Extensions for Using Data Elements from FHIR R4 in FHIR STU3
0.1.0 - STU International flag

Extensions for Using Data Elements from FHIR R4 in FHIR STU3 - Downloaded Version null See the Directory of published versions

ConceptMap: R4ObservationElementMapToR3

Official URL: http://hl7.org/fhir/uv/xver/ConceptMap/R4-Observation-element-map-to-R3 Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: R4ObservationElementMapToR3

This ConceptMap represents cross-version mappings for elements from a FHIR R4 Observation to FHIR STU3.

Mapping from http://hl7.org/fhir/4.0 to http://hl7.org/fhir/3.0


Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to http://hl7.org/fhir/StructureDefinition/Observation|3.0.2

Source CodeRelationshipTarget CodeComment
Observation.meta (meta)is equivalent toObservation.metaElement `Observation.meta` is mapped to FHIR STU3 element `Observation.meta` as `Equivalent`.
Observation.implicitRules (implicitRules)is equivalent toObservation.implicitRulesElement `Observation.implicitRules` is mapped to FHIR STU3 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. 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.
Observation.language (language)is equivalent toObservation.languageElement `Observation.language` is mapped to FHIR STU3 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)is equivalent toObservation.textElement `Observation.text` is mapped to FHIR STU3 element `Observation.text` as `Equivalent`. 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.
Observation.contained (contained)is equivalent toObservation.containedElement `Observation.contained` is mapped to FHIR STU3 element `Observation.contained` as `Equivalent`. 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.
Observation.identifier (identifier)is equivalent toObservation.identifierElement `Observation.identifier` is mapped to FHIR STU3 element `Observation.identifier` as `Equivalent`.
Observation.basedOn (basedOn)maps to wider conceptObservation.basedOnElement `Observation.basedOn` is mapped to FHIR STU3 element `Observation.basedOn` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4 element `Observation.basedOn` with unmapped reference targets: ServiceRequest.
Observation.status (status)is equivalent toObservation.statusElement `Observation.status` is mapped to FHIR STU3 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 toObservation.categoryElement `Observation.category` is mapped to FHIR STU3 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 toObservation.codeElement `Observation.code` is mapped to FHIR STU3 element `Observation.code` as `Equivalent`. *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.
Observation.subject (subject)is equivalent toObservation.subjectElement `Observation.subject` is mapped to FHIR STU3 element `Observation.subject` as `Equivalent`. 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.
Observation.encounter (encounter)is equivalent toObservation.contextElement `Observation.encounter` is mapped to FHIR STU3 element `Observation.context` as `Equivalent`. 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).
Observation.effective[x] (effective[x])maps to wider conceptObservation.effective[x]Element `Observation.effective[x]` is mapped to FHIR STU3 element `Observation.effective[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.effective[x]` do not cover the following types: instant, Timing. 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. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](https://hl7.org/fhir/datatyp.html#timing) datatype which allow the measurement to be tied to regular life events.
Observation.issued (issued)is equivalent toObservation.issuedElement `Observation.issued` is mapped to FHIR STU3 element `Observation.issued` as `Equivalent`. For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](https://hl7.org/fhir/resource-definiti.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.
Observation.performer (performer)maps to wider conceptObservation.performerElement `Observation.performer` is mapped to FHIR STU3 element `Observation.performer` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4 element `Observation.performer` with unmapped reference targets: CareTeam, PractitionerRole.
Observation.value[x] (value[x])maps to wider conceptObservation.value[x]Element `Observation.value[x]` is mapped to FHIR STU3 element `Observation.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.value[x]` do not cover the following types: integer. 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`. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](https://hl7.org/fhir/observ.html#notes) below.
Observation.dataAbsentReason (dataAbsentReason)is equivalent toObservation.dataAbsentReasonElement `Observation.dataAbsentReason` is mapped to FHIR STU3 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 toObservation.interpretationElement `Observation.interpretation` is mapped to FHIR STU3 element `Observation.interpretation` as `SourceIsBroaderThanTarget`. 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.
Observation.note (note)maps to wider conceptObservation.commentElement `Observation.note` is mapped to FHIR STU3 element `Observation.comment` as `SourceIsBroaderThanTarget`. The mappings for `Observation.note` do not cover the following types: Annotation. The mappings for `Observation.note` do not cover the following types based on type expansion: time. 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.
Observation.bodySite (bodySite)is equivalent toObservation.bodySiteElement `Observation.bodySite` is mapped to FHIR STU3 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[ bodySite](https://hl7.org/fhir/extension-bodysite.html).
Observation.method (method)is equivalent toObservation.methodElement `Observation.method` is mapped to FHIR STU3 element `Observation.method` as `Equivalent`. Only used if not implicit in code for Observation.code.
Observation.specimen (specimen)is equivalent toObservation.specimenElement `Observation.specimen` is mapped to FHIR STU3 element `Observation.specimen` as `Equivalent`. 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)is equivalent toObservation.deviceElement `Observation.device` is mapped to FHIR STU3 element `Observation.device` as `Equivalent`. Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.
Observation.referenceRange (referenceRange)maps to wider conceptObservation.referenceRangeElement `Observation.referenceRange` is mapped to FHIR STU3 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 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.
Observation.referenceRange.low (low)is equivalent toObservation.referenceRange.lowElement `Observation.referenceRange.low` is mapped to FHIR STU3 element `Observation.referenceRange.low` as `Equivalent`.
Observation.referenceRange.high (high)is equivalent toObservation.referenceRange.highElement `Observation.referenceRange.high` is mapped to FHIR STU3 element `Observation.referenceRange.high` as `Equivalent`.
Observation.referenceRange.type (type)is equivalent toObservation.referenceRange.typeElement `Observation.referenceRange.type` is mapped to FHIR STU3 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 toObservation.referenceRange.appliesToElement `Observation.referenceRange.appliesTo` is mapped to FHIR STU3 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)is equivalent toObservation.referenceRange.ageElement `Observation.referenceRange.age` is mapped to FHIR STU3 element `Observation.referenceRange.age` as `Equivalent`.
Observation.referenceRange.text (text)is equivalent toObservation.referenceRange.textElement `Observation.referenceRange.text` is mapped to FHIR STU3 element `Observation.referenceRange.text` as `Equivalent`.
Observation.hasMember (hasMember)is equivalent toObservation.related.targetElement `Observation.hasMember` is mapped to FHIR STU3 element `Observation.related.target` as `RelatedTo`. 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](https://hl7.org/fhir/observation..html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](https://hl7.org/fhir/questionnaireresponse.html) into a final score and represent the score as an Observation.
Observation.derivedFrom (derivedFrom)is related toObservation.related.targetElement `Observation.derivedFrom` is mapped to FHIR STU3 element `Observation.related.target` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4 element `Observation.derivedFrom` with unmapped reference targets: DocumentReference, ImagingStudy, Media. All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see [Notes](https://hl7.org/fhir/observation..html#obsgrouping) below.
Observation.component (component)maps to wider conceptObservation.componentElement `Observation.component` is mapped to FHIR STU3 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 toObservation.component.codeElement `Observation.component.code` is mapped to FHIR STU3 element `Observation.component.code` as `Equivalent`. *All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Observation.component.value[x] (value[x])maps to wider conceptObservation.component.value[x]Element `Observation.component.value[x]` is mapped to FHIR STU3 element `Observation.component.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.component.value[x]` do not cover the following types: boolean, integer. 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`. 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](https://hl7.org/fhir/observ.html#notes) below.
Observation.component.dataAbsentReason (dataAbsentReason)is equivalent toObservation.component.dataAbsentReasonElement `Observation.component.dataAbsentReason` is mapped to FHIR STU3 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 toObservation.component.interpretationElement `Observation.component.interpretation` is mapped to FHIR STU3 element `Observation.component.interpretation` as `SourceIsBroaderThanTarget`. 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.
Observation.component.referenceRange (referenceRange)is equivalent toObservation.component.referenceRangeElement `Observation.component.referenceRange` is mapped to FHIR STU3 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 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.

Group 2 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to R4: Part of referenced event (new)version: 0.1.0)

Source CodeRelationshipTarget CodeComment
Observation.partOf (partOf)maps to wider conceptExtension (R4: Part of referenced event (new))Element `Observation.partOf` has a context of Observation.related based on following the parent source element upwards and mapping to `Observation`. Element `Observation.partOf` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). To link an Observation to an Encounter use `encounter`. See the [Notes](https://hl7.org/fhir/observation..html#obsgrouping) below for guidance on referencing another Observation.

Group 3 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to R4: What the observation is about, when it is not about the subject of record (new)version: 0.1.0)

Source CodeRelationshipTarget CodeComment
Observation.focus (focus)maps to wider conceptExtension (R4: What the observation is about, when it is not about the subject of record (new))Element `Observation.focus` has a context of Observation.related based on following the parent source element upwards and mapping to `Observation`. Element `Observation.focus` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). 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](https://hl7.org/fhir/extension-observation-focuscode.html).

Group 4 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to R4: effective additional typesversion: 0.1.0)

Source CodeRelationshipTarget CodeComment
Observation.effective[x] (effective[x])is equivalent toExtension (R4: effective additional types)Element `Observation.effective[x]` is mapped to FHIR STU3 element `Observation.effective[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.effective[x]` do not cover the following types: instant, Timing. 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. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](https://hl7.org/fhir/datatyp.html#timing) datatype which allow the measurement to be tied to regular life events.

Group 5 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to R4: value additional typesversion: 0.1.0)

Source CodeRelationshipTarget CodeComment
Observation.value[x] (value[x])is equivalent toExtension (R4: value additional types)Element `Observation.value[x]` is mapped to FHIR STU3 element `Observation.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.value[x]` do not cover the following types: integer. 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`. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](https://hl7.org/fhir/observ.html#notes) below.

Group 6 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to R4: Comments about the observation additional typesversion: 0.1.0)

Source CodeRelationshipTarget CodeComment
Observation.note (note)maps to wider conceptExtension (R4: Comments about the observation additional types)Element `Observation.note` is mapped to FHIR STU3 element `Observation.comment` as `SourceIsBroaderThanTarget`. The mappings for `Observation.note` do not cover the following types: Annotation. The mappings for `Observation.note` do not cover the following types based on type expansion: time. 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.

Group 7 Mapping from http://hl7.org/fhir/StructureDefinition/Observation|4.0.1 to R4: value additional typesversion: 0.1.0)

Source CodeRelationshipTarget CodeComment
Observation.component.value[x] (value[x])is equivalent toExtension (R4: value additional types)Element `Observation.component.value[x]` is mapped to FHIR STU3 element `Observation.component.value[x]` as `SourceIsBroaderThanTarget`. The mappings for `Observation.component.value[x]` do not cover the following types: boolean, integer. 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`. 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](https://hl7.org/fhir/observ.html#notes) below.