R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

StructureDefinition: Cholesterol - XML

Orders and Observations Work Group Maturity Level: 1InformativeUse Context: Not Intended for Production use

Cholesterol

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cholesterol"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="oo"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/cholesterol"/> 
  <name value="Example Lipid Profile"/> 
  <status value="draft"/> 
  <experimental value="true"/> 
  <date value="2012-05-12"/> 
  <publisher value="Grahame Grieve"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="grahame@healthintersections.com.au"/> 
    </telecom> 
  </contact> 
  <description value="Describes how the lab report is used for a standard Lipid Profile - Cholesterol, Triglyceride
   and Cholesterol fractions. Uses LOINC codes"/> 
  <fhirVersion value="3.2.0"/> 
  <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/w5"/> 
    <name value="W5 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="sct-attr"/> 
    <uri value="http://snomed.info/sct"/> 
    <name value="SNOMED CT Attribute Binding"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="Observation"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Observation">
      <path value="Observation"/> 
      <short value="Measurements and simple assertions"/> 
      <definition value="Measurements and simple assertions made about a patient, device or other subject."/> 
      <comment value="Used for simple observations such as device measurements, laboratory atomic results, vital
       signs, height, weight, smoking status, comments, etc.  Other resources are used to provide
       context for observations such as lab reports, etc."/> 
      <alias value="Vital Signs"/> 
      <alias value="Measurement"/> 
      <alias value="Results"/> 
      <alias value="Tests"/> 
      <min value="1"/> 
      <max value="1"/> 
      <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="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-1"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/> 
        <expression value="contained.text.empty()"/> 
        <xpath value="not(parent::f:contained and f:text)"/> 
        <source value="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="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.all(('#'+id in %resource.descendants().reference) or descendants().where(reference
         = '#').exists())"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@va
        lue=concat('#', $contained/*/id/@value) or descendant::reference[@value='#'])]))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="obs-7"/> 
        <severity value="error"/> 
        <human value="If Observation.code is the same as a Observation.component.code then the value element
         associated with the code SHALL NOT be present"/> 
        <expression value="value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and
         (coding.system = %resource.code.coding.system)).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="Observation"/> 
      </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="Observation"/> 
      </constraint> 
      <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="&lt; 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> 
        <code value="id"/> 
      </type> 
      <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="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <isSummary value="true"/> 
    </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."/> 
      <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. 

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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="true"/> 
      <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> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference> 
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/> 
          </valueReference> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="A human language."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/languages"/> 
        </valueSetReference> 
      </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 may 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 &quot;clinically
       safe&quot; 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 &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded in formation 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> 
      <condition value="dom-1"/> 
      <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."/> 
      <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> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.extension">
      <path value="Observation.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 resource. In order 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."/> 
      <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="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </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.
       Usually modifier elements provide negation or qualification. In order 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."/> 
      <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="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Observation.identifier">
      <path value="Observation.identifier"/> 
      <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> 
      <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> 
      <mapping> 
        <identity value="w5"/> 
        <map value="id"/> 
      </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."/> 
      <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"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> 
      </type> 
      <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 `context`.  See the  [Notes](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"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> 
      </type> 
      <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."/> 
      <comment value="This element is labeled as a modifier because the status contains codes that mark the
       resource as not currently valid."/> 
      <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> 
      <isModifier value="true"/> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-status"/> 
        </valueSetReference> 
      </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="&lt; 445584004 |Report by finality status|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-11"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="status  Amended &amp; Final are differentiated by whether it is the subject of a ControlAct
         event with a type of &quot;revise&quot;"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="status"/> 
      </mapping> 
    </element> 
    <element id="Observation.category">
      <path value="Observation.category"/> 
      <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="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Observation.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-category"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quo
        t;].code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="class"/> 
      </mapping> 
    </element> 
    <element id="Observation.code">
      <path value="Observation.code"/> 
      <short value="Cholesterol"/> 
      <definition value="Cholesterol."/> 
      <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> 
      <fixedCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="35200-5"/> 
          <display value="Cholesterol [Moles/​volume] in Serum or Plasma"/> 
        </coding> 
      </fixedCodeableConcept> 
      <mustSupport value="true"/> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/> 
        </valueSetReference> 
      </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="&lt; 363787002 |Observable entity| OR &lt; 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> 
      <mapping> 
        <identity value="w5"/> 
        <map value="what"/> 
      </mapping> 
    </element> 
    <element id="Observation.subject">
      <path value="Observation.subject"/> 
      <short value="Who and/or what this is about"/> 
      <definition value="The patient, or group of patients, location, or device whose characteristics (direct or
       indirect) are described by the observation and into whose record the observation is placed.
        Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer
       (for example a relative or EMT), or any observation made about the subject."/> 
      <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.

If the target of the observation is different than the subject, the general extension
       [observation-focal-subject](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."/> 
      <requirements value="Observations have no value if you don't know who or what they're about."/> 
      <min value="0"/> 
      <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"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <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=SBJ]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="who.focus"/> 
      </mapping> 
    </element> 
    <element id="Observation.context">
      <path value="Observation.context"/> 
      <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 or episode but still
       be tied to the context of the encounter or episode (e.g. pre-admission lab tests)."/> 
      <requirements value="For some observations it may be important to know the link between an observation and
       a particular encounter."/> 
      <alias value="Encounter"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.context"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> 
      </type> 
      <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> 
      <mapping> 
        <identity value="w5"/> 
        <map value="context"/> 
      </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. For biological subjects
       - e.g. human patients - this is usually called the &quot;physiologically relevant time&quot;.
       This is usually either the time of the procedure or of specimen collection, but very often
       the source of the date/time is not known, only the date/time itself."/> 
      <comment value="At least a date should be present unless this observation is a historical report.  For
       recording imprecise or &quot;fuzzy&quot; times (For example, a blood glucose measurement
       taken &quot;after breakfast&quot;) use the [Timing](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="0"/> 
      <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> 
      <type> 
        <code value="Timing"/> 
      </type> 
      <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> 
      <mapping> 
        <identity value="w5"/> 
        <map value="when.done"/> 
      </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` ](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> 
      <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> 
      <mapping> 
        <identity value="w5"/> 
        <map value="when.recorded"/> 
      </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 &quot;true&quot;."/> 
      <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"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer"/> 
      </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> 
      <mapping> 
        <identity value="w5"/> 
        <map value="who.actor"/> 
      </mapping> 
    </element> 
    <element id="Observation.valueQuantity">
      <path value="Observation.valueQuantity"/> 
      <short value="Cholesterol value"/> 
      <definition value="Cholesterol value. If a result is not available, use the comments field."/> 
      <comment value="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](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.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <condition value="obs-7"/> 
      <mustSupport value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.notDone, Event.notDoneReason  {maps to value[x] or dataAbsentReason}"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 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.valueQuantity.id">
      <path value="Observation.valueQuantity.id"/> 
      <representation value="xmlAttr"/> 
      <short value="xml:id (or equivalent in JSON)"/> 
      <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> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.valueQuantity.extension">
      <path value="Observation.valueQuantity.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. In order 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."/> 
      <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> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Observation.valueQuantity.value">
      <path value="Observation.valueQuantity.value"/> 
      <short value="Actual numerical value"/> 
      <definition value="Actual numerical value."/> 
      <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="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.value"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <mustSupport value="true"/> 
      <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.valueQuantity.comparator">
      <path value="Observation.valueQuantity.comparator"/> 
      <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value"/> 
      <definition value="How the value should be understood and represented - whether the actual value is greater
       or less than the stated value due to measurement issues; e.g. if the comparator is &quot;&lt;&quot;
       , then the real value is &lt; stated value."/> 
      <comment value="No need for this on cholesterol."/> 
      <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;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"/> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuantityComparator"/> 
        </extension> 
        <strength value="required"/> 
        <description value="How the Quantity should be understood and represented."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator"/> 
        </valueSetReference> 
      </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.valueQuantity.unit">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="Observation.valueQuantity.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="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Quantity.unit"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <fixedString value="mmol/L"/> 
      <mustSupport value="true"/> 
      <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.valueQuantity.system">
      <path value="Observation.valueQuantity.system"/> 
      <short value="System that defines coded unit form"/> 
      <definition value="The identification of the 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"/> 
      <mustSupport value="true"/> 
      <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.valueQuantity.code">
      <path value="Observation.valueQuantity.code"/> 
      <short value="Coded form of the unit"/> 
      <definition value="A computer processable form of the unit in some unit representation system."/> 
      <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> 
      <fixedCode value="mmol/L"/> 
      <mustSupport value="true"/> 
      <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.dataAbsentReason">
      <path value="Observation.dataAbsentReason"/> 
      <short value="Why the result is missing"/> 
      <definition value="Provides a reason why the expected value in the element Observation.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  &quot;detected&quot;, &quot;not
       detected&quot;, &quot;inconclusive&quot;, or  &quot;specimen unsatisfactory&quot;.   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 &quot;error&quot; 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 &gt; 0.  Because of these options, use-case
       agreements are required to interpret general observations for null or 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.dataAbsentReason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <condition value="obs-6"/> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.notDone, Event.notDoneReason  {maps to value[x] or dataAbsentReason}"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="value.nullFlavor"/> 
      </mapping> 
    </element> 
    <element id="Observation.interpretation">
      <path value="Observation.interpretation"/> 
      <short value="+ | ++ | +++ | - | -- | ---"/> 
      <definition value="+ | ++ | +++ | - | -- | ---."/> 
      <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="1"/> 
      <base> 
        <path value="Observation.interpretation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationInterpretation"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying interpretations of observations."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 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.comment">
      <path value="Observation.comment"/> 
      <short value="Comments about result"/> 
      <definition value="May include statements about significant, unexpected or unreliable. values, or information
       about the source of the value where this may be relevant to the interpretation of the
       result."/> 
      <requirements value="Need to be able to provide free text additional information."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.comment"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <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=&quot;annotation&quot;].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[ body-structure](extension-body-structure.html)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Observation.bodySite"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes describing anatomical locations. May include laterality."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 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> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationMethod"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Methods for simple observations."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-methods"/> 
        </valueSetReference> 
      </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> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 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="An extension should be used if further typing of the device is needed.  Devices used to
       support obtaining an observation can be represented using an extension or the [Provenance](provenanc
      e.html) resource. (e.g., a device gateway such as a smart phone)."/> 
      <min value="0"/> 
      <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"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceComponent"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric"/> 
      </type> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 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.referenceRange">
      <path value="Observation.referenceRange"/> 
      <short value="Provides guide for interpretation"/> 
      <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 &quot;normal&quot; can help evaluate the significance
       of a particular result. Need to be able to provide multiple reference ranges for different
       contexts."/> 
      <min value="1"/> 
      <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"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="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="Observation.referenceRange"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <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="xml:id (or equivalent in JSON)"/> 
      <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> 
        <code value="string"/> 
      </type> 
      <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. In order 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."/> 
      <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> 
      <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"/> 
      <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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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."/> 
      <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"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <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 &gt;=5 - &lt;=9).   If the
       low bound is omitted,  it is assumed to be meaningless (e.g. reference range is &lt;=2.3)."/> 
      <min value="0"/> 
      <max value="0"/> 
      <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"/> 
      <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="&lt;4.5 mmol/L."/> 
      <comment value="Per Australian NHF Recommendations."/> 
      <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> 
      <fixedQuantity> 
        <value value="4.5"/> 
      </fixedQuantity> 
      <condition value="ele-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="qty-3"/> 
        <severity value="error"/> 
        <human value="If a code for the unit is present, the system SHALL also be present"/> 
        <expression value="code.empty() or system.exists()"/> 
        <xpath value="not(exists(f:code)) or exists(f:system)"/> 
        <source value="Quantity"/> 
      </constraint> 
      <constraint> 
        <key value="sqty-1"/> 
        <severity value="error"/> 
        <human value="The comparator is not used on a SimpleQuantity"/> 
        <expression value="comparator.empty()"/> 
        <xpath value="not(exists(f:comparator))"/> 
        <source value="Quantity"/> 
      </constraint> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="SN (see also Range) or CQ"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values"/> 
      </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="0"/> 
      <base> 
        <path value="Observation.referenceRange.type"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationRangeMeaning"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Code for the meaning of a reference range."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values| OR  
&lt; 365860008 |General clinical state finding| 
OR 
&lt; 250171008 |Clinical history or observation findings| OR  
&lt; 415229000 |Racial group| OR 
&lt; 365400002 |Finding of puberty stage| OR
&lt; 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."/> 
      <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="0"/> 
      <base> 
        <path value="Observation.referenceRange.appliesTo"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-appliesto"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 260245000 |Findings values| OR  
&lt; 365860008 |General clinical state finding| 
OR 
&lt; 250171008 |Clinical history or observation findings| OR  
&lt; 415229000 |Racial group| OR 
&lt; 365400002 |Finding of puberty stage| OR
&lt; 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="0"/> 
      <base> 
        <path value="Observation.referenceRange.age"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Range"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].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 &quot;Negative&quot
      ; 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> 
      <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](#obsgrouping) below."/> 
      <min value="0"/> 
      <max value="0"/> 
      <base> 
        <path value="Observation.hasMember"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Sequence"/> 
      </type> 
      <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="Related measurements the observation is made from"/> 
      <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="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](#obsgrouping) below."/> 
      <min value="0"/> 
      <max value="0"/> 
      <base> 
        <path value="Observation.derivedFrom"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Sequence"/> 
      </type> 
      <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"/> 
      <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](observatio
      n.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"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <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="xml:id (or equivalent in JSON)"/> 
      <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> 
        <code value="string"/> 
      </type> 
      <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. In order 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."/> 
      <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> 
      <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"/> 
      <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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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."/> 
      <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"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <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 &quot;code&quot;."/> 
      <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> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 363787002 |Observable entity| OR 
&lt; 386053000 |Evaluation procedure|"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="OBX-3"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="what"/> 
      </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 observations 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](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> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="363714003 |Interprets| &lt; 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="&quot;Null&quot; 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  &quot;detected&quot;,
       &quot;not detected&quot;, &quot;inconclusive&quot;, or  &quot;test not done&quot;.   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 &quot;error&quot; 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"/> 
      <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."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason"/> 
        </valueSetReference> 
      </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="The assessment made based on the result of the observation.  Intended as a simple compact
       code often placed adjacent to the result value in reports and flow sheets to signal the
       meaning/normalcy status of the result. Otherwise known as abnormal flag."/> 
      <comment value="The component interpretation applies only to the individual component value.  For an overall
       interpretation all components together use thes Observation.interpretation element."/> 
      <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="1"/> 
      <base> 
        <path value="Observation.component.interpretation"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ObservationInterpretation"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Codes identifying interpretations of observations."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="sct-concept"/> 
        <map value="&lt; 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 &quot;normal&quot; 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="#Observation.referenceRange"/> 
      <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"/> 
      <min value="1"/> 
      <max value="1"/> 
    </element> 
    <element id="Observation.code">
      <path value="Observation.code"/> 
      <short value="Cholesterol"/> 
      <definition value="Cholesterol."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <fixedCodeableConcept> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="35200-5"/> 
          <display value="Cholesterol [Moles/​volume] in Serum or Plasma"/> 
        </coding> 
      </fixedCodeableConcept> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.valueQuantity">
      <path value="Observation.valueQuantity"/> 
      <short value="Cholesterol value"/> 
      <definition value="Cholesterol value. If a result is not available, use the comments field."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.valueQuantity.value">
      <path value="Observation.valueQuantity.value"/> 
      <short value="Actual numerical value"/> 
      <definition value="Actual numerical value."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.valueQuantity.comparator">
      <path value="Observation.valueQuantity.comparator"/> 
      <comment value="No need for this on cholesterol."/> 
      <min value="0"/> 
      <max value="0"/> 
      <type> 
        <code value="code"/> 
      </type> 
    </element> 
    <element id="Observation.valueQuantity.unit">
      <path value="Observation.valueQuantity.unit"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <fixedString value="mmol/L"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.valueQuantity.system">
      <path value="Observation.valueQuantity.system"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
      <fixedUri value="http://unitsofmeasure.org"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.valueQuantity.code">
      <path value="Observation.valueQuantity.code"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <fixedCode value="mmol/L"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.interpretation">
      <path value="Observation.interpretation"/> 
      <short value="+ | ++ | +++ | - | -- | ---"/> 
      <definition value="+ | ++ | +++ | - | -- | ---."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.comment">
      <path value="Observation.comment"/> 
      <short value="Comments about result"/> 
      <definition value="May include statements about significant, unexpected or unreliable. values, or information
       about the source of the value where this may be relevant to the interpretation of the
       result."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.referenceRange">
      <path value="Observation.referenceRange"/> 
      <min value="1"/> 
      <max value="1"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="Observation.referenceRange.low">
      <path value="Observation.referenceRange.low"/> 
      <min value="0"/> 
      <max value="0"/> 
    </element> 
    <element id="Observation.referenceRange.high">
      <path value="Observation.referenceRange.high"/> 
      <definition value="&lt;4.5 mmol/L."/> 
      <comment value="Per Australian NHF Recommendations."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <fixedQuantity> 
        <value value="4.5"/> 
      </fixedQuantity> 
    </element> 
    <element id="Observation.referenceRange.type">
      <path value="Observation.referenceRange.type"/> 
      <min value="0"/> 
      <max value="0"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
    </element> 
    <element id="Observation.referenceRange.appliesTo">
      <path value="Observation.referenceRange.appliesTo"/> 
      <min value="0"/> 
      <max value="0"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
    </element> 
    <element id="Observation.referenceRange.age">
      <path value="Observation.referenceRange.age"/> 
      <min value="0"/> 
      <max value="0"/> 
      <type> 
        <code value="Range"/> 
      </type> 
    </element> 
    <element id="Observation.hasMember">
      <path value="Observation.hasMember"/> 
      <min value="0"/> 
      <max value="0"/> 
    </element> 
    <element id="Observation.derivedFrom">
      <path value="Observation.derivedFrom"/> 
      <min value="0"/> 
      <max value="0"/> 
    </element> 
  </differential> 
</StructureDefinition>