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
Draft as of 2017-06-02 |
Definitions for the PhdCodedEnumerationObservation resource profile.
Guidance on how to interpret the contents of this table can be found here
0. Observation | |
Definition | The PhdCodedEnumerationObservation reports PHD measurements that contain a Enum-Observed-Value-Simple-OID attribute. |
Short | Reports measurements that are enumeration MDC codes |
Comments | This type of measurement is used when the Personal Health Device reports a measurement as an IEEE 11073-10101 code. An example would be the most recent meal context associated with a glucose measurement such as 'breakfast', 'fasting', 'snack', etc. The list of codes for these meal options is finite. |
2. Observation.value[x] | |
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
4. Observation.value[x].coding | |
Control | 1..? |
Slicing | This element introduces a set of slices on Observation.value[x].coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
6. Observation.value[x].coding:MDCType | |
Slice Name | MDCType |
Short | Required MDC code entry |
Control | 1..1 |
8. Observation.value[x].coding:MDCType.system | |
Control | 1..? |
Fixed Value | urn:iso:std:iso:11073:10101 |
10. Observation.dataAbsentReason | |
Definition | Provides a reason why the expected value in the element Observation.valueCodeableConcept is missing. |
Short | Populated when the Measurement-Status or an Enum-Observed-Value status indicates invalid, not unavailable, or msmt ongoing |
Comments | Only the Measurement-Status/status flags indicating invalid, not unavailable, or msmt ongoing will generate this element and cause the value[x] to be absent. The remaining settings of the status values are reported in the meta.security element or interpretation element. |
12. Observation.dataAbsentReason.coding | |
Control | 1..? |
Slicing | This element introduces a set of slices on Observation.dataAbsentReason.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
14. Observation.dataAbsentReason.coding:FhirDefault | |
Slice Name | FhirDefault |
Control | 1..1 |
16. Observation.dataAbsentReason.coding:FhirDefault.system | |
Control | 1..? |
Fixed Value | http://terminology.hl7.org/CodeSystem/data-absent-reason |
18. Observation.dataAbsentReason.coding:FhirDefault.code | |
Control | 1..? |
Guidance on how to interpret the contents of this table can be found here
0. Observation | |
Definition | The PhdCodedEnumerationObservation reports PHD measurements that contain a Enum-Observed-Value-Simple-OID attribute. Measurements and simple assertions made about a patient, device or other subject. |
Short | Reports measurements that are enumeration MDC codesMeasurements and simple assertions |
Comments | This type of measurement is used when the Personal Health Device reports a measurement as an IEEE 11073-10101 code. An example would be the most recent meal context associated with a glucose measurement such as 'breakfast', 'fasting', 'snack', etc. The list of codes for these meal options is finite. 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. |
Control | 0..* |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | Vital Signs, Measurement, Results, Tests |
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty()) 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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()) |
2. Observation.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Short | Metadata about the resource |
Control | 10..1 |
Type | Meta |
Is Modifier | false |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
4. Observation.meta.security | |
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. |
Short | Security Labels applied to this resource |
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. |
Control | 0..* |
Binding | Unless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels (extensible to http://hl7.org/fhir/ValueSet/security-labels ) |
Type | Coding |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.meta.security . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
6. Observation.meta.security:PhdHtest | |
Slice Name | PhdHtest |
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. |
Short | Security value set to HTEST when measurement status indicates demo or test dataSecurity Labels applied to this resource |
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. |
Control | 0..1* |
Binding | Unless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels (extensible to http://hl7.org/fhir/ValueSet/security-labels ) |
Type | Coding |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
8. Observation.meta.security:PhdHtest.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | http://terminology.hl7.org/CodeSystem/v3-ActReason |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
10. Observation.meta.security:PhdHtest.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Fixed Value | HTEST |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
12. Observation.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Short | A set of rules under which this content was created |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. Observation.extension:GatewayDevice | |
Slice Name | GatewayDevice |
Definition | To be used when the actual gateway used at the time of the observation, and the referenced device is also specified. The gateway device may be acting as a communication/data collector, translator or controller; This extension is useful when there is more than one gateway device, for example, where there are apps on a phone and each are a device, and more than one app is used to pass on the data to a FHIR Server. In that case you need to be able to say from the observation which specific app was used to act as gateway. Note that the Provenance/AuditEvent resources can represent the same information. |
Short | Gateway Device |
Control | 0..1 |
Type | Extension(Observation Gateway Device) (Extension Type: Reference(Device)) |
Is Modifier | false |
Must Support | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
16. Observation.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Must Support | false |
Summary | false |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
18. Observation.identifier | |
Definition | A unique identifier assigned to this observation. |
Short | Business Identifier for observation |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Allows observations to be distinguished and referenced. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
20. Observation.identifier:conditionalCreate | |
Slice Name | conditionalCreate |
Definition | An identifier created from a combination of the measurement parameters like sensor time stamp, type code, unit code, patient and device identifiers, and selected elements of any component elements. A unique identifier assigned to this observation. |
Short | Unique identifier of this measurement for a given patient and deviceBusiness Identifier for observation |
Comments | This value is used in the conditional create to prevent data duplication. PHDs will often re-send already sent data for a variety of reasons. This element is required unless the metric measurement contains no time stamp or is a measurement containing a time stamp that is real time. By real time the time stamp reported by the PHD must be later than the current time reported by the PHD before any measurements are received. There might be other means to ascertain whether the data is real time. Temporarily stored data from IEEE 11073-10206 compliant devices, which are required to be deleted the data after sending, can be considered real time. An example of this are temporarily stored observation from a device implementing the Bluetooth SIG GHS profile or implementing another Bluetooth SIG medical sensor device profile. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1* |
Type | Identifier |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Allows observations to be distinguished in a selective enough manner to prevent resource duplication. Allows observations to be distinguished and referenced. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
22. Observation.identifier:conditionalCreate.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0 ) |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
24. Observation.identifier:conditionalCreate.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Short | Description of identifier |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
Control | 0..01 |
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type (extensible to http://hl7.org/fhir/ValueSet/identifier-type ) |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
26. Observation.identifier:conditionalCreate.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 0..01 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
28. Observation.identifier:conditionalCreate.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 10..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
30. Observation.status | |
Definition | The status of the result value. Either 'final' or 'preliminary' The status of the result value. |
Short | registered | preliminary | final | amended + |
Comments | The value shall be set to 'final' unless a Measurement-Status attribute or Nu-Observed-Value attribute status field indicates that the measurement is preliminary. In that case this field shall be set to 'preliminary' This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
Control | 1..1 |
Binding | The codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.3.0 (required to http://hl7.org/fhir/ValueSet/observation-status|4.3.0 )Codes providing the status of an observation. |
Type | code |
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Requirements | Need to track the status of individual results. Some results are finalized before the whole report is finalized. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
32. Observation.category | |
Definition | A code that classifies the general type of observation being made. |
Short | Classification of type of observation |
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set. |
Control | 10..* |
Binding | The codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category (preferred to http://hl7.org/fhir/ValueSet/observation-category )Codes for high level observation categories. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | Used for filtering what observations are retrieved and displayed. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.category . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
34. Observation.category:PHD-Observation | |
Slice Name | PHD-Observation |
Definition | A code that classifies the general type of observation being made. |
Short | Classification of type of observation |
Comments | The category enables identifying observations generated by PHDs. In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set. |
Control | 10..1* |
Binding | The codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category (preferred to http://hl7.org/fhir/ValueSet/observation-category )Codes for high level observation categories. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | Used for filtering what observations are retrieved and displayed. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
36. Observation.category:PHD-Observation.coding | |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
38. Observation.category:PHD-Observation.coding.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
40. Observation.category:PHD-Observation.coding.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Fixed Value | phd-observation |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
42. Observation.code | |
Definition | Describes what was observed. Sometimes this is called the observation "name". |
Short | Type of observation (code / type) |
Comments | All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. |
Control | 1..1 |
Binding | For example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes (example to http://hl7.org/fhir/ValueSet/observation-codes )Codes identifying names of simple observations. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Knowing what kind of observation is being made is essential to understanding the observation. |
Alternate Names | Name |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
44. Observation.code.coding | |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.code.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
46. Observation.code.coding:MDCType | |
Slice Name | MDCType |
Definition | This MDC code expresses what the measurement is. A reference to a code defined by a terminology system. |
Short | The 11073-10101 MDC code for the measurementCode defined by a terminology system |
Comments | The value for the code can be obtained from the IEEE 11073-10206 Observation.type attribute. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..1* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
48. Observation.code.coding:MDCType.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | urn:iso:std:iso:11073:10101 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
50. Observation.code.coding:MDCType.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Comments | Required for all measurements |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
52. Observation.code.coding:LoincCoding | |
Slice Name | LoincCoding |
Definition | This LOINC code expresses what the measurement is A reference to a code defined by a terminology system. |
Short | The LOINC code for the measurementCode defined by a terminology system |
Comments | If the observation is one of the FHIR-defined vital signs observation, the equivalent LOINC code for that vital sign as specified by FHIR appears here. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 0..1* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
54. Observation.code.coding:LoincCoding.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | http://loinc.org |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
56. Observation.code.coding:LoincCoding.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Comments | Required if the measurement is a vital sign |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
58. Observation.subject | |
Definition | The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the |
Short | Who and/or what the observation is about |
Comments | One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. |
Control | 10..1 |
Type | Reference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance) |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Observations have no value if you don't know who or what they're about. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
60. Observation.subject.reference | |
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
Short | Literal reference, Relative, internal or absolute URL |
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
Control | 10..1 This element is affected by the following invariants: ref-1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
62. Observation.effective[x] | |
Definition | The time or time-period the observed value is asserted as being true. It is a time period if a Measure-Active-Period (duration) attribute is part of the metric measurement sent by the PHD. Otherwise it is the time stamp sent by the PHD or the time of reception by the PHG if the PHD sent no time stamp. The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself. |
Short | Clinically relevant time/time-period for observation |
Comments | At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events. |
Control | 10..1 |
Type | Choice of: dateTime, Period, Timing, instant |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Requirements | Knowing when an observation was deemed true is important to its relevance as well as determining trends. |
Alternate Names | Occurrence |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
64. Observation.value[x] | |
Definition | The information determined as a result of making the observation, if the information has a simple value. |
Short | Actual result |
Comments | 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. |
Control | 0..1 This element is affected by the following invariants: obs-7 |
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | false |
Summary | true |
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. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
66. Observation.value[x].coding | |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.value[x].coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
68. Observation.value[x].coding:MDCType | |
Slice Name | MDCType |
Definition | A reference to a code defined by a terminology system. |
Short | Required MDC code entryCode defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..1* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
70. Observation.value[x].coding:MDCType.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | urn:iso:std:iso:11073:10101 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
72. Observation.dataAbsentReason | |
Definition | Provides a reason why the expected value in the element Observation.valueCodeableConcept is missing. Provides a reason why the expected value in the element Observation.value[x] is missing. |
Short | Populated when the Measurement-Status or an Enum-Observed-Value status indicates invalid, not unavailable, or msmt ongoingWhy the result is missing |
Comments | Only the Measurement-Status/status flags indicating invalid, not unavailable, or msmt ongoing will generate this element and cause the value[x] to be absent. The remaining settings of the status values are reported in the meta.security element or interpretation element. 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. |
Control | 0..1 This element is affected by the following invariants: obs-6 |
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason )Codes specifying why the result ( |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | For many results it is necessary to handle exceptional values in measurements. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
74. Observation.dataAbsentReason.coding | |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.dataAbsentReason.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
76. Observation.dataAbsentReason.coding:FhirDefault | |
Slice Name | FhirDefault |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..1* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
78. Observation.dataAbsentReason.coding:FhirDefault.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | http://terminology.hl7.org/CodeSystem/data-absent-reason |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
80. Observation.dataAbsentReason.coding:FhirDefault.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
82. Observation.device | |
Definition | The device used to generate the observation data. |
Short | (Measurement) Device |
Comments | This field will reference the PHD Device. Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant. |
Control | 10..1 |
Type | Reference(Device, DeviceMetric) |
Is Modifier | false |
Must Support | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
84. Observation.device.reference | |
Definition | Reference to the device-related resources that describe the sensor device taking the measurement. This element will point to a Device resource following the Phd Device Profile. A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
Short | Reference to the device responsible for the measurementLiteral reference, Relative, internal or absolute URL |
Comments | This reference points to the Device resource containing information about the sensor device that took the measurement. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
Control | 10..1 This element is affected by the following invariants: ref-1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
86. Observation.component | |
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. |
Short | Component results |
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below. |
Control | 0..* |
Type | BackboneElement |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation. |
Invariants | ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters) |
Slicing | This element introduces a set of slices on Observation.component . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
88. Observation.component.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored even if unrecognized |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
90. Observation.component.code | |
Definition | Describes what was observed. Sometimes this is called the observation "code". |
Short | Type of component observation (code / type) |
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. |
Control | 1..1 |
Binding | For example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes (example to http://hl7.org/fhir/ValueSet/observation-codes )Codes identifying names of simple observations. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Knowing what kind of observation is being made is essential to understanding the observation. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
92. Observation.component:supplementalTypesComponent | |
Slice Name | supplementalTypesComponent |
Definition | For each partition:term code pair contained in the Supplemental-Types attribute, a separate supplementalTypesComponent element is generated. The component is not generated if the attribute is absent or empty. The component shall be generated otherwise. 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. |
Short | Supplemental Type: A further description of the measurement type.Component results |
Comments | A PHD may send a Supplemental-Types attribute as part of the measurement. This attribute consists of a set of MDC nomenclature codes as partition:term code pairs. Each pair is a code describing something additional about the measurement, such as MDC_MODALITY_SPOT in the pulse oximeter which indicates that the provided measurement is a stable average. An MDC_MODALITY_FAST would indicate that a short averaging is used and the result reported regardless of stability. For a discussion on the ways Observations can be assembled in groups together see Notes below. |
Control | 0..* |
Type | BackboneElement |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation. |
Invariants | ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters) |
94. Observation.component:supplementalTypesComponent.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored even if unrecognized |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
96. Observation.component:supplementalTypesComponent.code | |
Definition | Describes what was observed. Sometimes this is called the observation "code". |
Short | Type of component observation (code / type) |
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. |
Control | 1..1 |
Binding | The codes SHALL be taken from For example codes, see CodeableConcept 11073 Attributeshttp://hl7.org/fhir/ValueSet/observation-codes (required to http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Knowing what kind of observation is being made is essential to understanding the observation. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
98. Observation.component:supplementalTypesComponent.code.coding | |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.component.code.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
100. Observation.component:supplementalTypesComponent.code.coding:MdcType | |
Slice Name | MdcType |
Definition | A reference to a code defined by a terminology system. |
Short | The 11073-10101 MDC code for the measurementCode defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..1* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
102. Observation.component:supplementalTypesComponent.code.coding:MdcType.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | urn:iso:std:iso:11073:10101 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
104. Observation.component:supplementalTypesComponent.code.coding:MdcType.code | |
Definition | 68193 is the 32-bit nomenclature code indicating a 'Supplemental-Types' value A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Fixed Value | 68193 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
106. Observation.component:supplementalTypesComponent.value[x] | |
Definition | The information determined as a result of making the observation, if the information has a simple value. |
Short | Actual component result |
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). 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. |
Control | 10..1 |
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | false |
Summary | true |
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. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.component.value[x] . The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
108. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept | |
Slice Name | valueCodeableConcept |
Definition | The supplemental information determined as a result of making the observation, if the information is a code. The information determined as a result of making the observation, if the information has a simple value. |
Short | Actual component result |
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). 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. |
Control | 10..1 |
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | false |
Summary | true |
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. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
110. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding | |
Definition | A reference to a code defined by a terminology system. |
Short | Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Observation.component.value[x].coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
112. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType | |
Slice Name | MDCType |
Definition | A reference to a code defined by a terminology system. |
Short | Required MDC code entry.Code defined by a terminology system |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Control | 10..1* |
Type | Coding |
Is Modifier | false |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
114. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Short | Identity of the terminology system |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Fixed Value | urn:iso:std:iso:11073:10101 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
116. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.code | |
Definition | For the given Supplemental-Types entry the code here is given by: partition * 2**16 + term code A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Short | Symbol in syntax defined by the system |
Control | 10..1 |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to refer to a particular code in the system. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
118. Observation.component:supplementalTypesComponent.dataAbsentReason | |
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing. |
Short | Why the component result is missing |
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values. |
Control | 0..01 This element is affected by the following invariants: obs-6 |
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason )Codes specifying why the result ( |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | For many results it is necessary to handle exceptional values in measurements. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. Observation | |||||
Definition | The PhdCodedEnumerationObservation reports PHD measurements that contain a Enum-Observed-Value-Simple-OID attribute. | ||||
Short | Reports measurements that are enumeration MDC codes | ||||
Comments | This type of measurement is used when the Personal Health Device reports a measurement as an IEEE 11073-10101 code. An example would be the most recent meal context associated with a glucose measurement such as 'breakfast', 'fasting', 'snack', etc. The list of codes for these meal options is finite. | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Alternate Names | Vital Signs, Measurement, Results, Tests | ||||
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty() )dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource ( 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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty() )dom-6: A resource should have narrative for robust management ( text.`div`.exists() )obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present ( dataAbsentReason.empty() or value.empty() )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 ( value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty() ) | ||||
2. Observation.id | |||||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
Short | Logical id of this artifact | ||||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
4. Observation.meta | |||||
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
Short | Metadata about the resource | ||||
Control | 1..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
6. Observation.meta.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
8. Observation.meta.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.meta.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
10. Observation.meta.versionId | |||||
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. | ||||
Short | Version specific identifier | ||||
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
12. Observation.meta.lastUpdated | |||||
Definition | When the resource last changed - e.g. when the version changed. | ||||
Short | When the resource version last changed | ||||
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. | ||||
Control | 0..1 | ||||
Type | instant | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
14. Observation.meta.source | |||||
Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. | ||||
Short | Identifies where the resource comes from | ||||
Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
16. Observation.meta.profile | |||||
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. | ||||
Short | Profiles this resource claims to conform to | ||||
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. | ||||
Control | 0..* | ||||
Type | canonical(StructureDefinition) | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
18. Observation.meta.security | |||||
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. | ||||
Short | Security Labels applied to this resource | ||||
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. | ||||
Control | 0..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to http://hl7.org/fhir/ValueSet/security-labels ) | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.meta.security . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
20. Observation.meta.security:PhdHtest | |||||
Slice Name | PhdHtest | ||||
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. | ||||
Short | Security value set to HTEST when measurement status indicates demo or test data | ||||
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to http://hl7.org/fhir/ValueSet/security-labels ) | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
22. Observation.meta.security:PhdHtest.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
24. Observation.meta.security:PhdHtest.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.meta.security.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
26. Observation.meta.security:PhdHtest.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | http://terminology.hl7.org/CodeSystem/v3-ActReason | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
28. Observation.meta.security:PhdHtest.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
30. Observation.meta.security:PhdHtest.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Fixed Value | HTEST | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
32. Observation.meta.security:PhdHtest.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
34. Observation.meta.security:PhdHtest.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
36. Observation.meta.tag | |||||
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. | ||||
Short | Tags applied to this resource | ||||
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. | ||||
Control | 0..* | ||||
Binding | For example codes, see CommonTags (example to http://hl7.org/fhir/ValueSet/common-tags ) | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
38. Observation.implicitRules | |||||
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
Short | A set of rules under which this content was created | ||||
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
40. Observation.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language of the resource content | ||||
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )IETF language tag
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
42. Observation.text | |||||
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
Short | Text summary of the resource, for human interpretation | ||||
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
Control | 0..1 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
44. Observation.contained | |||||
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
Short | Contained, inline Resources | ||||
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
Invariants | dom-r4b: Containing 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) ) | ||||
46. Observation.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
48. Observation.extension:GatewayDevice | |||||
Slice Name | GatewayDevice | ||||
Definition | To be used when the actual gateway used at the time of the observation, and the referenced device is also specified. The gateway device may be acting as a communication/data collector, translator or controller; This extension is useful when there is more than one gateway device, for example, where there are apps on a phone and each are a device, and more than one app is used to pass on the data to a FHIR Server. In that case you need to be able to say from the observation which specific app was used to act as gateway. Note that the Provenance/AuditEvent resources can represent the same information. | ||||
Short | Gateway Device | ||||
Control | 0..1 | ||||
Type | Extension(Observation Gateway Device) (Extension Type: Reference(Device)) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
50. Observation.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
52. Observation.identifier | |||||
Definition | A unique identifier assigned to this observation. | ||||
Short | Business Identifier for observation | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Allows observations to be distinguished and referenced. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
54. Observation.identifier:conditionalCreate | |||||
Slice Name | conditionalCreate | ||||
Definition | An identifier created from a combination of the measurement parameters like sensor time stamp, type code, unit code, patient and device identifiers, and selected elements of any component elements. | ||||
Short | Unique identifier of this measurement for a given patient and device | ||||
Comments | This value is used in the conditional create to prevent data duplication. PHDs will often re-send already sent data for a variety of reasons. This element is required unless the metric measurement contains no time stamp or is a measurement containing a time stamp that is real time. By real time the time stamp reported by the PHD must be later than the current time reported by the PHD before any measurements are received. There might be other means to ascertain whether the data is real time. Temporarily stored data from IEEE 11073-10206 compliant devices, which are required to be deleted the data after sending, can be considered real time. An example of this are temporarily stored observation from a device implementing the Bluetooth SIG GHS profile or implementing another Bluetooth SIG medical sensor device profile. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Allows observations to be distinguished in a selective enough manner to prevent resource duplication. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
56. Observation.identifier:conditionalCreate.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
58. Observation.identifier:conditionalCreate.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
60. Observation.identifier:conditionalCreate.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0 ) | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
62. Observation.identifier:conditionalCreate.type | |||||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | Description of identifier | ||||
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||||
Control | 0..0 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
64. Observation.identifier:conditionalCreate.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 0..0 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
66. Observation.identifier:conditionalCreate.value | |||||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||||
Short | The value that is unique | ||||
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. | ||||
Control | 1..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Example | <br/><b>General</b>:123456 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
68. Observation.identifier:conditionalCreate.period | |||||
Definition | Time period during which identifier is/was valid for use. | ||||
Short | Time period when id is/was valid for use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
70. Observation.identifier:conditionalCreate.assigner | |||||
Definition | Organization that issued/manages the identifier. | ||||
Short | Organization that issued id (may be just text) | ||||
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. | ||||
Control | 0..1 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
72. Observation.basedOn | |||||
Definition | A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed. | ||||
Short | Fulfills plan, proposal or order | ||||
Control | 0..* | ||||
Type | Reference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. | ||||
Alternate Names | Fulfills | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
74. Observation.partOf | |||||
Definition | A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure. | ||||
Short | Part of referenced event | ||||
Comments | To link an Observation to an Encounter use | ||||
Control | 0..* | ||||
Type | Reference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Alternate Names | Container | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
76. Observation.status | |||||
Definition | The status of the result value. Either 'final' or 'preliminary' | ||||
Short | registered | preliminary | final | amended + | ||||
Comments | The value shall be set to 'final' unless a Measurement-Status attribute or Nu-Observed-Value attribute status field indicates that the measurement is preliminary. In that case this field shall be set to 'preliminary' | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from ObservationStatus (required to http://hl7.org/fhir/ValueSet/observation-status|4.3.0 )Codes providing the status of an observation. | ||||
Type | code | ||||
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Need to track the status of individual results. Some results are finalized before the whole report is finalized. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
78. Observation.category | |||||
Definition | A code that classifies the general type of observation being made. | ||||
Short | Classification of type of observation | ||||
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set. | ||||
Control | 1..* | ||||
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to http://hl7.org/fhir/ValueSet/observation-category )Codes for high level observation categories. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Used for filtering what observations are retrieved and displayed. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.category . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
80. Observation.category:PHD-Observation | |||||
Slice Name | PHD-Observation | ||||
Definition | A code that classifies the general type of observation being made. | ||||
Short | Classification of type of observation | ||||
Comments | The category enables identifying observations generated by PHDs. | ||||
Control | 1..1 | ||||
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to http://hl7.org/fhir/ValueSet/observation-category )Codes for high level observation categories. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Used for filtering what observations are retrieved and displayed. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
82. Observation.category:PHD-Observation.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
84. Observation.category:PHD-Observation.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.category.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
86. Observation.category:PHD-Observation.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
88. Observation.category:PHD-Observation.coding.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
90. Observation.category:PHD-Observation.coding.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.category.coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
92. Observation.category:PHD-Observation.coding.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
94. Observation.category:PHD-Observation.coding.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
96. Observation.category:PHD-Observation.coding.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Fixed Value | phd-observation | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
98. Observation.category:PHD-Observation.coding.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
100. Observation.category:PHD-Observation.coding.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
102. Observation.category:PHD-Observation.text | |||||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
Short | Plain text representation of the concept | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
104. Observation.code | |||||
Definition | Describes what was observed. Sometimes this is called the observation "name". | ||||
Short | Type of observation (code / type) | ||||
Comments | All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. | ||||
Control | 1..1 | ||||
Binding | For example codes, see LOINCCodes (example to http://hl7.org/fhir/ValueSet/observation-codes )Codes identifying names of simple observations. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Knowing what kind of observation is being made is essential to understanding the observation. | ||||
Alternate Names | Name | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
106. Observation.code.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
108. Observation.code.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.code.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
110. Observation.code.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.code.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
112. Observation.code.coding:MDCType | |||||
Slice Name | MDCType | ||||
Definition | This MDC code expresses what the measurement is. | ||||
Short | The 11073-10101 MDC code for the measurement | ||||
Comments | The value for the code can be obtained from the IEEE 11073-10206 Observation.type attribute. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
114. Observation.code.coding:MDCType.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
116. Observation.code.coding:MDCType.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.code.coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
118. Observation.code.coding:MDCType.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | urn:iso:std:iso:11073:10101 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
120. Observation.code.coding:MDCType.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
122. Observation.code.coding:MDCType.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Comments | Required for all measurements | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
124. Observation.code.coding:MDCType.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
126. Observation.code.coding:MDCType.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
128. Observation.code.coding:LoincCoding | |||||
Slice Name | LoincCoding | ||||
Definition | This LOINC code expresses what the measurement is | ||||
Short | The LOINC code for the measurement | ||||
Comments | If the observation is one of the FHIR-defined vital signs observation, the equivalent LOINC code for that vital sign as specified by FHIR appears here. | ||||
Control | 0..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
130. Observation.code.coding:LoincCoding.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
132. Observation.code.coding:LoincCoding.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.code.coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
134. Observation.code.coding:LoincCoding.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | http://loinc.org | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
136. Observation.code.coding:LoincCoding.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
138. Observation.code.coding:LoincCoding.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Comments | Required if the measurement is a vital sign | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
140. Observation.code.coding:LoincCoding.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
142. Observation.code.coding:LoincCoding.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
144. Observation.code.text | |||||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
Short | It is recommended to display at least the reference identifier for the MDC code | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
146. Observation.subject | |||||
Definition | The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the | ||||
Short | Who and/or what the observation is about | ||||
Comments | One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. | ||||
Control | 1..1 | ||||
Type | Reference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Observations have no value if you don't know who or what they're about. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
148. Observation.subject.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
150. Observation.subject.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.subject.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
152. Observation.subject.reference | |||||
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. | ||||
Short | Literal reference, Relative, internal or absolute URL | ||||
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||
Control | 1..1 This element is affected by the following invariants: ref-1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
154. Observation.subject.type | |||||
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||
Short | Type the reference refers to (e.g. "Patient") | ||||
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types ) | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
156. Observation.subject.identifier | |||||
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||
Short | Logical reference, when literal reference is not known | ||||
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
158. Observation.subject.display | |||||
Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||
Short | Text alternative for the resource | ||||
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
160. Observation.focus | |||||
Definition | The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus. | ||||
Short | What the observation is about, when it is not about the subject of record | ||||
Comments | Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use | ||||
Control | 0..* | ||||
Type | Reference(Resource) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
162. Observation.encounter | |||||
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made. | ||||
Short | Healthcare event during which this observation is made | ||||
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). | ||||
Control | 0..1 | ||||
Type | Reference(Encounter) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | For some observations it may be important to know the link between an observation and a particular encounter. | ||||
Alternate Names | Context | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
164. Observation.effective[x] | |||||
Definition | The time or time-period the observed value is asserted as being true. It is a time period if a Measure-Active-Period (duration) attribute is part of the metric measurement sent by the PHD. Otherwise it is the time stamp sent by the PHD or the time of reception by the PHG if the PHD sent no time stamp. | ||||
Short | Clinically relevant time/time-period for observation | ||||
Comments | At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events. | ||||
Control | 1..1 | ||||
Type | Choice of: dateTime, Period | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Knowing when an observation was deemed true is important to its relevance as well as determining trends. | ||||
Alternate Names | Occurrence | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
166. Observation.issued | |||||
Definition | The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified. | ||||
Short | Date/Time this version was made available | ||||
Comments | For Observations that don’t require review and verification, it may be the same as the | ||||
Control | 0..1 | ||||
Type | instant | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
168. Observation.performer | |||||
Definition | Who was responsible for asserting the observed value as "true". | ||||
Short | Who is responsible for the observation | ||||
Control | 0..* | ||||
Type | Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
170. Observation.value[x] | |||||
Definition | The information determined as a result of making the observation, if the information has a simple value. | ||||
Short | Actual result | ||||
Comments | 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. | ||||
Control | 0..1 This element is affected by the following invariants: obs-7 | ||||
Type | CodeableConcept | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
172. Observation.value[x].id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
174. Observation.value[x].extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.value[x].extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
176. Observation.value[x].coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.value[x].coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
178. Observation.value[x].coding:MDCType | |||||
Slice Name | MDCType | ||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Required MDC code entry | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
180. Observation.value[x].coding:MDCType.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
182. Observation.value[x].coding:MDCType.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.value[x].coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
184. Observation.value[x].coding:MDCType.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | urn:iso:std:iso:11073:10101 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
186. Observation.value[x].coding:MDCType.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
188. Observation.value[x].coding:MDCType.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 0..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
190. Observation.value[x].coding:MDCType.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
192. Observation.value[x].coding:MDCType.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
194. Observation.value[x].text | |||||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
Short | Plain text representation of the concept | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
196. Observation.dataAbsentReason | |||||
Definition | Provides a reason why the expected value in the element Observation.valueCodeableConcept is missing. | ||||
Short | Populated when the Measurement-Status or an Enum-Observed-Value status indicates invalid, not unavailable, or msmt ongoing | ||||
Comments | Only the Measurement-Status/status flags indicating invalid, not unavailable, or msmt ongoing will generate this element and cause the value[x] to be absent. The remaining settings of the status values are reported in the meta.security element or interpretation element. | ||||
Control | 0..1 This element is affected by the following invariants: obs-6 | ||||
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason )Codes specifying why the result ( | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For many results it is necessary to handle exceptional values in measurements. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
198. Observation.dataAbsentReason.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
200. Observation.dataAbsentReason.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.dataAbsentReason.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
202. Observation.dataAbsentReason.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.dataAbsentReason.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
204. Observation.dataAbsentReason.coding:FhirDefault | |||||
Slice Name | FhirDefault | ||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
206. Observation.dataAbsentReason.coding:FhirDefault.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
208. Observation.dataAbsentReason.coding:FhirDefault.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.dataAbsentReason.coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
210. Observation.dataAbsentReason.coding:FhirDefault.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | http://terminology.hl7.org/CodeSystem/data-absent-reason | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
212. Observation.dataAbsentReason.coding:FhirDefault.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
214. Observation.dataAbsentReason.coding:FhirDefault.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
216. Observation.dataAbsentReason.coding:FhirDefault.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
218. Observation.dataAbsentReason.coding:FhirDefault.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
220. Observation.dataAbsentReason.text | |||||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
Short | Plain text representation of the concept | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
222. Observation.interpretation | |||||
Definition | A categorical assessment of an observation value. For example, high, low, normal. | ||||
Short | High, low, normal, etc. | ||||
Comments | Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. | ||||
Control | 0..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation )Codes identifying interpretations of observations. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. | ||||
Alternate Names | Abnormal Flag | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
224. Observation.interpretation.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
226. Observation.interpretation.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.interpretation.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
228. Observation.interpretation.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.interpretation.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
230. Observation.interpretation.coding:MsmtStatusInterpretation | |||||
Slice Name | MsmtStatusInterpretation | ||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Measurement status interpretation when questionable, calibration-ongoing, validated, early-indication, threshold exceeded, alarm inhibited | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
232. Observation.interpretation.coding:MsmtStatusInterpretation.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
234. Observation.interpretation.coding:MsmtStatusInterpretation.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.interpretation.coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
236. Observation.interpretation.coding:MsmtStatusInterpretation.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | http://hl7.org/fhir/uv/pocd/CodeSystem/measurement-status | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
238. Observation.interpretation.coding:MsmtStatusInterpretation.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
240. Observation.interpretation.coding:MsmtStatusInterpretation.code | |||||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
242. Observation.interpretation.coding:MsmtStatusInterpretation.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
244. Observation.interpretation.coding:MsmtStatusInterpretation.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
246. Observation.interpretation.text | |||||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
Short | Plain text representation of the concept | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
248. Observation.note | |||||
Definition | Comments about the observation or the results. | ||||
Short | Comments about the observation | ||||
Comments | May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation. | ||||
Control | 0..* | ||||
Type | Annotation | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Need to be able to provide free text additional information. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
250. Observation.bodySite | |||||
Definition | Indicates the site on the subject's body where the observation was made (i.e. the target site). | ||||
Short | Observed body part | ||||
Comments | Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite. | ||||
Control | 0..1 | ||||
Binding | For example codes, see SNOMEDCTBodyStructures (example to http://hl7.org/fhir/ValueSet/body-site )SNOMED CT Body site concepts | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
252. Observation.method | |||||
Definition | Indicates the mechanism used to perform the observation. | ||||
Short | How it was done | ||||
Comments | Only used if not implicit in code for Observation.code. | ||||
Control | 0..1 | ||||
Binding | For example codes, see ObservationMethods (example to http://hl7.org/fhir/ValueSet/observation-methods )Methods for simple observations. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
254. Observation.specimen | |||||
Definition | The specimen that was used when this observation was made. | ||||
Short | Specimen used for this observation | ||||
Comments | Should only be used if not implicit in code found in | ||||
Control | 0..1 | ||||
Type | Reference(Specimen) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
256. Observation.device | |||||
Definition | The device used to generate the observation data. | ||||
Short | (Measurement) Device | ||||
Comments | This field will reference the PHD Device. | ||||
Control | 1..1 | ||||
Type | Reference(Device, DeviceMetric) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
258. Observation.device.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
260. Observation.device.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.device.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
262. Observation.device.reference | |||||
Definition | Reference to the device-related resources that describe the sensor device taking the measurement. This element will point to a Device resource following the Phd Device Profile. | ||||
Short | Reference to the device responsible for the measurement | ||||
Comments | This reference points to the Device resource containing information about the sensor device that took the measurement. | ||||
Control | 1..1 This element is affected by the following invariants: ref-1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
264. Observation.device.type | |||||
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||
Short | Type the reference refers to (e.g. "Patient") | ||||
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types ) | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
266. Observation.device.identifier | |||||
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||
Short | Logical reference, when literal reference is not known | ||||
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
268. Observation.device.display | |||||
Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||
Short | Text alternative for the resource | ||||
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
270. Observation.referenceRange | |||||
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two | ||||
Short | Provides guide for interpretation | ||||
Comments | Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters )obs-3: Must have at least a low or a high or text ( low.exists() or high.exists() or text.exists() ) | ||||
272. Observation.referenceRange.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
274. Observation.referenceRange.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
276. Observation.referenceRange.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
278. Observation.referenceRange.low | |||||
Definition | The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3). | ||||
Short | Low Range, if relevant | ||||
Control | 0..1 This element is affected by the following invariants: obs-3 | ||||
Type | Quantity(SimpleQuantity) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
280. Observation.referenceRange.high | |||||
Definition | The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3). | ||||
Short | High Range, if relevant | ||||
Control | 0..1 This element is affected by the following invariants: obs-3 | ||||
Type | Quantity(SimpleQuantity) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
282. Observation.referenceRange.type | |||||
Definition | Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range. | ||||
Short | Reference range qualifier | ||||
Comments | This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed. | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from ObservationReferenceRangeMeaningCodes (preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning )Code for the meaning of a reference range. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
284. Observation.referenceRange.appliesTo | |||||
Definition | Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple | ||||
Short | Reference range population | ||||
Comments | This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed. | ||||
Control | 0..* | ||||
Binding | For example codes, see ObservationReferenceRangeAppliesToCodes (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto )Codes identifying the population the reference range applies to. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Need to be able to identify the target population for proper interpretation. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
286. Observation.referenceRange.age | |||||
Definition | The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so. | ||||
Short | Applicable age range, if relevant | ||||
Control | 0..1 | ||||
Type | Range | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Some analytes vary greatly over age. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
288. Observation.referenceRange.text | |||||
Definition | Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals". | ||||
Short | Text based reference range in an observation | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
290. Observation.hasMember | |||||
Definition | This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group. | ||||
Short | Related resource that belongs to the Observation group | ||||
Comments | 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. | ||||
Control | 0..* | ||||
Type | Reference(Observation, QuestionnaireResponse, MolecularSequence) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
292. Observation.derivedFrom | |||||
Definition | 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. | ||||
Short | Reference to the Coincident Time Stamp Observation and/or Source-Handle-Reference Observation | ||||
Comments | When the PHD reports a time stamp a reference to the Coincident Time Stamp Observation is placed here. When the PHD reports a Source-Handle-Reference/-List attribute the Observation(s) pointed to by that Source-Handle-Reference/-List is (are) placed here. One may end up with several Observation.derivedFrom elements. | ||||
Control | 0..* | ||||
Type | Reference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
294. Observation.component | |||||
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. | ||||
Short | Component results | ||||
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters ) | ||||
Slicing | This element introduces a set of slices on Observation.component . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
296. Observation.component.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
298. Observation.component.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
300. Observation.component.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
302. Observation.component.code | |||||
Definition | Describes what was observed. Sometimes this is called the observation "code". | ||||
Short | Type of component observation (code / type) | ||||
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. | ||||
Control | 1..1 | ||||
Binding | For example codes, see LOINCCodes (example to http://hl7.org/fhir/ValueSet/observation-codes )Codes identifying names of simple observations. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Knowing what kind of observation is being made is essential to understanding the observation. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
304. Observation.component.value[x] | |||||
Definition | The information determined as a result of making the observation, if the information has a simple value. | ||||
Short | Actual component result | ||||
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). 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. | ||||
Control | 0..1 | ||||
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
306. Observation.component.dataAbsentReason | |||||
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing. | ||||
Short | Why the component result is missing | ||||
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values. | ||||
Control | 0..1 This element is affected by the following invariants: obs-6 | ||||
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason )Codes specifying why the result ( | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For many results it is necessary to handle exceptional values in measurements. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
308. Observation.component.interpretation | |||||
Definition | A categorical assessment of an observation value. For example, high, low, normal. | ||||
Short | High, low, normal, etc. | ||||
Comments | Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. | ||||
Control | 0..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation )Codes identifying interpretations of observations. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. | ||||
Alternate Names | Abnormal Flag | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
310. Observation.component.referenceRange | |||||
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range. | ||||
Short | Provides guide for interpretation of component result | ||||
Comments | Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties. | ||||
Control | 0..* | ||||
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
312. Observation.component:supplementalTypesComponent | |||||
Slice Name | supplementalTypesComponent | ||||
Definition | For each partition:term code pair contained in the Supplemental-Types attribute, a separate supplementalTypesComponent element is generated. The component is not generated if the attribute is absent or empty. The component shall be generated otherwise. | ||||
Short | Supplemental Type: A further description of the measurement type. | ||||
Comments | A PHD may send a Supplemental-Types attribute as part of the measurement. This attribute consists of a set of MDC nomenclature codes as partition:term code pairs. Each pair is a code describing something additional about the measurement, such as MDC_MODALITY_SPOT in the pulse oximeter which indicates that the provided measurement is a stable average. An MDC_MODALITY_FAST would indicate that a short averaging is used and the result reported regardless of stability. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters ) | ||||
314. Observation.component:supplementalTypesComponent.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
316. Observation.component:supplementalTypesComponent.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
318. Observation.component:supplementalTypesComponent.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
320. Observation.component:supplementalTypesComponent.code | |||||
Definition | Describes what was observed. Sometimes this is called the observation "code". | ||||
Short | Type of component observation (code / type) | ||||
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from CodeableConcept 11073 Attributes (required to http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Knowing what kind of observation is being made is essential to understanding the observation. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
322. Observation.component:supplementalTypesComponent.code.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
324. Observation.component:supplementalTypesComponent.code.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.component.code.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
326. Observation.component:supplementalTypesComponent.code.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.component.code.coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
328. Observation.component:supplementalTypesComponent.code.coding:MdcType | |||||
Slice Name | MdcType | ||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | The 11073-10101 MDC code for the measurement | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
330. Observation.component:supplementalTypesComponent.code.coding:MdcType.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
332. Observation.component:supplementalTypesComponent.code.coding:MdcType.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.component.code.coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
334. Observation.component:supplementalTypesComponent.code.coding:MdcType.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | urn:iso:std:iso:11073:10101 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
336. Observation.component:supplementalTypesComponent.code.coding:MdcType.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
338. Observation.component:supplementalTypesComponent.code.coding:MdcType.code | |||||
Definition | 68193 is the 32-bit nomenclature code indicating a 'Supplemental-Types' value | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Fixed Value | 68193 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
340. Observation.component:supplementalTypesComponent.code.coding:MdcType.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
342. Observation.component:supplementalTypesComponent.code.coding:MdcType.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
344. Observation.component:supplementalTypesComponent.code.text | |||||
Definition | It is recommended to display at least the reference identifier for the Supplemental-Types which is MDC_ATTR_SUPPLEMENTAL_TYPES | ||||
Short | Plain text representation of the concept | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
346. Observation.component:supplementalTypesComponent.value[x] | |||||
Definition | The information determined as a result of making the observation, if the information has a simple value. | ||||
Short | Actual component result | ||||
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). 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. | ||||
Control | 1..1 | ||||
Type | CodeableConcept | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.component.value[x] . The slices areUnordered and Closed, and can be differentiated using the following discriminators: | ||||
348. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept | |||||
Slice Name | valueCodeableConcept | ||||
Definition | The supplemental information determined as a result of making the observation, if the information is a code. | ||||
Short | Actual component result | ||||
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). 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. | ||||
Control | 1..1 | ||||
Type | CodeableConcept | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
350. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
352. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.component.value[x].extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
354. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Code defined by a terminology system | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Observation.component.value[x].coding . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
356. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType | |||||
Slice Name | MDCType | ||||
Definition | A reference to a code defined by a terminology system. | ||||
Short | Required MDC code entry. | ||||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
358. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
360. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Observation.component.value[x].coding.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
362. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | Identity of the terminology system | ||||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
Fixed Value | urn:iso:std:iso:11073:10101 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
364. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.version | |||||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
Short | Version of the system - if relevant | ||||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
Note | This is a business version Id, not a resource version Id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
366. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.code | |||||
Definition | For the given Supplemental-Types entry the code here is given by: partition * 2**16 + term code | ||||
Short | Symbol in syntax defined by the system | ||||
Control | 1..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to refer to a particular code in the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
368. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.display | |||||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
Short | Representation defined by the system | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
370. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.userSelected | |||||
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
Short | If this coding was chosen directly by the user | ||||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
372. Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.text | |||||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
Short | Plain text representation of the concept | ||||
Comments | Very often the text is the same as a displayName of one of the codings. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
374. Observation.component:supplementalTypesComponent.dataAbsentReason | |||||
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing. | ||||
Short | Why the component result is missing | ||||
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values. | ||||
Control | 0..0 This element is affected by the following invariants: obs-6 | ||||
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason )Codes specifying why the result ( | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For many results it is necessary to handle exceptional values in measurements. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
376. Observation.component:supplementalTypesComponent.interpretation | |||||
Definition | A categorical assessment of an observation value. For example, high, low, normal. | ||||
Short | High, low, normal, etc. | ||||
Comments | Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. | ||||
Control | 0..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation )Codes identifying interpretations of observations. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. | ||||
Alternate Names | Abnormal Flag | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
378. Observation.component:supplementalTypesComponent.referenceRange | |||||
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range. | ||||
Short | Provides guide for interpretation of component result | ||||
Comments | Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties. | ||||
Control | 0..* | ||||
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |