Generated Narrative: ConceptMap R3-Observation-element-map-to-R4B Mapping from http://hl7.org/fhir/3.0 to http://hl7.org/fhir/4.3 Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to Observationversion: 4.3.0) Source Concept Details Relationship Target Concept Details Comment Codes from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 Codes from Observation Observation.meta meta maps to wider concept Observation.meta Observation.meta Element `Observation.meta` is mapped to FHIR R4B element `Observation.meta` as `SourceIsBroaderThanTarget`. The mappings for `Observation.meta` do not cover the following types: Meta. The mappings for `Observation.meta` do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId. Observation.implicitRules implicitRules is equivalent to Observation.implicitRules Observation.implicitRules Element `Observation.implicitRules` is mapped to FHIR R4B element `Observation.implicitRules` as `Equivalent`. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Observation.language language is equivalent to Observation.language Observation.language Element `Observation.language` is mapped to FHIR R4B element `Observation.language` as `Equivalent`. 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). Observation.text text maps to wider concept Observation.text Observation.text Element `Observation.text` is mapped to FHIR R4B element `Observation.text` as `SourceIsBroaderThanTarget`. The mappings for `Observation.text` do not cover the following types: Narrative. The mappings for `Observation.text` do not cover the following types based on type expansion: div, status. 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 in formation is added later. Observation.contained contained is equivalent to Observation.contained Observation.contained Element `Observation.contained` is mapped to FHIR R4B element `Observation.contained` as `SourceIsBroaderThanTarget`. 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. Observation.identifier identifier maps to wider concept Observation.identifier Observation.identifier Element `Observation.identifier` is mapped to FHIR R4B element `Observation.identifier` as `SourceIsBroaderThanTarget`. The mappings for `Observation.identifier` do not cover the following types: Identifier. The mappings for `Observation.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value. Observation.basedOn basedOn maps to wider concept Observation.basedOn Observation.basedOn Element `Observation.basedOn` is mapped to FHIR R4B element `Observation.basedOn` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.basedOn` with unmapped reference targets: CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ProcedureRequest, ReferralRequest. Observation.status status is equivalent to Observation.status Observation.status Element `Observation.status` is mapped to FHIR R4B element `Observation.status` as `Equivalent`. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Observation.category category is equivalent to Observation.category Observation.category Element `Observation.category` is mapped to FHIR R4B element `Observation.category` as `Equivalent`. 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. Observation.code code is equivalent to Observation.code Observation.code Element `Observation.code` is mapped to FHIR R4B element `Observation.code` as `Equivalent`. Observation.subject subject maps to wider concept Observation.subject Observation.subject Element `Observation.subject` is mapped to FHIR R4B element `Observation.subject` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.subject` with unmapped reference targets: Device, Group, Location, Patient. 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.#xD;#xD;If the target of the observation is different than the subject, the general extension [observation-focal-subject](https://hl7.org/fhir/extension-observation-focal-subject.html). may be used. However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code. Observation.context context maps to wider concept Observation.encounter Observation.encounter Element `Observation.context` is mapped to FHIR R4B element `Observation.encounter` as `SourceIsBroaderThanTarget`. The mappings for `Observation.context` do not cover the following types based on type expansion: display, identifier, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.context` with unmapped reference targets: Encounter, EpisodeOfCare. 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 or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests). Observation.effective[x] effective[x] is equivalent to Observation.effective[x] Observation.effective[x] Element `Observation.effective[x]` is mapped to FHIR R4B element `Observation.effective[x]` as `SourceIsBroaderThanTarget`. The target context `Observation.effective[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation`. At least a date should be present unless this observation is a historical report. Observation.issued issued is equivalent to Observation.issued Observation.issued Element `Observation.issued` is mapped to FHIR R4B element `Observation.issued` as `Equivalent`. Updated when the result is updated. Observation.performer performer maps to wider concept Observation.performer Observation.performer Element `Observation.performer` is mapped to FHIR R4B element `Observation.performer` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.performer` with unmapped reference targets: Organization, Patient, Practitioner, RelatedPerson. Observation.value[x] value[x] maps to wider concept Observation.value[x] Observation.value[x] Element `Observation.value[x]` is mapped to FHIR R4B element `Observation.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.value[x]` do not cover the following types: Attachment, Period, Range, Ratio, SampledData. The target context `Observation.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation`. Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type).#xD;#xD;#xD;If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the [notes section](https://hl7.org/fhir/observ.html#notes) below. Observation.dataAbsentReason dataAbsentReason is equivalent to Observation.dataAbsentReason Observation.dataAbsentReason Element `Observation.dataAbsentReason` is mapped to FHIR R4B element `Observation.dataAbsentReason` as `Equivalent`. Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values. Observation.interpretation interpretation is equivalent to Observation.interpretation Observation.interpretation Element `Observation.interpretation` is mapped to FHIR R4B element `Observation.interpretation` as `SourceIsNarrowerThanTarget`. Observation.comment comment is related to Observation.note Observation.note Element `Observation.comment` is mapped to FHIR R4B element `Observation.note` as `RelatedTo`. The mappings for `Observation.comment` do not cover the following types: string. The mappings for `Observation.comment` do not cover the following types based on type expansion: value. Observation.bodySite bodySite is equivalent to Observation.bodySite Observation.bodySite Element `Observation.bodySite` is mapped to FHIR R4B element `Observation.bodySite` as `Equivalent`. 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[ body-site-instance](https://hl7.org/fhir/extension-body-site-instance.html). Observation.method method is equivalent to Observation.method Observation.method Element `Observation.method` is mapped to FHIR R4B element `Observation.method` as `Equivalent`. Only used if not implicit in code for Observation.code. Observation.specimen specimen maps to wider concept Observation.specimen Observation.specimen Element `Observation.specimen` is mapped to FHIR R4B element `Observation.specimen` as `SourceIsBroaderThanTarget`. The mappings for `Observation.specimen` do not cover the following types based on type expansion: display, identifier, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.specimen` with unmapped reference targets: Specimen. 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). Observation.device device maps to wider concept Observation.device Observation.device Element `Observation.device` is mapped to FHIR R4B element `Observation.device` as `SourceIsBroaderThanTarget`. The mappings for `Observation.device` do not cover the following types based on type expansion: display, identifier, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.device` with unmapped reference targets: Device, DeviceMetric. An extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element. Observation.referenceRange referenceRange maps to wider concept Observation.referenceRange Observation.referenceRange Element `Observation.referenceRange` is mapped to FHIR R4B element `Observation.referenceRange` as `Equivalent`. 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 may 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. Observation.referenceRange.low low is equivalent to Observation.referenceRange.low Observation.referenceRange.low Element `Observation.referenceRange.low` is mapped to FHIR R4B element `Observation.referenceRange.low` as `Equivalent`. Observation.referenceRange.high high is equivalent to Observation.referenceRange.high Observation.referenceRange.high Element `Observation.referenceRange.high` is mapped to FHIR R4B element `Observation.referenceRange.high` as `Equivalent`. Observation.referenceRange.type type is equivalent to Observation.referenceRange.type Observation.referenceRange.type Element `Observation.referenceRange.type` is mapped to FHIR R4B element `Observation.referenceRange.type` as `Equivalent`. This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed. Observation.referenceRange.appliesTo appliesTo is equivalent to Observation.referenceRange.appliesTo Observation.referenceRange.appliesTo Element `Observation.referenceRange.appliesTo` is mapped to FHIR R4B element `Observation.referenceRange.appliesTo` as `Equivalent`. This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed. Observation.referenceRange.age age maps to wider concept Observation.referenceRange.age Observation.referenceRange.age Element `Observation.referenceRange.age` is mapped to FHIR R4B element `Observation.referenceRange.age` as `SourceIsBroaderThanTarget`. The mappings for `Observation.referenceRange.age` do not cover the following types: Range. The mappings for `Observation.referenceRange.age` do not cover the following types based on type expansion: high, low. Observation.referenceRange.text text is equivalent to Observation.referenceRange.text Observation.referenceRange.text Element `Observation.referenceRange.text` is mapped to FHIR R4B element `Observation.referenceRange.text` as `Equivalent`. Observation.related related is related to Observation Observation Element `Observation.related` is mapped to FHIR R4B element `Observation` as `SourceIsNarrowerThanTarget`. Element `Observation.related` is mapped to FHIR R4B element `Observation.hasMember` as `Equivalent`. Element `Observation.related` is mapped to FHIR R4B element `Observation.derivedFrom` as `Equivalent`. For a discussion on the ways Observations can assembled in groups together see [Notes below](https://hl7.org/fhir/observa.html#4.20.4). is related to Observation.derivedFrom Observation.derivedFrom Element `Observation.related` is mapped to FHIR R4B element `Observation` as `SourceIsNarrowerThanTarget`. Element `Observation.related` is mapped to FHIR R4B element `Observation.hasMember` as `Equivalent`. Element `Observation.related` is mapped to FHIR R4B element `Observation.derivedFrom` as `Equivalent`. For a discussion on the ways Observations can assembled in groups together see [Notes below](https://hl7.org/fhir/observa.html#4.20.4). is related to Observation.hasMember Observation.hasMember Element `Observation.related` is mapped to FHIR R4B element `Observation` as `SourceIsNarrowerThanTarget`. Element `Observation.related` is mapped to FHIR R4B element `Observation.hasMember` as `Equivalent`. Element `Observation.related` is mapped to FHIR R4B element `Observation.derivedFrom` as `Equivalent`. For a discussion on the ways Observations can assembled in groups together see [Notes below](https://hl7.org/fhir/observa.html#4.20.4). Observation.related.target target is related to Observation.derivedFrom Observation.derivedFrom Element `Observation.related.target` is mapped to FHIR R4B element `Observation.hasMember` as `RelatedTo`. Element `Observation.related.target` is mapped to FHIR R4B element `Observation.derivedFrom` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.related.target` with unmapped reference targets: Observation, QuestionnaireResponse, Sequence. is related to Observation.hasMember Observation.hasMember Element `Observation.related.target` is mapped to FHIR R4B element `Observation.hasMember` as `RelatedTo`. Element `Observation.related.target` is mapped to FHIR R4B element `Observation.derivedFrom` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.related.target` with unmapped reference targets: Observation, QuestionnaireResponse, Sequence. Observation.component component maps to wider concept Observation.component Observation.component Element `Observation.component` is mapped to FHIR R4B element `Observation.component` as `Equivalent`. For a discussion on the ways Observations can be assembled in groups together see [Notes](https://hl7.org/fhir/observ.html#notes) below. Observation.component.code code is equivalent to Observation.component.code Observation.component.code Element `Observation.component.code` is mapped to FHIR R4B element `Observation.component.code` as `Equivalent`. Observation.component.value[x] value[x] maps to wider concept Observation.component.value[x] Observation.component.value[x] Element `Observation.component.value[x]` is mapped to FHIR R4B element `Observation.component.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.component.value[x]` do not cover the following types: Attachment, Period, Range, Ratio, SampledData. The target context `Observation.component.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation.component`. Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is 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 boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type). Observation.component.dataAbsentReason dataAbsentReason is equivalent to Observation.component.dataAbsentReason Observation.component.dataAbsentReason Element `Observation.component.dataAbsentReason` is mapped to FHIR R4B element `Observation.component.dataAbsentReason` as `Equivalent`. "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. Observation.component.interpretation interpretation is equivalent to Observation.component.interpretation Observation.component.interpretation Element `Observation.component.interpretation` is mapped to FHIR R4B element `Observation.component.interpretation` as `SourceIsNarrowerThanTarget`. The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element. Observation.component.referenceRange referenceRange is equivalent to Observation.component.referenceRange Observation.component.referenceRange Element `Observation.component.referenceRange` is mapped to FHIR R4B element `Observation.component.referenceRange` as `Equivalent`. 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 may 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. Group 2 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: meta additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.meta (meta) is equivalent to Extension (STU3: meta additional types) Element `Observation.meta` is mapped to FHIR R4B element `Observation.meta` as `SourceIsBroaderThanTarget`. The mappings for `Observation.meta` do not cover the following types: Meta. The mappings for `Observation.meta` do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId. Group 3 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: text additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.text (text) is equivalent to Extension (STU3: text additional types) Element `Observation.text` is mapped to FHIR R4B element `Observation.text` as `SourceIsBroaderThanTarget`. The mappings for `Observation.text` do not cover the following types: Narrative. The mappings for `Observation.text` do not cover the following types based on type expansion: div, status. 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 in formation is added later. Group 4 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: identifier additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.identifier (identifier) is equivalent to Extension (STU3: identifier additional types) Element `Observation.identifier` is mapped to FHIR R4B element `Observation.identifier` as `SourceIsBroaderThanTarget`. The mappings for `Observation.identifier` do not cover the following types: Identifier. The mappings for `Observation.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value. Group 5 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: value additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.value[x] (value[x]) is equivalent to Extension (STU3: value additional types) Element `Observation.value[x]` is mapped to FHIR R4B element `Observation.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.value[x]` do not cover the following types: Attachment, Period, Range, Ratio, SampledData. The target context `Observation.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation`. Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type).#xD;#xD;#xD;If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the [notes section](https://hl7.org/fhir/observ.html#notes) below. Group 6 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: Comments about result additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.comment (comment) maps to wider concept Extension (STU3: Comments about result additional types) Element `Observation.comment` is mapped to FHIR R4B element `Observation.note` as `RelatedTo`. The mappings for `Observation.comment` do not cover the following types: string. The mappings for `Observation.comment` do not cover the following types based on type expansion: value. Group 7 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: age additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.referenceRange.age (age) is equivalent to Extension (STU3: age additional types) Element `Observation.referenceRange.age` is mapped to FHIR R4B element `Observation.referenceRange.age` as `SourceIsBroaderThanTarget`. The mappings for `Observation.referenceRange.age` do not cover the following types: Range. The mappings for `Observation.referenceRange.age` do not cover the following types based on type expansion: high, low. Group 8 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by (new)version: 0.1.0) Source Code Relationship Target Code Comment Observation.related.type (type) is equivalent to Extension (STU3: has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by (new)) Element `Observation.related.type` has a context of Observation based on following the parent source element upwards and mapping to `Observation`. Element `Observation.related.type` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). The "derived-from" type is the only logical choice when referencing the QuestionnaireAnswer resource. Group 9 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|3.0.2 to STU3: value additional typesversion: 0.1.0) Source Code Relationship Target Code Comment Observation.component.value[x] (value[x]) is equivalent to Extension (STU3: value additional types) Element `Observation.component.value[x]` is mapped to FHIR R4B element `Observation.component.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.component.value[x]` do not cover the following types: Attachment, Period, Range, Ratio, SampledData. The target context `Observation.component.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation.component`. Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is 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 boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).
Cross-version mapping for FHIR STU3 Observation to FHIR R4B Observation
This ConceptMap represents cross-version mappings for elements from a FHIR STU3 Observation to FHIR R4B.
Element `Observation.meta` is mapped to FHIR R4B element `Observation.meta` as `SourceIsBroaderThanTarget`. The mappings for `Observation.meta` do not cover the following types: Meta. The mappings for `Observation.meta` do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.
Element `Observation.implicitRules` is mapped to FHIR R4B element `Observation.implicitRules` as `Equivalent`. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Element `Observation.language` is mapped to FHIR R4B element `Observation.language` as `Equivalent`. 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).
Element `Observation.text` is mapped to FHIR R4B element `Observation.text` as `SourceIsBroaderThanTarget`. The mappings for `Observation.text` do not cover the following types: Narrative. The mappings for `Observation.text` do not cover the following types based on type expansion: div, status. 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 in formation is added later.
Element `Observation.contained` is mapped to FHIR R4B element `Observation.contained` as `SourceIsBroaderThanTarget`. 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.
Element `Observation.identifier` is mapped to FHIR R4B element `Observation.identifier` as `SourceIsBroaderThanTarget`. The mappings for `Observation.identifier` do not cover the following types: Identifier. The mappings for `Observation.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value.
Element `Observation.basedOn` is mapped to FHIR R4B element `Observation.basedOn` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.basedOn` with unmapped reference targets: CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ProcedureRequest, ReferralRequest.
Element `Observation.status` is mapped to FHIR R4B element `Observation.status` as `Equivalent`. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Element `Observation.category` is mapped to FHIR R4B element `Observation.category` as `Equivalent`. 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.
Element `Observation.code` is mapped to FHIR R4B element `Observation.code` as `Equivalent`.
Element `Observation.subject` is mapped to FHIR R4B element `Observation.subject` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.subject` with unmapped reference targets: Device, Group, Location, Patient. 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. If the target of the observation is different than the subject, the general extension [observation-focal-subject](https://hl7.org/fhir/extension-observation-focal-subject.html). may be used. However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.
Element `Observation.context` is mapped to FHIR R4B element `Observation.encounter` as `SourceIsBroaderThanTarget`. The mappings for `Observation.context` do not cover the following types based on type expansion: display, identifier, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.context` with unmapped reference targets: Encounter, EpisodeOfCare. 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 or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).
Element `Observation.effective[x]` is mapped to FHIR R4B element `Observation.effective[x]` as `SourceIsBroaderThanTarget`. The target context `Observation.effective[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation`. At least a date should be present unless this observation is a historical report.
Element `Observation.issued` is mapped to FHIR R4B element `Observation.issued` as `Equivalent`. Updated when the result is updated.
Element `Observation.performer` is mapped to FHIR R4B element `Observation.performer` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.performer` with unmapped reference targets: Organization, Patient, Practitioner, RelatedPerson.
Element `Observation.value[x]` is mapped to FHIR R4B element `Observation.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.value[x]` do not cover the following types: Attachment, Period, Range, Ratio, SampledData. The target context `Observation.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation`. Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type). If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the [notes section](https://hl7.org/fhir/observ.html#notes) below.
Element `Observation.dataAbsentReason` is mapped to FHIR R4B element `Observation.dataAbsentReason` as `Equivalent`. Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.
Element `Observation.interpretation` is mapped to FHIR R4B element `Observation.interpretation` as `SourceIsNarrowerThanTarget`.
Element `Observation.comment` is mapped to FHIR R4B element `Observation.note` as `RelatedTo`. The mappings for `Observation.comment` do not cover the following types: string. The mappings for `Observation.comment` do not cover the following types based on type expansion: value.
Element `Observation.bodySite` is mapped to FHIR R4B element `Observation.bodySite` as `Equivalent`. 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[ body-site-instance](https://hl7.org/fhir/extension-body-site-instance.html).
Element `Observation.method` is mapped to FHIR R4B element `Observation.method` as `Equivalent`. Only used if not implicit in code for Observation.code.
Element `Observation.specimen` is mapped to FHIR R4B element `Observation.specimen` as `SourceIsBroaderThanTarget`. The mappings for `Observation.specimen` do not cover the following types based on type expansion: display, identifier, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.specimen` with unmapped reference targets: Specimen. 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).
Element `Observation.device` is mapped to FHIR R4B element `Observation.device` as `SourceIsBroaderThanTarget`. The mappings for `Observation.device` do not cover the following types based on type expansion: display, identifier, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.device` with unmapped reference targets: Device, DeviceMetric. An extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.
Element `Observation.referenceRange` is mapped to FHIR R4B element `Observation.referenceRange` as `Equivalent`. 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 may 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.
Element `Observation.referenceRange.low` is mapped to FHIR R4B element `Observation.referenceRange.low` as `Equivalent`.
Element `Observation.referenceRange.high` is mapped to FHIR R4B element `Observation.referenceRange.high` as `Equivalent`.
Element `Observation.referenceRange.type` is mapped to FHIR R4B element `Observation.referenceRange.type` as `Equivalent`. This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.
Element `Observation.referenceRange.appliesTo` is mapped to FHIR R4B element `Observation.referenceRange.appliesTo` as `Equivalent`. This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.
Element `Observation.referenceRange.age` is mapped to FHIR R4B element `Observation.referenceRange.age` as `SourceIsBroaderThanTarget`. The mappings for `Observation.referenceRange.age` do not cover the following types: Range. The mappings for `Observation.referenceRange.age` do not cover the following types based on type expansion: high, low.
Element `Observation.referenceRange.text` is mapped to FHIR R4B element `Observation.referenceRange.text` as `Equivalent`.
Element `Observation.related` is mapped to FHIR R4B element `Observation` as `SourceIsNarrowerThanTarget`. Element `Observation.related` is mapped to FHIR R4B element `Observation.hasMember` as `Equivalent`. Element `Observation.related` is mapped to FHIR R4B element `Observation.derivedFrom` as `Equivalent`. For a discussion on the ways Observations can assembled in groups together see [Notes below](https://hl7.org/fhir/observa.html#4.20.4).
Element `Observation.related.target` is mapped to FHIR R4B element `Observation.hasMember` as `RelatedTo`. Element `Observation.related.target` is mapped to FHIR R4B element `Observation.derivedFrom` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `Observation.related.target` with unmapped reference targets: Observation, QuestionnaireResponse, Sequence.
Element `Observation.component` is mapped to FHIR R4B element `Observation.component` as `Equivalent`. For a discussion on the ways Observations can be assembled in groups together see [Notes](https://hl7.org/fhir/observ.html#notes) below.
Element `Observation.component.code` is mapped to FHIR R4B element `Observation.component.code` as `Equivalent`.
Element `Observation.component.value[x]` is mapped to FHIR R4B element `Observation.component.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.component.value[x]` do not cover the following types: Attachment, Period, Range, Ratio, SampledData. The target context `Observation.component.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Observation.component`. Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is 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 boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type).
Element `Observation.component.dataAbsentReason` is mapped to FHIR R4B element `Observation.component.dataAbsentReason` as `Equivalent`. "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.
Element `Observation.component.interpretation` is mapped to FHIR R4B element `Observation.component.interpretation` as `SourceIsNarrowerThanTarget`. The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element.
Element `Observation.component.referenceRange` is mapped to FHIR R4B element `Observation.component.referenceRange` as `Equivalent`. 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 may 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.
Element `Observation.related.type` has a context of Observation based on following the parent source element upwards and mapping to `Observation`. Element `Observation.related.type` has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). The "derived-from" type is the only logical choice when referencing the QuestionnaireAnswer resource.