax defined by the system
... device 1..1 Reference(Device | DeviceMetric) (Measurement) Device
.... reference ΣC 1..1 string Reference to the device responsible for the measurement
... Slices for component Σ 0..* BackboneElement Component results
Slice: Unordered, Open by value:code
.... component:All Slices Content/Rules for all slices
..... 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.

.... component:supplementalTypesComponent Σ 0..* BackboneElement Supplemental Type: A further description of the measurement type.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: CodeableConcept 11073 Attributes (required)
...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:MdcType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 68193
..... Slices for value[x] Σ 1..1 CodeableConcept Actual component result
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
....... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
........ coding:MDCType Σ 1..1 Coding Required MDC code entry.
......... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
......... code Σ 1..1 code Symbol in syntax defined by the system
.... component:bitsComponent Σ 0..* BackboneElement BITs measurements entry components
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: ANS1ToHL7 codes defined for measurement attributes (required)
...... coding Σ 1..* Coding The ANS1 BITs code for the measurement
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7
....... code Σ 1..1 code Symbol in syntax defined by the system
..... value[x] Σ 0..1 CodeableConcept Actual component result
..... dataAbsentReason C 0..1 CodeableConcept For the optional reporting of unsupported bits
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:FhirDefault Σ 1..1 Coding FHIR default code system for reporting 'unsupported'
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: unsupported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.security:PhdHtestextensibleFixed Value: HTEST
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.identifier:conditionalCreate.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.3.0
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.3.0
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:PHD-ObservationpreferredObservationCategoryCodes
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.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
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:supplementalTypesComponent.coderequiredCodeableConcept11073MDC
http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC
from this IG
Observation.component:bitsComponent.coderequiredASN1measurement
http://hl7.org/fhir/uv/phd/ValueSet/ASN1measurement
from this IG
Observation.component:bitsComponent.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
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.exists() and ('#'+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(uri) = '#').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()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* PhdBaseObservation 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
... id Σ 0..1 id Logical id of this artifact
... meta Σ 1..1 Meta Metadata about the resource
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... Slices for security Σ 0..* Coding Security Labels applied to this resource
Slice: Unordered, Open by value:system, value:code
Binding: All Security Labels (extensible)
..... security:PhdHtest Σ 0..1 Coding Security value set to HTEST when measurement status indicates demo or test data
Binding: All Security Labels (extensible)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActReason
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: HTEST
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example)
... 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): IETF language tag

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... GatewayDevice 0..1 Reference(Device) Gateway Device
URL: http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business Identifier for observation
Slice: Unordered, Open by exists:value, exists:system, exists:type
.... identifier:conditionalCreate Σ 0..1 Identifier Unique identifier of this measurement for a given patient and device
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... 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 registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... Slices for category 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.


.... category:PHD-Observation 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 1..* Coding Code defined by a terminology system
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: phd-observation
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... code Σ 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:MDCType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:LoincCoding Σ 0..1 Coding The LOINC code for the measurement
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string It is recommended to display at least the reference identifier for the MDC code
... subject Σ 1..1 Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance) Who and/or what the observation is about
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... 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 1..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:FhirDefault Σ 1..1 Coding Code defined by a terminology system
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:MsmtStatusInterpretation Σ 1..1 Coding Measurement status interpretation when questionable, calibration-ongoing, validated, early-indication, threshold exceeded, alarm inhibited
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/pocd/CodeSystem/measurement-status
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts

... 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 1..1 Reference(Device | DeviceMetric) (Measurement) Device
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to the device responsible for the measurement
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... 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(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Reference to the Coincident Time Stamp Observation and/or Source-Handle-Reference Observation
... Slices for component Σ 0..* BackboneElement Component results
Slice: Unordered, Open by value:code
.... component:All Slices Content/Rules for all slices
..... 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
.... component:supplementalTypesComponent Σ 0..* BackboneElement Supplemental Type: A further description of the measurement type.
..... 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: CodeableConcept 11073 Attributes (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:MdcType Σ 1..1 Coding The 11073-10101 MDC code for the measurement
........ id 0..1 id Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 68193
........ display Σ 0..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... Slices for value[x] Σ 1..1 CodeableConcept Actual component result
Slice: Unordered, Closed by type:$this
..... Slices for value[x] Content/Rules for all slices
...... value[x]:valueCodeableConcept Σ 1..1 CodeableConcept Actual component result
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
........ coding:MDCType Σ 1..1 Coding Required MDC code entry.
......... id 0..1 id Unique id for inter-element referencing
......... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
......... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:iso:std:iso:11073:10101
......... version Σ 0..1 string Version of the system - if relevant
......... code Σ 1..1 code Symbol in syntax defined by the system
......... display Σ 0..1 string Representation defined by the system
......... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
..... 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
.... component:bitsComponent Σ 0..* BackboneElement BITs measurements entry components
..... 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: ANS1ToHL7 codes defined for measurement attributes (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 1..* Coding The ANS1 BITs code for the measurement
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... value[x] Σ 0..1 CodeableConcept Actual component result
..... dataAbsentReason C 0..1 CodeableConcept For the optional reporting of unsupported bits
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
....... coding:FhirDefault Σ 1..1 Coding FHIR default code system for reporting 'unsupported'
........ id 0..1 id Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
........ system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/data-absent-reason
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: unsupported
........ display Σ 0..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... 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

PathConformanceValueSetURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.security:PhdHtestextensibleFixed Value: HTEST
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.identifier:conditionalCreate.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.3.0
from the FHIR Standard
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.3.0
from the FHIR Standard
Observation.categorypreferredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.category:PHD-ObservationpreferredObservationCategoryCodes
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.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
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.device.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
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
Observation.component:supplementalTypesComponent.coderequiredCodeableConcept11073MDC
http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC
from this IG
Observation.component:supplementalTypesComponent.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component:bitsComponent.coderequiredASN1measurement
http://hl7.org/fhir/uv/phd/ValueSet/ASN1measurement
from this IG
Observation.component:bitsComponent.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component:bitsComponent.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.exists() and ('#'+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(uri) = '#').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()
dom-r4bwarningObservation.containedContaining new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()

This structure is derived from PhdBaseObservation

Summary

Mandatory: 0 element(15 nested mandatory elements)
Fixed: 5 elements
Prohibited: 2 elements

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.value[x]
  • The element 1 is sliced based on the value of Observation.value[x].coding (ordered)
  • The element 1 is sliced based on the value of Observation.dataAbsentReason.coding
  • The element 1 is sliced based on the value of Observation.component.dataAbsentReason.coding

 

Other representations of profile: CSV, Excel, Schematron

Notes:

The fololwing sections give more details on the mapping of BITS to a FHIR Observation resource.

Mapping BITs Enumerations to FHIR

FHIR has no data type that corresponds to this kind of measurement. Consequently we developed a code system which maps the BITs measurement to a set of codes. The details of the mapping and how these codes are generated from data received from the PHD are given in ASN1 BITS Code System. These codes are reported in the component element; one component per reported bit setting. Thus similar to the compound numerical measurement, there is no Observation.value[x] element. There may still be an Observation.dataAbsentReason element if a measurement status indicates a measurement failure in which case no component elements representing the BITs setting are reported.

IEEE 11073-10206 Observation Attribute FHIR coding
state: Boolean[0..N] for i=0..N
Observation.component[i].code.coding.code=”Type.i
Observation.component[i].code.coding.system=”http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7”
Observation.component[i].valueCodableConcept.coding.code=”Y"|"N” if bit i is set|cleared
Observation.component[i].valueCodableConcept.coding.system=”http://terminology.hl7.org/CodeSystem/v2-0136”

When mapping Bluetooth GHS bitstring Observation values only supported bits are reported. For bits of type 'event' only set bits need to be reported. If of type 'state' both set and cleared states need to be reported. This means that some bits can be skipped and that the index of the FHIR component j can be smaller than the index i of the bit in the GHS bitstring.

Bluetooth GHS Observation Attribute FHIR coding
state: Boolean[0..N] for i=0..N
if supported[i]
if isState[i] or isSet[i]
  Observation.component[j].code.coding.code=”Type.i
  Observation.component[j].code.coding.system=”http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7”
  Observation.component[j].valueCodableConcept.coding.code=”Y"|"N” if bit i is set|cleared
  Observation.component[j].valueCodableConcept.coding.system=”http://terminology.hl7.org/CodeSystem/v2-0136”
else skip bit i

Below is an example of one Observation.component element containing one of the perhaps several bit settings from a pulse oximeter device and sensor status measurement:

component": [
    {
        "code": {
            "coding": [
                {
                    "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7",
                    "code": "150604.2"
                }
            ],
            "text": "sensor-displaced"
        },
        "valueCodeableConcept": {
            "coding": [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                    "code": "Y"
                }
            ],
            "text": "Sensor is incorrectly placed on user"
        }
}

There would be one such component element for every bit setting to be reported. If one examines the ASN1ToHL7 code system here one will see that the code 150604.2 means "Sensor is incorrectly placed on user".

Conditional Create Identifier Generation

For a general description of the PHD Observation Identifier see the "PHD Observation Identifier" section in PHD Base Observation Profile. The table below lists the items that make up the identifier.

Entry value Additional information
device "PHD Device.identifier.value" This value is the PHD IEEE EUI-64 system identifier
patient "Patient.identifier.value-Patient.identifier.system" or
provided logical id
The dashes are part of the identifier.
When the service provider gives the PHG a pre-determined patient logical id the PHG creates no Patient resource and has no patient information. In that special case the provided logical id is used
type "Observation.code.coding.code" See Obtaining the Observation.code
value The raw 16-bit or 32-bit integer delivered by the PHD  
reported PHD timestamp "timestamp" See Generating the PHD Reported Time Stamp
Supplemental Information "Supplemental-Types.N-" A sequence of 32-bit MDC codes separated by a dash

The final identifier is made by concatenating the entries above as follows:

  • "device-patient-type-value-reported PHD timestamp-Supplemental Information"

Additional Enumeration Measurement Information

There are no additional descriptive attributes that are unique to the Enumeration type of measurement.

Examples:

A BITs observation example from a pulse oximeter is shown in BITs Observation Example. This observation results when the pulse oximeter is having difficulty obtaining the measurement, perhaps due to motion or position of the finger in the sensor, a bad signal, etc.

The Other Profiles