Personal Health Device Implementation Guide
2.0.0-ballot - STU2 Ballot
Personal Health Device Implementation Guide
2.0.0-ballot - STU2 Ballot
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 |
XML representation of the PhdRtsaObservation resource profile.
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="PhdRtsaObservation"/>
<meta>
<lastUpdated value="2017-12-14T07:44:36.955-05:00"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition PhdRtsaObservation</b></p><a name="PhdRtsaObservation"> </a><a name="hcPhdRtsaObservation"> </a><a name="PhdRtsaObservation-en-US"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2017-12-14 07:44:36-0500</p></div><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation" title="The PhdRtsaObservation reports PHD measurements that contain a Simple-Sa-Observed-Value attribute.">Observation</a><a name="Observation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-PhdBaseObservation.html">PhdBaseObservation</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Measurements and simple assertions</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for category<a name="Observation.category"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.category:vitalSignsCategory" title="Slice vitalSignsCategory">category:vitalSignsCategory</a><a name="Observation.category.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Required by the FHIR specification if the measurement value is a vital sign<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1243.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.category:vitalSignsCategory.coding">Slices for coding</a><a name="Observation.category.coding"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="font-style: italic">1</span><span style="font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4B/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Code defined by a terminology system</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by value:system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12425.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.category:vitalSignsCategory.coding:vitalSigns" title="Slice vitalSigns">coding:vitalSigns</a><a name="Observation.category.coding.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Required Vital Signs category code system entry</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck124250.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.category:vitalSignsCategory.coding:vitalSigns.system">system</a><a name="Observation.category.coding.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Identity of the terminology system</span><br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">http://terminology.hl7.org/CodeSystem/observation-category</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck124240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.category:vitalSignsCategory.coding:vitalSigns.code" title="The 'vital-signs' category code">code</a><a name="Observation.category.coding.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Symbol in syntax defined by the system</span><br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">vital-signs</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x]" title="The information determined as a result of making the observation, when the observation consists of a periodic sample of numeric measurements.">value[x]</a><a name="Observation.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4B/datatypes.html#SampledData">SampledData</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Actual result</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck111.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].origin" title="The 'origin' data type contains the 'y-intercept' for the equation that relates the scaled data to the actual data. If valueSampledData.data[i] is the array of sampled scaled data, the actual data is obtained by:
x[i] =valueSampledData.data[i] * valueSampledData.factor + valueSampledData.origin.value">origin</a><a name="Observation.value_x_.origin"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#SimpleQuantity" title="Quantity">SimpleQuantity</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Scaling intecept value and units</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].origin.value" title="The intercept value with the indicated precision of the data as determined by the device.">value</a><a name="Observation.value_x_.origin.value"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Intercept value (with implicit precision)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].origin.system" title="The identification of the UCUM coding system that provides the coded form of the unit.">system</a><a name="Observation.value_x_.origin.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The UCUM coding system<br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">http://unitsofmeasure.org</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].origin.code" title="The unit code.">code</a><a name="Observation.value_x_.origin.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Coded form of the unit</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].factor">factor</a><a name="Observation.value_x_.factor"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The scale factor</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].dimensions" title="The number of rtsa sample points at each time point. This value gives the number of data points in the valueSampledData.data[] array.">dimensions</a><a name="Observation.value_x_.dimensions"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#positiveInt">positiveInt</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Number of rtsa sample points at each time point</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.value[x].data" title="A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) are not used. The device does not provide such individual values. ">data</a><a name="Observation.value_x_.data"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Decimal values with spaces, or "E" | "U" | "L"</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.dataAbsentReason" title="Provides a reason why the expected value in the element Observation.valueSampledData is missing.">dataAbsentReason</a><a name="Observation.dataAbsentReason"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Populated when the Measurement-Status indicates invalid, not unavailable, or msmt ongoing</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.dataAbsentReason.coding">Slices for coding</a><a name="Observation.dataAbsentReason.coding"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="font-style: italic">1</span><span style="font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4B/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Code defined by a terminology system</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by value:system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.dataAbsentReason.coding:FhirDefault" title="Slice FhirDefault">coding:FhirDefault</a><a name="Observation.dataAbsentReason.coding.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#Coding">Coding</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Code defined by a terminology system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10250.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.dataAbsentReason.coding:FhirDefault.system">system</a><a name="Observation.dataAbsentReason.coding.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Identity of the terminology system</span><br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">http://terminology.hl7.org/CodeSystem/data-absent-reason</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.dataAbsentReason.coding:FhirDefault.code">code</a><a name="Observation.dataAbsentReason.coding.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Symbol in syntax defined by the system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange">Slices for referenceRange</a><a name="Observation.referenceRange"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="opacity: 0.5; font-style: italic">0</span><span style="opacity: 0.5; font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4B/backboneelement.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">Provides guide for interpretation</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by value:low.system</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck025.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange" title="Slice scaleAndReferenceRange">referenceRange:scaleAndReferenceRange</a><a name="Observation.referenceRange.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/backboneelement.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Provides the scale factors as sent by the 20601 device</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0251.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.low" title="The Scale-and-Range-SpecificationX.lower-absolute-value from the RTSA metric where X is one of 8, 16, or 32.">low</a><a name="Observation.referenceRange.low"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#SimpleQuantity" title="Quantity">SimpleQuantity</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Low Range, if relevant</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02510.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.low.value" title="This is the value from the Scale-and-Range-SpecificationX.lower-absolute-value attribute where X is 8, 16, or 32. It is the minimum value that will be reported by the sensor. The attribute reports the value as an Mder FLOAT. Note that the word 'absolute' does not mean the mathematical absolute value!">value</a><a name="Observation.referenceRange.low.value"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Numerical value (with implicit precision)</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02510.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.low.system" title="This value identifies the MDC coding system">system</a><a name="Observation.referenceRange.low.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">System that defines coded unit form</span><br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">http://unitsofmeasure.org</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02500.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.low.code" title="This unit code shall be the same as reported in the valueSampledData">code</a><a name="Observation.referenceRange.low.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Coded form of the unit</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0241.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.high">high</a><a name="Observation.referenceRange.high"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#SimpleQuantity" title="Quantity">SimpleQuantity</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">High Range, if relevant</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02410.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.high.value" title="This is the value from the Scale-and-Range-SpecificationX.upper-absolute-value attribute where X is 8, 16, or 32. It is the maximum value that will be reported by the sensor. The attribute reports the value as an Mder FLOAT. Note that the word 'absolute' does not mean the mathematical absolute value!">value</a><a name="Observation.referenceRange.high.value"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#decimal">decimal</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Numerical value (with implicit precision)</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02410.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.high.system" title="This value identifies theUCUM coding system">system</a><a name="Observation.referenceRange.high.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">System that defines coded unit form</span><br/><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">http://unitsofmeasure.org</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck02400.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-PhdRtsaObservation-definitions.html#Observation.referenceRange:scaleAndReferenceRange.high.code" title="This unit code shall be the same as reported in the valueSampledData">code</a><a name="Observation.referenceRange.high.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4B/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Coded form of the unit</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="dev"/>
</extension>
<url
value="http://hl7.org/fhir/uv/phd/StructureDefinition/PhdRtsaObservation"/>
<version value="2.0.0-ballot"/>
<name value="PhdRtsaObservation"/>
<status value="draft"/>
<date value="2017-06-02T14:29:52.39367-04:00"/>
<publisher value="HL7 International / Health Care Devices"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/healthcaredevices"/>
</telecom>
</contact>
<description
value="StructureDefinition for Observation Resources representing measurement data coming from a medical device where the measurement is a waveform."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<fhirVersion value="4.3.0"/>
<mapping>
<identity value="workflow"/>
<uri value="http://hl7.org/fhir/workflow"/>
<name value="Workflow Pattern"/>
</mapping>
<mapping>
<identity value="sct-concept"/>
<uri value="http://snomed.info/conceptdomain"/>
<name value="SNOMED CT Concept Domain Binding"/>
</mapping>
<mapping>
<identity value="v2"/>
<uri value="http://hl7.org/v2"/>
<name value="HL7 v2 Mapping"/>
</mapping>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM Mapping"/>
</mapping>
<mapping>
<identity value="w5"/>
<uri value="http://hl7.org/fhir/fivews"/>
<name value="FiveWs Pattern Mapping"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<uri value="http://snomed.org/attributebinding"/>
<name value="SNOMED CT Attribute Binding"/>
</mapping>
<kind value="resource"/>
<abstract value="false"/>
<type value="Observation"/>
<baseDefinition
value="http://hl7.org/fhir/uv/phd/StructureDefinition/PhdBaseObservation"/>
<derivation value="constraint"/>
<snapshot>
<element id="Observation">
<path value="Observation"/>
<short value="Measurements and simple assertions"/>
<definition
value="The PhdRtsaObservation reports PHD measurements that contain a Simple-Sa-Observed-Value attribute."/>
<comment
value="Used for RTSA (waveform) observations from Personal Health Devices"/>
<alias value="Vital Signs"/>
<alias value="Measurement"/>
<alias value="Results"/>
<alias value="Tests"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation"/>
<min value="0"/>
<max value="*"/>
</base>
<constraint>
<key value="dom-2"/>
<severity value="error"/>
<human
value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
<expression value="contained.contained.empty()"/>
<xpath value="not(parent::f:contained and f:contained)"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-3"/>
<severity value="error"/>
<human
value="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"/>
<expression
value="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()"/>
<xpath
value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-4"/>
<severity value="error"/>
<human
value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
<expression
value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
<xpath
value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-5"/>
<severity value="error"/>
<human
value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
<expression value="contained.meta.security.empty()"/>
<xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown
value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
</extension>
<key value="dom-6"/>
<severity value="warning"/>
<human
value="A resource should have narrative for robust management"/>
<expression value="text.`div`.exists()"/>
<xpath value="exists(f:text/h:div)"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="obs-6"/>
<severity value="error"/>
<human
value="dataAbsentReason SHALL only be present if Observation.value[x] is not present"/>
<expression value="dataAbsentReason.empty() or value.empty()"/>
<xpath
value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/>
</constraint>
<constraint>
<key value="obs-7"/>
<severity value="error"/>
<human
value="If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present"/>
<expression
value="value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()"/>
<xpath
value="not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@value]))"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Entity. Role, or Act"/>
</mapping>
<mapping>
<identity value="workflow"/>
<map value="Event"/>
</mapping>
<mapping>
<identity value="sct-concept"/>
<map value="< 363787002 |Observable entity|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Observation[classCode=OBS, moodCode=EVN]"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="clinical.diagnostics"/>
</mapping>
</element>
<element id="Observation.id">
<path value="Observation.id"/>
<short value="Logical id of this artifact"/>
<definition
value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
<comment
value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Observation.meta">
<path value="Observation.meta"/>
<short value="Metadata about the resource"/>
<definition
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Resource.meta"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Meta"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Observation.meta.id">
<path value="Observation.meta.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.meta.extension">
<path value="Observation.meta.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.meta.versionId">
<path value="Observation.meta.versionId"/>
<short value="Version specific identifier"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Meta.versionId"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="id"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Observation.meta.lastUpdated">
<path value="Observation.meta.lastUpdated"/>
<short value="When the resource version last changed"/>
<definition
value="When the resource last changed - e.g. when the version changed."/>
<comment
value="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](http://hl7.org/fhir/R4B/http.html#read) interaction."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Meta.lastUpdated"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="instant"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Observation.meta.source">
<path value="Observation.meta.source"/>
<short value="Identifies where the resource comes from"/>
<definition
value="A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) 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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Meta.source"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Observation.meta.profile">
<path value="Observation.meta.profile"/>
<short value="Profiles this resource claims to conform to"/>
<definition
value="A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url)."/>
<comment
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Meta.profile"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="canonical"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/StructureDefinition"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Observation.meta.security">
<path value="Observation.meta.security"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<discriminator>
<type value="value"/>
<path value="code"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Security Labels applied to this resource"/>
<definition
value="Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure."/>
<comment
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Meta.security"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="Security Labels from the Healthcare Privacy and Security Classification System."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SecurityLabels"/>
</extension>
<strength value="extensible"/>
<valueSet value="http://hl7.org/fhir/ValueSet/security-labels"/>
</binding>
</element>
<element id="Observation.meta.security:PhdHtest">
<path value="Observation.meta.security"/>
<sliceName value="PhdHtest"/>
<short
value="Security value set to HTEST when measurement status indicates demo or test data"/>
<definition
value="Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Meta.security"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="Security Labels from the Healthcare Privacy and Security Classification System."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SecurityLabels"/>
</extension>
<strength value="extensible"/>
<valueSet value="http://hl7.org/fhir/ValueSet/security-labels"/>
</binding>
</element>
<element id="Observation.meta.security:PhdHtest.id">
<path value="Observation.meta.security.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.meta.security:PhdHtest.extension">
<path value="Observation.meta.security.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.meta.security:PhdHtest.system">
<path value="Observation.meta.security.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element id="Observation.meta.security:PhdHtest.version">
<path value="Observation.meta.security.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Observation.meta.security:PhdHtest.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.meta.security.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
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)."/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<fixedCode value="HTEST"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element id="Observation.meta.security:PhdHtest.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.meta.security.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element id="Observation.meta.security:PhdHtest.userSelected">
<path value="Observation.meta.security.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.meta.tag">
<path value="Observation.meta.tag"/>
<short value="Tags applied to this resource"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Meta.tag"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Tags"/>
</extension>
<strength value="example"/>
<valueSet value="http://hl7.org/fhir/ValueSet/common-tags"/>
</binding>
</element>
<element id="Observation.implicitRules">
<path value="Observation.implicitRules"/>
<short value="A set of rules under which this content was created"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.implicitRules"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="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"/>
<isSummary value="true"/>
</element>
<element id="Observation.language">
<path value="Observation.language"/>
<short value="Language of the resource content"/>
<definition
value="The base language in which the resource is written."/>
<comment
value="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)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.language"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language"/>
</extension>
<strength value="preferred"/>
<description value="IETF language tag"/>
<valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
</binding>
</element>
<element id="Observation.text">
<path value="Observation.text"/>
<short value="Text summary of the resource, for human interpretation"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="narrative"/>
<alias value="html"/>
<alias value="xhtml"/>
<alias value="display"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="DomainResource.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Narrative"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Act.text?"/>
</mapping>
</element>
<element id="Observation.contained">
<path value="Observation.contained"/>
<short value="Contained, inline Resources"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="inline resources"/>
<alias value="anonymous resources"/>
<alias value="contained resources"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.contained"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Resource"/>
</type>
<constraint>
<key value="dom-r4b"/>
<severity value="warning"/>
<human
value="Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems"/>
<expression
value="($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)"/>
<xpath
value="not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:PackagedProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedAuthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citation|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDefinition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingredient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic)"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.extension">
<path value="Observation.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<ordered value="false"/>
<rules value="open"/>
</slicing>
<short value="Extension"/>
<definition value="An Extension"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Observation.extension:GatewayDevice">
<path value="Observation.extension"/>
<sliceName value="GatewayDevice"/>
<short value="Gateway Device"/>
<definition
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
</element>
<element id="Observation.modifierExtension">
<path value="Observation.modifierExtension"/>
<short value="Extensions that cannot be ignored"/>
<definition
value="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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.identifier">
<path value="Observation.identifier"/>
<slicing>
<discriminator>
<type value="exists"/>
<path value="value"/>
</discriminator>
<discriminator>
<type value="exists"/>
<path value="system"/>
</discriminator>
<discriminator>
<type value="exists"/>
<path value="type"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Business Identifier for observation"/>
<definition value="A unique identifier assigned to this observation."/>
<requirements
value="Allows observations to be distinguished and referenced."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.identifier"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.identifier"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.identifier"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="OBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="id"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate">
<path value="Observation.identifier"/>
<sliceName value="conditionalCreate"/>
<short
value="Unique identifier of this measurement for a given patient and device"/>
<definition
value="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."/>
<comment
value="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."/>
<requirements
value="Allows observations to be distinguished in a selective enough manner to prevent resource duplication."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.identifier"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.identifier"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.identifier"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="OBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="id"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.id">
<path value="Observation.identifier.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.extension">
<path value="Observation.identifier.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.use">
<path value="Observation.identifier.use"/>
<short value="usual | official | temp | secondary | old (If known)"/>
<definition value="The purpose of this identifier."/>
<comment
value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary."/>
<requirements
value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Identifier.use"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one."/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="Identifies the purpose for this identifier, if known ."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse"/>
</extension>
<strength value="required"/>
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.3.0"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Role.code or implied by context"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.type">
<path value="Observation.identifier.type"/>
<short value="Description of identifier"/>
<definition
value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose."/>
<comment
value="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."/>
<requirements
value="Allows users to make use of identifiers when the identifier system is not known."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Identifier.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType"/>
</extension>
<strength value="extensible"/>
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="CX.5"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Role.code or implied by context"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.system">
<path value="Observation.identifier.system"/>
<short value="The namespace for the identifier value"/>
<definition
value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique."/>
<comment value="Identifier.system is always case sensitive."/>
<requirements
value="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."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Identifier.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<example>
<label value="General"/>
<valueUri value="http://www.acme.com/identifiers/patient"/>
</example>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="CX.4 / EI-2-4"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="II.root or Role.id.root"/>
</mapping>
<mapping>
<identity value="servd"/>
<map value="./IdentifierType"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.value">
<path value="Observation.identifier.value"/>
<short value="The value that is unique"/>
<definition
value="The portion of the identifier typically relevant to the user and which is unique within the context of the system."/>
<comment
value="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](http://hl7.org/fhir/R4B/extension-rendered-value.html). 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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Identifier.value"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<example>
<label value="General"/>
<valueString value="123456"/>
</example>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="CX.1 / EI.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"/>
</mapping>
<mapping>
<identity value="servd"/>
<map value="./Value"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.period">
<path value="Observation.identifier.period"/>
<short value="Time period when id is/was valid for use"/>
<definition
value="Time period during which identifier is/was valid for use."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Identifier.period"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="CX.7 + CX.8"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="Role.effectiveTime or implied by context"/>
</mapping>
<mapping>
<identity value="servd"/>
<map value="./StartDate and ./EndDate"/>
</mapping>
</element>
<element id="Observation.identifier:conditionalCreate.assigner">
<path value="Observation.identifier.assigner"/>
<short value="Organization that issued id (may be just text)"/>
<definition value="Organization that issued/manages the identifier."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Identifier.assigner"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="CX.4 / (CX.4,CX.9,CX.10)"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"/>
</mapping>
<mapping>
<identity value="servd"/>
<map value="./IdentifierIssuingAuthority"/>
</mapping>
</element>
<element id="Observation.basedOn">
<path value="Observation.basedOn"/>
<short value="Fulfills plan, proposal or order"/>
<definition
value="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."/>
<requirements
value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon."/>
<alias value="Fulfills"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.basedOn"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/DeviceRequest"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.basedOn"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="ORC"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/>
</mapping>
</element>
<element id="Observation.partOf">
<path value="Observation.partOf"/>
<short value="Part of referenced event"/>
<definition
value="A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure."/>
<comment
value="To link an Observation to an Encounter use `encounter`. See the [Notes](http://hl7.org/fhir/R4B/observation.html#obsgrouping) below for guidance on referencing another Observation."/>
<alias value="Container"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.partOf"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MedicationStatement"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.partOf"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="Varies by domain"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".outboundRelationship[typeCode=FLFS].target"/>
</mapping>
</element>
<element id="Observation.status">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
<valueString value="default: final"/>
</extension>
<path value="Observation.status"/>
<short value="registered | preliminary | final | amended +"/>
<definition
value="The status of the result value. Either 'final' or 'preliminary'"/>
<comment
value="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'"/>
<requirements
value="Need to track the status of individual results. Some results are finalized before the whole report is finalized."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.status"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="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"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationStatus"/>
</extension>
<strength value="required"/>
<description value="Codes providing the status of an observation."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/observation-status|4.3.0"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Event.status"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.status"/>
</mapping>
<mapping>
<identity value="sct-concept"/>
<map value="< 445584004 |Report by finality status|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-11"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise""/>
</mapping>
</element>
<element id="Observation.category">
<path value="Observation.category"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="coding.code"/>
</discriminator>
<discriminator>
<type value="value"/>
<path value="coding.system"/>
</discriminator>
<ordered value="false"/>
<rules value="open"/>
</slicing>
<short value="Classification of type of observation"/>
<definition
value="A code that classifies the general type of observation being made."/>
<comment
value="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."/>
<requirements
value="Used for filtering what observations are retrieved and displayed."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="Observation.category"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCategory"/>
</extension>
<strength value="preferred"/>
<description value="Codes for high level observation categories."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/>
</binding>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation">
<path value="Observation.category"/>
<sliceName value="PHD-Observation"/>
<short value="Classification of type of observation"/>
<definition
value="A code that classifies the general type of observation being made."/>
<comment
value="The category enables identifying observations generated by PHDs."/>
<requirements
value="Used for filtering what observations are retrieved and displayed."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.category"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCategory"/>
</extension>
<strength value="preferred"/>
<description value="Codes for high level observation categories."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/>
</binding>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.id">
<path value="Observation.category.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.extension">
<path value="Observation.category.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding">
<path value="Observation.category.coding"/>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.id">
<path value="Observation.category.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.extension">
<path value="Observation.category.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.system">
<path value="Observation.category.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri
value="http://hl7.org/fhir/uv/phd/CodeSystem/PhdObservationCategories"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.version">
<path value="Observation.category.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.category.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
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)."/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<fixedCode value="phd-observation"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.category.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.coding.userSelected">
<path value="Observation.category.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.category:PHD-Observation.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.category.text"/>
<short value="Plain text representation of the concept"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="Observation.category:vitalSignsCategory">
<path value="Observation.category"/>
<sliceName value="vitalSignsCategory"/>
<short
value="Required by the FHIR specification if the measurement value is a vital sign"/>
<definition
value="A code that classifies the general type of observation being made."/>
<comment
value="Vitals signs are not too common in waveforms but one might have pulse rates"/>
<requirements
value="Used for filtering what observations are retrieved and displayed."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.category"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCategory"/>
</extension>
<strength value="preferred"/>
<description value="Codes for high level observation categories."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-category"/>
</binding>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code"/>
</mapping>
</element>
<element id="Observation.category:vitalSignsCategory.id">
<path value="Observation.category.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.category:vitalSignsCategory.extension">
<path value="Observation.category.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.category:vitalSignsCategory.coding">
<path value="Observation.category.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.category:vitalSignsCategory.coding:vitalSigns">
<path value="Observation.category.coding"/>
<sliceName value="vitalSigns"/>
<short value="Required Vital Signs category code system entry"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.id">
<path value="Observation.category.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.extension">
<path value="Observation.category.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.system">
<path value="Observation.category.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.version">
<path value="Observation.category.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.category.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition value="The 'vital-signs' category code"/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<fixedCode value="vital-signs"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.category.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.userSelected">
<path value="Observation.category.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.category:vitalSignsCategory.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.category.text"/>
<short value="Plain text representation of the concept"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="Observation.code">
<path value="Observation.code"/>
<short value="Type of observation (code / type)"/>
<definition
value="Describes what was observed. Sometimes this is called the observation "name"."/>
<comment
value="*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."/>
<requirements
value="Knowing what kind of observation is being made is essential to understanding the observation."/>
<alias value="Name"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.code"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCode"/>
</extension>
<strength value="example"/>
<description value="Codes identifying names of simple observations."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-codes"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Event.code"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.what[x]"/>
</mapping>
<mapping>
<identity value="sct-concept"/>
<map
value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="code"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="116680003 |Is a|"/>
</mapping>
</element>
<element id="Observation.code.id">
<path value="Observation.code.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.code.extension">
<path value="Observation.code.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.code.coding">
<path value="Observation.code.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType">
<path value="Observation.code.coding"/>
<sliceName value="MDCType"/>
<short value="The 11073-10101 MDC code for the measurement"/>
<definition value="This MDC code expresses what the measurement is."/>
<comment
value="The value for the code can be obtained from the IEEE 11073-10206 Observation.type attribute."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.id">
<path value="Observation.code.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.extension">
<path value="Observation.code.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.system">
<path value="Observation.code.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="urn:iso:std:iso:11073:10101"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.version">
<path value="Observation.code.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.code.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
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)."/>
<comment value="Required for all measurements"/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.code.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element id="Observation.code.coding:MDCType.userSelected">
<path value="Observation.code.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding">
<path value="Observation.code.coding"/>
<sliceName value="LoincCoding"/>
<short value="The LOINC code for the measurement"/>
<definition value="This LOINC code expresses what the measurement is"/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.id">
<path value="Observation.code.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.extension">
<path value="Observation.code.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.system">
<path value="Observation.code.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="http://loinc.org"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.version">
<path value="Observation.code.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.code.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
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)."/>
<comment value="Required if the measurement is a vital sign"/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.code.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element id="Observation.code.coding:LoincCoding.userSelected">
<path value="Observation.code.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.code.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.code.text"/>
<short
value="It is recommended to display at least the reference identifier for the MDC code"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="Observation.subject">
<path value="Observation.subject"/>
<short value="Who and/or what the observation is about"/>
<definition
value="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 `focus` element or the `code` itself specifies the actual focus of the observation."/>
<comment
value="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."/>
<requirements
value="Observations have no value if you don't know who or what they're about."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.subject"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Device"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Location"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Medication"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Substance"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.subject"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="PID-3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="participation[typeCode=RTGT]"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject"/>
</mapping>
</element>
<element id="Observation.subject.id">
<path value="Observation.subject.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.subject.extension">
<path value="Observation.subject.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.subject.reference">
<path value="Observation.subject.reference"/>
<short value="Literal reference, Relative, internal or absolute URL"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Reference.reference"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<condition value="ref-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.subject.type">
<path value="Observation.subject.type"/>
<short value="Type the reference refers to (e.g. "Patient")"/>
<definition
value="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)."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Reference.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="Aa resource (or, for logical models, the URI of the logical model)."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt"/>
</extension>
<strength value="extensible"/>
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types"/>
</binding>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.subject.identifier">
<path value="Observation.subject.identifier"/>
<short value="Logical reference, when literal reference is not known"/>
<definition
value="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."/>
<comment
value="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)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Reference.identifier"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value=".identifier"/>
</mapping>
</element>
<element id="Observation.subject.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.subject.display"/>
<short value="Text alternative for the resource"/>
<definition
value="Plain text narrative that identifies the resource in addition to the resource reference."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Reference.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.focus">
<path value="Observation.focus"/>
<short
value="What the observation is about, when it is not about the subject of record"/>
<definition
value="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."/>
<comment
value="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 `specimen` if a reference to a specimen is required. If a code is required instead of a resource use either `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/R4B/extension-observation-focuscode.html)."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.focus"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Resource"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="participation[typeCode=SBJ]"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject"/>
</mapping>
</element>
<element id="Observation.encounter">
<path value="Observation.encounter"/>
<short value="Healthcare event during which this observation is made"/>
<definition
value="The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made."/>
<comment
value="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)."/>
<requirements
value="For some observations it may be important to know the link between an observation and a particular encounter."/>
<alias value="Context"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.encounter"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.context"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.context"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="PV1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
</mapping>
</element>
<element id="Observation.effective[x]">
<path value="Observation.effective[x]"/>
<short value="Clinically relevant time/time-period for observation"/>
<definition
value="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."/>
<comment
value="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](http://hl7.org/fhir/R4B/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events."/>
<requirements
value="Knowing when an observation was deemed true is important to its relevance as well as determining trends."/>
<alias value="Occurrence"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.effective[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="dateTime"/>
</type>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.occurrence[x]"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.done[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="effectiveTime"/>
</mapping>
</element>
<element id="Observation.issued">
<path value="Observation.issued"/>
<short value="Date/Time this version was made available"/>
<definition
value="The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified."/>
<comment
value="For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/R4B/resource-definitions.html#Meta.lastUpdated) time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.issued"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="instant"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.recorded"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="participation[typeCode=AUT].time"/>
</mapping>
</element>
<element id="Observation.performer">
<path value="Observation.performer"/>
<short value="Who is responsible for the observation"/>
<definition
value="Who was responsible for asserting the observed value as "true"."/>
<requirements
value="May give a degree of confidence in the observation and also indicates where follow-up questions should be directed."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.performer"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Event.performer.actor"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.actor"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="OBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="participation[typeCode=PRF]"/>
</mapping>
</element>
<element id="Observation.value[x]">
<path value="Observation.value[x]"/>
<short value="Actual result"/>
<definition
value="The information determined as a result of making the observation, when the observation consists of a periodic sample of numeric measurements."/>
<comment
value="The RTSA metric is typically used for reporting waveform type data such as an ECG trace, spirometer exhalation rates, pulse oximetry pleth waves, etc., though it can be used to report any set of numric measurements that are periodic. The periodicity is important as the time stamps of each individual entry is known from the start time and the period. Since the amount of data to be transmitted can be large, the data is scaled in such a way to minimize the number of bits taken up by each entry (though the minimization is restricted to 8, 16, or 32 bits). This scaling information is sent along with the start time and period in order for the receiver to recover the original data and to obtain the time stamp of each data point. In theory, this data could be sent using countless phdNumericObservation type resources at a great cost in bandwidth!"/>
<requirements
value="An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="SampledData"/>
</type>
<condition value="obs-7"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="sct-concept"/>
<map value="< 441742003 |Evaluation finding|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX.2, OBX.5, OBX.6"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363714003 |Interprets|"/>
</mapping>
</element>
<element id="Observation.value[x].id">
<path value="Observation.value[x].id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.value[x].extension">
<path value="Observation.value[x].extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.value[x].origin">
<path value="Observation.value[x].origin"/>
<short value="Scaling intecept value and units"/>
<definition
value="The 'origin' data type contains the 'y-intercept' for the equation that relates the scaled data to the actual data. If valueSampledData.data[i] is the array of sampled scaled data, the actual data is obtained by:
x[i] =valueSampledData.data[i] * valueSampledData.factor + valueSampledData.origin.value"/>
<comment
value="The data sent in the Sa-Simple-Observation-Value array is also scaled. Thus with the proper setting of the valueSampledData.origin.value and valueSampledData.factor, the data from the IEEE device can be placed into the data[i] array without modification."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="SampledData.origin"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="SLIST.origin"/>
</mapping>
</element>
<element id="Observation.value[x].origin.id">
<path value="Observation.value[x].origin.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.value[x].origin.extension">
<path value="Observation.value[x].origin.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.value[x].origin.value">
<path value="Observation.value[x].origin.value"/>
<short value="Intercept value (with implicit precision)"/>
<definition
value="The intercept value with the indicated precision of the data as determined by the device."/>
<comment
value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)."/>
<requirements
value="Precision is handled implicitly in almost all cases of measurement."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.value"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="SN.2 / CQ - N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/>
</mapping>
</element>
<element id="Observation.value[x].origin.comparator">
<path value="Observation.value[x].origin.comparator"/>
<short
value="< | <= | >= | > - how to understand the value"/>
<definition value="Not allowed to be used in this context"/>
<requirements
value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Quantity.comparator"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<meaningWhenMissing
value="If there is no comparator, then there is no modification of the value"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="How the Quantity should be understood and represented."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="QuantityComparator"/>
</extension>
<strength value="required"/>
<valueSet
value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.3.0"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="SN.1 / CQ.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="IVL properties"/>
</mapping>
</element>
<element id="Observation.value[x].origin.unit">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.value[x].origin.unit"/>
<short value="Unit representation"/>
<definition value="A human-readable form of the unit."/>
<requirements
value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Quantity.unit"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ.unit"/>
</mapping>
</element>
<element id="Observation.value[x].origin.system">
<path value="Observation.value[x].origin.system"/>
<short value="The UCUM coding system"/>
<definition
value="The identification of the UCUM coding system that provides the coded form of the unit."/>
<requirements
value="Need to know the system that defines the coded form of the unit."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="http://unitsofmeasure.org"/>
<condition value="qty-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CO.codeSystem, PQ.translation.codeSystem"/>
</mapping>
</element>
<element id="Observation.value[x].origin.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.value[x].origin.code"/>
<short value="Coded form of the unit"/>
<definition value="The unit code."/>
<comment
value="The UCUM code translated from the MDC Unit Code attribute noting that the partition is always 4."/>
<requirements
value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ.code, MO.currency, PQ.translation.code"/>
</mapping>
</element>
<element id="Observation.value[x].period">
<path value="Observation.value[x].period"/>
<short value="Number of milliseconds between samples"/>
<definition
value="The length of time between sampling times, measured in milliseconds."/>
<comment value="This is usually a whole number."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="SampledData.period"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="GLIST.increment"/>
</mapping>
</element>
<element id="Observation.value[x].factor">
<path value="Observation.value[x].factor"/>
<short value="The scale factor"/>
<definition
value="A correction factor that is applied to the sampled data points before they are added to the origin."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="SampledData.factor"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<meaningWhenMissing
value="If no factor is assigned, the data is not adjusted before adding to the origin"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="SLIST.factor"/>
</mapping>
</element>
<element id="Observation.value[x].lowerLimit">
<path value="Observation.value[x].lowerLimit"/>
<short value="Lower limit of detection"/>
<definition
value="The lower limit of detection of the measured points. This is needed if any of the data points have the value "L" (lower than detection limit)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="SampledData.lowerLimit"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A (use SLIST.digits.nullFlavor)"/>
</mapping>
</element>
<element id="Observation.value[x].upperLimit">
<path value="Observation.value[x].upperLimit"/>
<short value="Upper limit of detection"/>
<definition
value="The upper limit of detection of the measured points. This is needed if any of the data points have the value "U" (higher than detection limit)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="SampledData.upperLimit"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A (use SLIST.digits.nullFlavor)"/>
</mapping>
</element>
<element id="Observation.value[x].dimensions">
<path value="Observation.value[x].dimensions"/>
<short value="Number of rtsa sample points at each time point"/>
<definition
value="The number of rtsa sample points at each time point. This value gives the number of data points in the valueSampledData.data[] array."/>
<comment
value="This value is obtained from the Sa-Specification.array-size field of the Sa-Specification attribute."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="SampledData.dimensions"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="positiveInt"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A (fixed to 1)"/>
</mapping>
</element>
<element id="Observation.value[x].data">
<path value="Observation.value[x].data"/>
<short
value="Decimal values with spaces, or "E" | "U" | "L""/>
<definition
value="A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) are not used. The device does not provide such individual values. "/>
<comment
value="One is strongly encouraged to use the scaling from the 11073 device as it is likely the scaling was chosen to optimize transmission. If
A = Scale-and-Range-SpecificationX.lower-absolute-value as an Mder FLOAT
B = Scale-and-Range-SpecificationX.upper-absolute-value as an Mder FLOAT
I = Scale-and-Range-SpecificationX.lower-scaled-value as a X-bit integer
J = Scale-and-Range-SpecificationX.upper-scaled-value as a X-bit integer
valueSampledData.factor is given by (A-B)/(I-J)
and
valueSampledData.origin.value = A – (A-B)*I/(I-J)
and
valueSampledData.data[i] = Sa-Simple-Observed-Value.values[i]"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="SampledData.data"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="SLIST.digits"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason">
<path value="Observation.dataAbsentReason"/>
<short
value="Populated when the Measurement-Status indicates invalid, not unavailable, or msmt ongoing"/>
<definition
value="Provides a reason why the expected value in the element Observation.valueSampledData is missing."/>
<comment value="Thre are no special values sent in RTSA data."/>
<requirements
value="For many results it is necessary to handle exceptional values in measurements."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.dataAbsentReason"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<condition value="obs-6"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason"/>
</extension>
<strength value="extensible"/>
<description
value="Codes specifying why the result (`Observation.value[x]`) is missing."/>
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value.nullFlavor"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.id">
<path value="Observation.dataAbsentReason.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.extension">
<path value="Observation.dataAbsentReason.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding">
<path value="Observation.dataAbsentReason.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault">
<path value="Observation.dataAbsentReason.coding"/>
<sliceName value="FhirDefault"/>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.id">
<path value="Observation.dataAbsentReason.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.extension">
<path value="Observation.dataAbsentReason.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.system">
<path value="Observation.dataAbsentReason.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri
value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.version">
<path value="Observation.dataAbsentReason.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.dataAbsentReason.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
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)."/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.dataAbsentReason.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Observation.dataAbsentReason.coding:FhirDefault.userSelected">
<path value="Observation.dataAbsentReason.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.dataAbsentReason.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.dataAbsentReason.text"/>
<short value="Plain text representation of the concept"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="Observation.interpretation">
<path value="Observation.interpretation"/>
<short value="High, low, normal, etc."/>
<definition
value="A categorical assessment of an observation value. For example, high, low, normal."/>
<comment
value="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."/>
<requirements
value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result."/>
<alias value="Abnormal Flag"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.interpretation"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation"/>
</extension>
<strength value="extensible"/>
<description
value="Codes identifying interpretations of observations."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map value="< 260245000 |Findings values|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-8"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363713009 |Has interpretation|"/>
</mapping>
</element>
<element id="Observation.interpretation.id">
<path value="Observation.interpretation.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.interpretation.extension">
<path value="Observation.interpretation.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.interpretation.coding">
<path value="Observation.interpretation.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Observation.interpretation.coding:MsmtStatusInterpretation">
<path value="Observation.interpretation.coding"/>
<sliceName value="MsmtStatusInterpretation"/>
<short
value="Measurement status interpretation when questionable, calibration-ongoing, validated, early-indication, threshold exceeded, alarm inhibited"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.id">
<path value="Observation.interpretation.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.extension">
<path value="Observation.interpretation.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.system">
<path value="Observation.interpretation.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri
value="http://hl7.org/fhir/uv/pocd/CodeSystem/measurement-status"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.version">
<path value="Observation.interpretation.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.interpretation.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
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)."/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.interpretation.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Observation.interpretation.coding:MsmtStatusInterpretation.userSelected">
<path value="Observation.interpretation.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.interpretation.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.interpretation.text"/>
<short value="Plain text representation of the concept"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="Observation.note">
<path value="Observation.note"/>
<short value="Comments about the observation"/>
<definition value="Comments about the observation or the results."/>
<comment
value="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."/>
<requirements
value="Need to be able to provide free text additional information."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.note"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Annotation"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map
value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="subjectOf.observationEvent[code="annotation"].value"/>
</mapping>
</element>
<element id="Observation.bodySite">
<path value="Observation.bodySite"/>
<short value="Observed body part"/>
<definition
value="Indicates the site on the subject's body where the observation was made (i.e. the target site)."/>
<comment
value="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](http://hl7.org/fhir/R4B/extension-bodysite.html)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.bodySite"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodySite"/>
</extension>
<strength value="example"/>
<description value="SNOMED CT Body site concepts"/>
<valueSet value="http://hl7.org/fhir/ValueSet/body-site"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map value="< 123037004 |Body structure|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-20"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="targetSiteCode"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="718497002 |Inherent location|"/>
</mapping>
</element>
<element id="Observation.method">
<path value="Observation.method"/>
<short value="How it was done"/>
<definition
value="Indicates the mechanism used to perform the observation."/>
<comment
value="Only used if not implicit in code for Observation.code."/>
<requirements
value="In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.method"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationMethod"/>
</extension>
<strength value="example"/>
<description value="Methods for simple observations."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-methods"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="OBX-17"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="methodCode"/>
</mapping>
</element>
<element id="Observation.specimen">
<path value="Observation.specimen"/>
<short value="Specimen used for this observation"/>
<definition
value="The specimen that was used when this observation was made."/>
<comment
value="Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.specimen"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Specimen"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="sct-concept"/>
<map value="< 123038009 |Specimen|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="SPM segment"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="participation[typeCode=SPC].specimen"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="704319004 |Inherent in|"/>
</mapping>
</element>
<element id="Observation.device">
<path value="Observation.device"/>
<short value="(Measurement) Device"/>
<definition value="The device used to generate the observation data."/>
<comment value="This field will reference the PHD Device."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.device"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Device"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/DeviceMetric"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="sct-concept"/>
<map value="< 49062001 |Device|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-17 / PRT -10"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="participation[typeCode=DEV]"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="424226004 |Using device|"/>
</mapping>
</element>
<element id="Observation.device.id">
<path value="Observation.device.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.device.extension">
<path value="Observation.device.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.device.reference">
<path value="Observation.device.reference"/>
<short value="Reference to the device responsible for the measurement"/>
<definition
value="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."/>
<comment
value="This reference points to the Device resource containing information about the sensor device that took the measurement."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Reference.reference"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<condition value="ref-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.device.type">
<path value="Observation.device.type"/>
<short value="Type the reference refers to (e.g. "Patient")"/>
<definition
value="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)."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Reference.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="Aa resource (or, for logical models, the URI of the logical model)."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt"/>
</extension>
<strength value="extensible"/>
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types"/>
</binding>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.device.identifier">
<path value="Observation.device.identifier"/>
<short value="Logical reference, when literal reference is not known"/>
<definition
value="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."/>
<comment
value="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)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Reference.identifier"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value=".identifier"/>
</mapping>
</element>
<element id="Observation.device.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.device.display"/>
<short value="Text alternative for the resource"/>
<definition
value="Plain text narrative that identifies the resource in addition to the resource reference."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Reference.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.referenceRange">
<path value="Observation.referenceRange"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="low.system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Provides guide for interpretation"/>
<definition
value="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 `referenceRange` elements would be used."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.referenceRange"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human
value="All FHIR elements must have a @value or children unless an empty Parameters resource"/>
<expression
value="hasValue() or (children().count() > id.count()) or $this is Parameters"/>
<xpath value="@value|f:*|h:div|self::f:Parameters"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="obs-3"/>
<severity value="error"/>
<human value="Must have at least a low or a high or text"/>
<expression value="low.exists() or high.exists() or text.exists()"/>
<xpath value="(exists(f:low) or exists(f:high)or exists(f:text))"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
</mapping>
</element>
<element id="Observation.referenceRange.id">
<path value="Observation.referenceRange.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.referenceRange.extension">
<path value="Observation.referenceRange.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.referenceRange.modifierExtension">
<path value="Observation.referenceRange.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.referenceRange.low">
<path value="Observation.referenceRange.low"/>
<short value="Low Range, if relevant"/>
<definition
value="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)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.low"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<condition value="obs-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX-7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value:IVL_PQ.low"/>
</mapping>
</element>
<element id="Observation.referenceRange.high">
<path value="Observation.referenceRange.high"/>
<short value="High Range, if relevant"/>
<definition
value="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)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.high"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<condition value="obs-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX-7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value:IVL_PQ.high"/>
</mapping>
</element>
<element id="Observation.referenceRange.type">
<path value="Observation.referenceRange.type"/>
<short value="Reference range qualifier"/>
<definition
value="Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range."/>
<comment
value="This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed."/>
<requirements
value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationRangeMeaning"/>
</extension>
<strength value="preferred"/>
<description value="Code for the meaning of a reference range."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map
value="< 260245000 |Findings values| OR
< 365860008 |General clinical state finding|
OR
< 250171008 |Clinical history or observation findings| OR
< 415229000 |Racial group| OR
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-10"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
</element>
<element id="Observation.referenceRange.appliesTo">
<path value="Observation.referenceRange.appliesTo"/>
<short value="Reference range population"/>
<definition
value="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 `appliesTo` are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used."/>
<comment
value="This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed."/>
<requirements
value="Need to be able to identify the target population for proper interpretation."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.referenceRange.appliesTo"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationRangeType"/>
</extension>
<strength value="example"/>
<description
value="Codes identifying the population the reference range applies to."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/referencerange-appliesto"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map
value="< 260245000 |Findings values| OR
< 365860008 |General clinical state finding|
OR
< 250171008 |Clinical history or observation findings| OR
< 415229000 |Racial group| OR
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-10"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
</element>
<element id="Observation.referenceRange.age">
<path value="Observation.referenceRange.age"/>
<short value="Applicable age range, if relevant"/>
<definition
value="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."/>
<requirements value="Some analytes vary greatly over age."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.age"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Range"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map
value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value"/>
</mapping>
</element>
<element id="Observation.referenceRange.text">
<path value="Observation.referenceRange.text"/>
<short value="Text based reference range in an observation"/>
<definition
value="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"."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX-7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value:ST"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange">
<path value="Observation.referenceRange"/>
<sliceName value="scaleAndReferenceRange"/>
<short value="Provides the scale factors as sent by the 20601 device"/>
<definition
value="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 `referenceRange` elements would be used."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human
value="All FHIR elements must have a @value or children unless an empty Parameters resource"/>
<expression
value="hasValue() or (children().count() > id.count()) or $this is Parameters"/>
<xpath value="@value|f:*|h:div|self::f:Parameters"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="obs-3"/>
<severity value="error"/>
<human value="Must have at least a low or a high or text"/>
<expression value="low.exists() or high.exists() or text.exists()"/>
<xpath value="(exists(f:low) or exists(f:high)or exists(f:text))"/>
<source value="http://hl7.org/fhir/StructureDefinition/Observation"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.id">
<path value="Observation.referenceRange.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.extension">
<path value="Observation.referenceRange.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.modifierExtension">
<path value="Observation.referenceRange.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.low">
<path value="Observation.referenceRange.low"/>
<short value="Low Range, if relevant"/>
<definition
value="The Scale-and-Range-SpecificationX.lower-absolute-value from the RTSA metric where X is one of 8, 16, or 32."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.low"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<condition value="obs-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX-7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value:IVL_PQ.low"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.low.id">
<path value="Observation.referenceRange.low.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.low.extension">
<path value="Observation.referenceRange.low.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.low.value">
<path value="Observation.referenceRange.low.value"/>
<short value="Numerical value (with implicit precision)"/>
<definition
value="This is the value from the Scale-and-Range-SpecificationX.lower-absolute-value attribute where X is 8, 16, or 32. It is the minimum value that will be reported by the sensor. The attribute reports the value as an Mder FLOAT. Note that the word 'absolute' does not mean the mathematical absolute value!"/>
<comment
value="The implicit precision in the value should always be honored. The precision is given by the Mder FLOAT."/>
<requirements
value="Precision is handled implicitly in almost all cases of measurement."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.value"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="SN.2 / CQ - N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.low.comparator">
<path value="Observation.referenceRange.low.comparator"/>
<short
value="< | <= | >= | > - how to understand the value"/>
<definition value="Not allowed to be used in this context"/>
<requirements
value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Quantity.comparator"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<meaningWhenMissing
value="If there is no comparator, then there is no modification of the value"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="How the Quantity should be understood and represented."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="QuantityComparator"/>
</extension>
<strength value="required"/>
<valueSet
value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.3.0"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="SN.1 / CQ.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="IVL properties"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.low.unit">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.referenceRange.low.unit"/>
<short value="Unit representation"/>
<definition value="A human-readable form of the unit."/>
<requirements
value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Quantity.unit"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ.unit"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.low.system">
<path value="Observation.referenceRange.low.system"/>
<short value="System that defines coded unit form"/>
<definition value="This value identifies the MDC coding system"/>
<requirements
value="Need to know the system that defines the coded form of the unit."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="http://unitsofmeasure.org"/>
<condition value="qty-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CO.codeSystem, PQ.translation.codeSystem"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.low.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.referenceRange.low.code"/>
<short value="Coded form of the unit"/>
<definition
value="This unit code shall be the same as reported in the valueSampledData"/>
<comment
value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system."/>
<requirements
value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ.code, MO.currency, PQ.translation.code"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.high">
<path value="Observation.referenceRange.high"/>
<short value="High Range, if relevant"/>
<definition
value="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)."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.high"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<condition value="obs-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX-7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value:IVL_PQ.high"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.high.id">
<path value="Observation.referenceRange.high.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.extension">
<path value="Observation.referenceRange.high.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.value">
<path value="Observation.referenceRange.high.value"/>
<short value="Numerical value (with implicit precision)"/>
<definition
value="This is the value from the Scale-and-Range-SpecificationX.upper-absolute-value attribute where X is 8, 16, or 32. It is the maximum value that will be reported by the sensor. The attribute reports the value as an Mder FLOAT. Note that the word 'absolute' does not mean the mathematical absolute value!"/>
<comment
value="The implicit precision in the value should always be honored. The precision is given by the Mder FLOAT."/>
<requirements
value="Precision is handled implicitly in almost all cases of measurement."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.value"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="decimal"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="SN.2 / CQ - N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.comparator">
<path value="Observation.referenceRange.high.comparator"/>
<short
value="< | <= | >= | > - how to understand the value"/>
<definition value="Not allowed to be used in this context"/>
<requirements
value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Quantity.comparator"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<meaningWhenMissing
value="If there is no comparator, then there is no modification of the value"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/build/StructureDefinition/binding-definition">
<valueString
value="How the Quantity should be understood and represented."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="QuantityComparator"/>
</extension>
<strength value="required"/>
<valueSet
value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.3.0"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="SN.1 / CQ.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="IVL properties"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.unit">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.referenceRange.high.unit"/>
<short value="Unit representation"/>
<definition value="A human-readable form of the unit."/>
<requirements
value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Quantity.unit"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ.unit"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.system">
<path value="Observation.referenceRange.high.system"/>
<short value="System that defines coded unit form"/>
<definition value="This value identifies theUCUM coding system"/>
<requirements
value="Need to know the system that defines the coded form of the unit."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="http://unitsofmeasure.org"/>
<condition value="qty-3"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CO.codeSystem, PQ.translation.codeSystem"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.referenceRange.high.code"/>
<short value="Coded form of the unit"/>
<definition
value="This unit code shall be the same as reported in the valueSampledData"/>
<comment
value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system."/>
<requirements
value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Quantity.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="(see OBX.6 etc.) / CQ.2"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ.code, MO.currency, PQ.translation.code"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.type">
<path value="Observation.referenceRange.type"/>
<short value="Reference range qualifier"/>
<definition
value="Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range."/>
<comment
value="This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed."/>
<requirements
value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.type"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationRangeMeaning"/>
</extension>
<strength value="preferred"/>
<description value="Code for the meaning of a reference range."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map
value="< 260245000 |Findings values| OR
< 365860008 |General clinical state finding|
OR
< 250171008 |Clinical history or observation findings| OR
< 415229000 |Racial group| OR
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-10"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.appliesTo">
<path value="Observation.referenceRange.appliesTo"/>
<short value="Reference range population"/>
<definition
value="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 `appliesTo` are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used."/>
<comment
value="This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed."/>
<requirements
value="Need to be able to identify the target population for proper interpretation."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.referenceRange.appliesTo"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationRangeType"/>
</extension>
<strength value="example"/>
<description
value="Codes identifying the population the reference range applies to."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/referencerange-appliesto"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map
value="< 260245000 |Findings values| OR
< 365860008 |General clinical state finding|
OR
< 250171008 |Clinical history or observation findings| OR
< 415229000 |Racial group| OR
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-10"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.age">
<path value="Observation.referenceRange.age"/>
<short value="Applicable age range, if relevant"/>
<definition
value="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."/>
<requirements value="Some analytes vary greatly over age."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.age"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Range"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map
value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value"/>
</mapping>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.text">
<path value="Observation.referenceRange.text"/>
<short value="Text based reference range in an observation"/>
<definition
value="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"."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.referenceRange.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX-7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value:ST"/>
</mapping>
</element>
<element id="Observation.hasMember">
<path value="Observation.hasMember"/>
<short value="Related resource that belongs to the Observation group"/>
<definition
value="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."/>
<comment
value="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](http://hl7.org/fhir/R4B/observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](questionnaireresponse.html) into a final score and represent the score as an Observation."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.hasMember"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Relationships established by OBX-4 usage"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="outBoundRelationship"/>
</mapping>
</element>
<element id="Observation.derivedFrom">
<path value="Observation.derivedFrom"/>
<short
value="Reference to the Coincident Time Stamp Observation and/or Source-Handle-Reference Observation"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.derivedFrom"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/>
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Media"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MolecularSequence"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Relationships established by OBX-4 usage"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".targetObservation"/>
</mapping>
</element>
<element id="Observation.component">
<path value="Observation.component"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="code"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Component results"/>
<definition
value="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."/>
<comment
value="For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/R4B/observation.html#notes) below."/>
<requirements
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.component"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human
value="All FHIR elements must have a @value or children unless an empty Parameters resource"/>
<expression
value="hasValue() or (children().count() > id.count()) or $this is Parameters"/>
<xpath value="@value|f:*|h:div|self::f:Parameters"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="containment by OBX-4?"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="outBoundRelationship[typeCode=COMP]"/>
</mapping>
</element>
<element id="Observation.component.id">
<path value="Observation.component.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.component.extension">
<path value="Observation.component.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.component.modifierExtension">
<path value="Observation.component.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.component.code">
<path value="Observation.component.code"/>
<short value="Type of component observation (code / type)"/>
<definition
value="Describes what was observed. Sometimes this is called the observation "code"."/>
<comment
value="*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation."/>
<requirements
value="Knowing what kind of observation is being made is essential to understanding the observation."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.component.code"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCode"/>
</extension>
<strength value="example"/>
<description value="Codes identifying names of simple observations."/>
<valueSet value="http://hl7.org/fhir/ValueSet/observation-codes"/>
</binding>
<mapping>
<identity value="w5"/>
<map value="FiveWs.what[x]"/>
</mapping>
<mapping>
<identity value="sct-concept"/>
<map
value="< 363787002 |Observable entity| OR
< 386053000 |Evaluation procedure|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="code"/>
</mapping>
</element>
<element id="Observation.component.value[x]">
<path value="Observation.component.value[x]"/>
<short value="Actual component result"/>
<definition
value="The information determined as a result of making the observation, if the information has a simple value."/>
<comment
value="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](http://hl7.org/fhir/R4B/observation.html#notes) below."/>
<requirements
value="An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.component.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
</type>
<type>
<code value="CodeableConcept"/>
</type>
<type>
<code value="string"/>
</type>
<type>
<code value="boolean"/>
</type>
<type>
<code value="integer"/>
</type>
<type>
<code value="Range"/>
</type>
<type>
<code value="Ratio"/>
</type>
<type>
<code value="SampledData"/>
</type>
<type>
<code value="time"/>
</type>
<type>
<code value="dateTime"/>
</type>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="sct-concept"/>
<map
value="363714003 |Interprets| < 441742003 |Evaluation finding|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX.2, OBX.5, OBX.6"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363714003 |Interprets|"/>
</mapping>
</element>
<element id="Observation.component.dataAbsentReason">
<path value="Observation.component.dataAbsentReason"/>
<short value="Why the component result is missing"/>
<definition
value="Provides a reason why the expected value in the element Observation.component.value[x] is missing."/>
<comment
value=""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."/>
<requirements
value="For many results it is necessary to handle exceptional values in measurements."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Observation.component.dataAbsentReason"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<condition value="obs-6"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason"/>
</extension>
<strength value="extensible"/>
<description
value="Codes specifying why the result (`Observation.value[x]`) is missing."/>
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value.nullFlavor"/>
</mapping>
</element>
<element id="Observation.component.interpretation">
<path value="Observation.component.interpretation"/>
<short value="High, low, normal, etc."/>
<definition
value="A categorical assessment of an observation value. For example, high, low, normal."/>
<comment
value="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."/>
<requirements
value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result."/>
<alias value="Abnormal Flag"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.component.interpretation"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation"/>
</extension>
<strength value="extensible"/>
<description
value="Codes identifying interpretations of observations."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map value="< 260245000 |Findings values|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-8"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363713009 |Has interpretation|"/>
</mapping>
</element>
<element id="Observation.component.referenceRange">
<path value="Observation.component.referenceRange"/>
<short value="Provides guide for interpretation of component result"/>
<definition
value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.component.referenceRange"/>
<min value="0"/>
<max value="*"/>
</base>
<contentReference
value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent">
<path value="Observation.component"/>
<sliceName value="supplementalTypesComponent"/>
<short
value="Supplemental Type: A further description of the measurement type."/>
<definition
value="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."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.component"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human
value="All FHIR elements must have a @value or children unless an empty Parameters resource"/>
<expression
value="hasValue() or (children().count() > id.count()) or $this is Parameters"/>
<xpath value="@value|f:*|h:div|self::f:Parameters"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="containment by OBX-4?"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="outBoundRelationship[typeCode=COMP]"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent.id">
<path value="Observation.component.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent.extension">
<path value="Observation.component.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.modifierExtension">
<path value="Observation.component.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R4B/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent.code">
<path value="Observation.component.code"/>
<short value="Type of component observation (code / type)"/>
<definition
value="Describes what was observed. Sometimes this is called the observation "code"."/>
<comment
value="*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation."/>
<requirements
value="Knowing what kind of observation is being made is essential to understanding the observation."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.component.code"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<strength value="required"/>
<valueSet
value="http://hl7.org/fhir/uv/phd/ValueSet/CodeableConcept11073MDC"/>
</binding>
<mapping>
<identity value="w5"/>
<map value="FiveWs.what[x]"/>
</mapping>
<mapping>
<identity value="sct-concept"/>
<map
value="< 363787002 |Observable entity| OR
< 386053000 |Evaluation procedure|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="code"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent.code.id">
<path value="Observation.component.code.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.extension">
<path value="Observation.component.code.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding">
<path value="Observation.component.code.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType">
<path value="Observation.component.code.coding"/>
<sliceName value="MdcType"/>
<short value="The 11073-10101 MDC code for the measurement"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.id">
<path value="Observation.component.code.coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.extension">
<path value="Observation.component.code.coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.system">
<path value="Observation.component.code.coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="urn:iso:std:iso:11073:10101"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.version">
<path value="Observation.component.code.coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.component.code.coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
value="68193 is the 32-bit nomenclature code indicating a 'Supplemental-Types' value"/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<fixedCode value="68193"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.component.code.coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.code.coding:MdcType.userSelected">
<path value="Observation.component.code.coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent.code.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.component.code.text"/>
<short value="Plain text representation of the concept"/>
<definition
value="It is recommended to display at least the reference identifier for the Supplemental-Types which is MDC_ATTR_SUPPLEMENTAL_TYPES"/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="Observation.component:supplementalTypesComponent.value[x]">
<path value="Observation.component.value[x]"/>
<slicing>
<discriminator>
<type value="type"/>
<path value="$this"/>
</discriminator>
<ordered value="false"/>
<rules value="closed"/>
</slicing>
<short value="Actual component result"/>
<definition
value="The information determined as a result of making the observation, if the information has a simple value."/>
<comment
value="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](http://hl7.org/fhir/R4B/observation.html#notes) below."/>
<requirements
value="An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.component.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="sct-concept"/>
<map
value="363714003 |Interprets| < 441742003 |Evaluation finding|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX.2, OBX.5, OBX.6"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363714003 |Interprets|"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept">
<path value="Observation.component.value[x]"/>
<sliceName value="valueCodeableConcept"/>
<short value="Actual component result"/>
<definition
value="The supplemental information determined as a result of making the observation, if the information is a code."/>
<comment
value="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](http://hl7.org/fhir/R4B/observation.html#notes) below."/>
<requirements
value="An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Observation.component.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="sct-concept"/>
<map
value="363714003 |Interprets| < 441742003 |Evaluation finding|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX.2, OBX.5, OBX.6"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363714003 |Interprets|"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.id">
<path value="Observation.component.value[x].id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.extension">
<path value="Observation.component.value[x].extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding">
<path value="Observation.component.value[x].coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType">
<path value="Observation.component.value[x].coding"/>
<sliceName value="MDCType"/>
<short value="Required MDC code entry."/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.id">
<path value="Observation.component.value[x].coding.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.extension">
<path value="Observation.component.value[x].coding.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.system">
<path value="Observation.component.value[x].coding.system"/>
<short value="Identity of the terminology system"/>
<definition
value="The identification of the code system that defines the meaning of the symbol in the code."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="urn:iso:std:iso:11073:10101"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.version">
<path value="Observation.component.value[x].coding.version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.code">
<extension
url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
<valueBoolean value="true"/>
</extension>
<path value="Observation.component.value[x].coding.code"/>
<short value="Symbol in syntax defined by the system"/>
<definition
value="For the given Supplemental-Types entry the code here is given by: partition * 2**16 + term code"/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.component.value[x].coding.display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.coding:MDCType.userSelected">
<path value="Observation.component.value[x].coding.userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.value[x]:valueCodeableConcept.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Observation.component.value[x].text"/>
<short value="Plain text representation of the concept"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.dataAbsentReason">
<path value="Observation.component.dataAbsentReason"/>
<short value="Why the component result is missing"/>
<definition
value="Provides a reason why the expected value in the element Observation.component.value[x] is missing."/>
<comment
value=""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."/>
<requirements
value="For many results it is necessary to handle exceptional values in measurements."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Observation.component.dataAbsentReason"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<condition value="obs-6"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason"/>
</extension>
<strength value="extensible"/>
<description
value="Codes specifying why the result (`Observation.value[x]`) is missing."/>
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
</binding>
<mapping>
<identity value="v2"/>
<map value="N/A"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="value.nullFlavor"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.interpretation">
<path value="Observation.component.interpretation"/>
<short value="High, low, normal, etc."/>
<definition
value="A categorical assessment of an observation value. For example, high, low, normal."/>
<comment
value="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."/>
<requirements
value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result."/>
<alias value="Abnormal Flag"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.component.interpretation"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation"/>
</extension>
<strength value="extensible"/>
<description
value="Codes identifying interpretations of observations."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
</binding>
<mapping>
<identity value="sct-concept"/>
<map value="< 260245000 |Findings values|"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="OBX-8"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="interpretationCode"/>
</mapping>
<mapping>
<identity value="sct-attr"/>
<map value="363713009 |Has interpretation|"/>
</mapping>
</element>
<element
id="Observation.component:supplementalTypesComponent.referenceRange">
<path value="Observation.component.referenceRange"/>
<short value="Provides guide for interpretation of component result"/>
<definition
value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Observation.component.referenceRange"/>
<min value="0"/>
<max value="*"/>
</base>
<contentReference
value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="v2"/>
<map value="OBX.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
</mapping>
</element>
</snapshot>
<differential>
<element id="Observation">
<path value="Observation"/>
<definition
value="The PhdRtsaObservation reports PHD measurements that contain a Simple-Sa-Observed-Value attribute."/>
<comment
value="Used for RTSA (waveform) observations from Personal Health Devices"/>
</element>
<element id="Observation.category:vitalSignsCategory">
<path value="Observation.category"/>
<sliceName value="vitalSignsCategory"/>
<short
value="Required by the FHIR specification if the measurement value is a vital sign"/>
<comment
value="Vitals signs are not too common in waveforms but one might have pulse rates"/>
<min value="0"/>
<max value="*"/>
</element>
<element id="Observation.category:vitalSignsCategory.coding">
<path value="Observation.category.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<min value="1"/>
</element>
<element id="Observation.category:vitalSignsCategory.coding:vitalSigns">
<path value="Observation.category.coding"/>
<sliceName value="vitalSigns"/>
<short value="Required Vital Signs category code system entry"/>
<min value="1"/>
<max value="1"/>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.system">
<path value="Observation.category.coding.system"/>
<min value="1"/>
<fixedUri
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
</element>
<element
id="Observation.category:vitalSignsCategory.coding:vitalSigns.code">
<path value="Observation.category.coding.code"/>
<definition value="The 'vital-signs' category code"/>
<min value="1"/>
<fixedCode value="vital-signs"/>
</element>
<element id="Observation.value[x]">
<path value="Observation.value[x]"/>
<definition
value="The information determined as a result of making the observation, when the observation consists of a periodic sample of numeric measurements."/>
<comment
value="The RTSA metric is typically used for reporting waveform type data such as an ECG trace, spirometer exhalation rates, pulse oximetry pleth waves, etc., though it can be used to report any set of numric measurements that are periodic. The periodicity is important as the time stamps of each individual entry is known from the start time and the period. Since the amount of data to be transmitted can be large, the data is scaled in such a way to minimize the number of bits taken up by each entry (though the minimization is restricted to 8, 16, or 32 bits). This scaling information is sent along with the start time and period in order for the receiver to recover the original data and to obtain the time stamp of each data point. In theory, this data could be sent using countless phdNumericObservation type resources at a great cost in bandwidth!"/>
<type>
<code value="SampledData"/>
</type>
</element>
<element id="Observation.value[x].origin">
<path value="Observation.value[x].origin"/>
<short value="Scaling intecept value and units"/>
<definition
value="The 'origin' data type contains the 'y-intercept' for the equation that relates the scaled data to the actual data. If valueSampledData.data[i] is the array of sampled scaled data, the actual data is obtained by:
x[i] =valueSampledData.data[i] * valueSampledData.factor + valueSampledData.origin.value"/>
<comment
value="The data sent in the Sa-Simple-Observation-Value array is also scaled. Thus with the proper setting of the valueSampledData.origin.value and valueSampledData.factor, the data from the IEEE device can be placed into the data[i] array without modification."/>
</element>
<element id="Observation.value[x].origin.value">
<path value="Observation.value[x].origin.value"/>
<short value="Intercept value (with implicit precision)"/>
<definition
value="The intercept value with the indicated precision of the data as determined by the device."/>
<min value="1"/>
</element>
<element id="Observation.value[x].origin.system">
<path value="Observation.value[x].origin.system"/>
<short value="The UCUM coding system"/>
<definition
value="The identification of the UCUM coding system that provides the coded form of the unit."/>
<min value="1"/>
<fixedUri value="http://unitsofmeasure.org"/>
</element>
<element id="Observation.value[x].origin.code">
<path value="Observation.value[x].origin.code"/>
<definition value="The unit code."/>
<comment
value="The UCUM code translated from the MDC Unit Code attribute noting that the partition is always 4."/>
<min value="1"/>
</element>
<element id="Observation.value[x].factor">
<path value="Observation.value[x].factor"/>
<short value="The scale factor"/>
<min value="1"/>
</element>
<element id="Observation.value[x].dimensions">
<path value="Observation.value[x].dimensions"/>
<short value="Number of rtsa sample points at each time point"/>
<definition
value="The number of rtsa sample points at each time point. This value gives the number of data points in the valueSampledData.data[] array."/>
<comment
value="This value is obtained from the Sa-Specification.array-size field of the Sa-Specification attribute."/>
</element>
<element id="Observation.value[x].data">
<path value="Observation.value[x].data"/>
<definition
value="A series of data points which are decimal values separated by a single space (character u20). The special values "E" (error), "L" (below detection limit) and "U" (above detection limit) are not used. The device does not provide such individual values. "/>
<comment
value="One is strongly encouraged to use the scaling from the 11073 device as it is likely the scaling was chosen to optimize transmission. If
A = Scale-and-Range-SpecificationX.lower-absolute-value as an Mder FLOAT
B = Scale-and-Range-SpecificationX.upper-absolute-value as an Mder FLOAT
I = Scale-and-Range-SpecificationX.lower-scaled-value as a X-bit integer
J = Scale-and-Range-SpecificationX.upper-scaled-value as a X-bit integer
valueSampledData.factor is given by (A-B)/(I-J)
and
valueSampledData.origin.value = A – (A-B)*I/(I-J)
and
valueSampledData.data[i] = Sa-Simple-Observed-Value.values[i]"/>
</element>
<element id="Observation.dataAbsentReason">
<path value="Observation.dataAbsentReason"/>
<short
value="Populated when the Measurement-Status indicates invalid, not unavailable, or msmt ongoing"/>
<definition
value="Provides a reason why the expected value in the element Observation.valueSampledData is missing."/>
<comment value="Thre are no special values sent in RTSA data."/>
</element>
<element id="Observation.dataAbsentReason.coding">
<path value="Observation.dataAbsentReason.coding"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="system"/>
</discriminator>
<rules value="open"/>
</slicing>
<min value="1"/>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault">
<path value="Observation.dataAbsentReason.coding"/>
<sliceName value="FhirDefault"/>
<min value="1"/>
<max value="1"/>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.system">
<path value="Observation.dataAbsentReason.coding.system"/>
<min value="1"/>
<fixedUri
value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/>
</element>
<element id="Observation.dataAbsentReason.coding:FhirDefault.code">
<path value="Observation.dataAbsentReason.coding.code"/>
<min value="1"/>
</element>
<element id="Observation.referenceRange">
<path value="Observation.referenceRange"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="low.system"/>
</discriminator>
<rules value="open"/>
</slicing>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange">
<path value="Observation.referenceRange"/>
<sliceName value="scaleAndReferenceRange"/>
<short value="Provides the scale factors as sent by the 20601 device"/>
<min value="0"/>
<max value="1"/>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.low">
<path value="Observation.referenceRange.low"/>
<definition
value="The Scale-and-Range-SpecificationX.lower-absolute-value from the RTSA metric where X is one of 8, 16, or 32."/>
<min value="1"/>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.low.value">
<path value="Observation.referenceRange.low.value"/>
<definition
value="This is the value from the Scale-and-Range-SpecificationX.lower-absolute-value attribute where X is 8, 16, or 32. It is the minimum value that will be reported by the sensor. The attribute reports the value as an Mder FLOAT. Note that the word 'absolute' does not mean the mathematical absolute value!"/>
<comment
value="The implicit precision in the value should always be honored. The precision is given by the Mder FLOAT."/>
<min value="1"/>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.low.system">
<path value="Observation.referenceRange.low.system"/>
<definition value="This value identifies the MDC coding system"/>
<min value="1"/>
<fixedUri value="http://unitsofmeasure.org"/>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.low.code">
<path value="Observation.referenceRange.low.code"/>
<definition
value="This unit code shall be the same as reported in the valueSampledData"/>
<min value="1"/>
</element>
<element id="Observation.referenceRange:scaleAndReferenceRange.high">
<path value="Observation.referenceRange.high"/>
<min value="1"/>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.value">
<path value="Observation.referenceRange.high.value"/>
<definition
value="This is the value from the Scale-and-Range-SpecificationX.upper-absolute-value attribute where X is 8, 16, or 32. It is the maximum value that will be reported by the sensor. The attribute reports the value as an Mder FLOAT. Note that the word 'absolute' does not mean the mathematical absolute value!"/>
<comment
value="The implicit precision in the value should always be honored. The precision is given by the Mder FLOAT."/>
<min value="1"/>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.system">
<path value="Observation.referenceRange.high.system"/>
<definition value="This value identifies theUCUM coding system"/>
<min value="1"/>
<fixedUri value="http://unitsofmeasure.org"/>
</element>
<element
id="Observation.referenceRange:scaleAndReferenceRange.high.code">
<path value="Observation.referenceRange.high.code"/>
<definition
value="This unit code shall be the same as reported in the valueSampledData"/>
<min value="1"/>
</element>
</differential>
</StructureDefinition>
IG © 2016+ HL7 International / Health Care Devices. Package hl7.fhir.uv.phd#2.0.0-ballot based on FHIR 4.3.0. Generated 2024-08-16
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