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: R3 R2

Extension: focal-subject

Orders and Observations Work Group

Maturity Level: 1

Informative

Use Context: Any

URL for this extension:

http://hl7.org/fhir/StructureDefinition/observation-focal-subject

Status: draft. Extension maintained by: Health Level Seven, Inc. - FHIR WG

The focus of an observation when the focus is not the patient of record. In other words, the focus of the observation is different from Observation.subject. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's trachestomy tube. In this example, the child is the patient of record and the mother is focal subject referenced using this extension. Other example focal subjects include spouses, related persons, feti, or donors.

Context of Use: Use on element: Observation

usage info: insert a list of places where this extension is used

Summary

Name	Card.	Type	Description & Constraints
modifierExtension	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/observation-focal-subject focal-subject: The focus of an observation when the focus is not the patient of record. In other words, the focus of the observation is different from `Observation.subject`. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's trachestomy tube. In this example, the child is the patient of record and the mother is focal subject referenced using this extension. Other example focal subjects include spouses, related persons, feti, or donors. Use on element: Observation
code	0..1	CodeableConcept	A code representing the focal subject.
reference	0..1	Reference(Patient), Reference(Person), Reference(RelatedPerson), Reference(Group), Reference(Device)	A reference to another entity that represents the focal subject ( e.g., a RelatedPerson).
Documentation for this format

Full Structure

Name	Card.	Type	Description & Constraints
modifierExtension	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/observation-focal-subject focal-subject: The focus of an observation when the focus is not the patient of record. In other words, the focus of the observation is different from `Observation.subject`. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's trachestomy tube. In this example, the child is the patient of record and the mother is focal subject referenced using this extension. Other example focal subjects include spouses, related persons, feti, or donors. Use on element: Observation
extension	0..1	Extension	Code
url	1..1	uri	"code"
valueCodeableConcept	0..1	CodeableConcept	Value of extension Binding: Focal Subject Codes (example)
extension	0..1	Extension	Reference
url	1..1	uri	"reference"
value[x]	1..1	Reference(Patient), Reference(Person), Reference(RelatedPerson), Reference(Group), Reference(Device)	Value of extension
url	1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-focal-subject"
value[x]	0..0
Documentation for this format

XML Template

<!-- focal-subject -->

<modifierExtension xmlns="http://hl7.org/fhir"
     url="http://hl7.org/fhir/StructureDefinition/observation-focal-subject" >
 <-- extension sliced by value:url  in the specified orderOpen-->
 <extension url="code"> 0..1 Extension  <!-- 0..1 Code -->
  <valueCodeableConcept><!-- 0..1 CodeableConcept Value of extension --></valueCodeableConcept>
 </extension>
 <extension url="reference"> 0..1 Extension  <!-- 0..1 Reference -->
  <value[x]><!-- 1..1 Reference(Patient)|Reference(Person)|Reference(RelatedPerson)|
    Reference(Group)|Reference(Device) Value of extension --></value[x]>
 </extension>
</modifierExtension>

JSON Template

{ // focal-subject
    "extension" : [ //  sliced by value:url  in the specified order, Open 
      { // Code //
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "code", // R! 
        "valueCodeableConcept" : { CodeableConcept } //Value of extension
      },
      { // Reference //
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "reference", // R! 
// value[x]: Value of extension. One of these 5:
        "valueReference" : { Reference(Patient) } // R! Value of extension
        "valueReference" : { Reference(Person) }, // R! Value of extension
        "valueReference" : { Reference(RelatedPerson) }, // R! Value of extension
        "valueReference" : { Reference(Group) }, // R! Value of extension
        "valueReference" : { Reference(Device) }, // R! Value of extension
      }
    ],
    "url" : "http://hl7.org/fhir/StructureDefinition/observation-focal-subject", // R! 
// value[x]: Value of extension. One of these 46:
  }

Summary

Name	Card.	Type	Description & Constraints
modifierExtension	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/observation-focal-subject focal-subject: The focus of an observation when the focus is not the patient of record. In other words, the focus of the observation is different from `Observation.subject`. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's trachestomy tube. In this example, the child is the patient of record and the mother is focal subject referenced using this extension. Other example focal subjects include spouses, related persons, feti, or donors. Use on element: Observation
code	0..1	CodeableConcept	A code representing the focal subject.
reference	0..1	Reference(Patient), Reference(Person), Reference(RelatedPerson), Reference(Group), Reference(Device)	A reference to another entity that represents the focal subject ( e.g., a RelatedPerson).
Documentation for this format

Full Structure

Name	Card.	Type	Description & Constraints
modifierExtension	0..*	Extension	URL = http://hl7.org/fhir/StructureDefinition/observation-focal-subject focal-subject: The focus of an observation when the focus is not the patient of record. In other words, the focus of the observation is different from `Observation.subject`. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's trachestomy tube. In this example, the child is the patient of record and the mother is focal subject referenced using this extension. Other example focal subjects include spouses, related persons, feti, or donors. Use on element: Observation
extension	0..1	Extension	Code
url	1..1	uri	"code"
valueCodeableConcept	0..1	CodeableConcept	Value of extension Binding: Focal Subject Codes (example)
extension	0..1	Extension	Reference
url	1..1	uri	"reference"
value[x]	1..1	Reference(Patient), Reference(Person), Reference(RelatedPerson), Reference(Group), Reference(Device)	Value of extension
url	1..1	uri	"http://hl7.org/fhir/StructureDefinition/observation-focal-subject"
value[x]	0..0
Documentation for this format

XML Template

<!-- focal-subject -->

<modifierExtension xmlns="http://hl7.org/fhir"
     url="http://hl7.org/fhir/StructureDefinition/observation-focal-subject" >
 <-- extension sliced by value:url  in the specified orderOpen-->
 <extension url="code"> 0..1 Extension  <!-- 0..1 Code -->
  <valueCodeableConcept><!-- 0..1 CodeableConcept Value of extension --></valueCodeableConcept>
 </extension>
 <extension url="reference"> 0..1 Extension  <!-- 0..1 Reference -->
  <value[x]><!-- 1..1 Reference(Patient)|Reference(Person)|Reference(RelatedPerson)|
    Reference(Group)|Reference(Device) Value of extension --></value[x]>
 </extension>
</modifierExtension>

JSON Template

{ // focal-subject
    "extension" : [ //  sliced by value:url  in the specified order, Open 
      { // Code //
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "code", // R! 
        "valueCodeableConcept" : { CodeableConcept } //Value of extension
      },
      { // Reference //
        // from Element: extension
        "extension" : [ //  sliced by value:url  in the specified order, Open ]
        "url" : "reference", // R! 
// value[x]: Value of extension. One of these 5:
        "valueReference" : { Reference(Patient) } // R! Value of extension
        "valueReference" : { Reference(Person) }, // R! Value of extension
        "valueReference" : { Reference(RelatedPerson) }, // R! Value of extension
        "valueReference" : { Reference(Group) }, // R! Value of extension
        "valueReference" : { Reference(Device) }, // R! Value of extension
      }
    ],
    "url" : "http://hl7.org/fhir/StructureDefinition/observation-focal-subject", // R! 
// value[x]: Value of extension. One of these 46:
  }

Constraints

ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div)
ext-1: Must have either extensions or value[x], not both (xpath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')]))