Release 4B Ballot #1

This page is part of the FHIR Specification v4.1.0: R4B Ballot. About the R4B version of FHIR. 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

10.3.13.8.4 StructureDefinition: Example Lipid Profile - Mappings

Orders and Observations Work Group Maturity Level: 0Trial Use Use Context: Not yet ready for Production use

Mappings:

Workflow Pattern

SNOMED CT Concept Domain Binding

HL7 v2 Mapping

RIM Mapping

FiveWs Pattern Mapping

SNOMED CT Attribute Binding

Mappings for the cholesterol Profile (see Mappings to Other Standards for further information & status).

10.3.13.9 Workflow Pattern (http://hl7.org/fhir/workflow)

Example Lipid Profile
ObservationEvent
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierEvent.identifier
   basedOnEvent.basedOn
   partOfEvent.partOf
   statusEvent.status
   category
   codeEvent.code
   subjectEvent.subject
   focus
   encounterEvent.context
   effective[x]Event.occurrence[x]
   issued
   performerEvent.performer.actor
   value[x]
   value[x]valueQuantity
      id
      extension
      value
      unit
      system
      code
   dataAbsentReason
   interpretation
   note
   bodySite
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      high
      text
   component
      id
      extension
      modifierExtension
      code
      value[x]
      dataAbsentReason
      interpretation
      referenceRange

10.3.13.10 SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

Concept domain bindings link a resource or an element to a set of SNOMED CT concepts that represent the intended semantics of the instances (whether or not SNOMED CT is used to encode that data element). This set of concepts is represented using a SNOMED CT expression constraint. Note that the 'Concept domain binding' may be a superset of the 'value set binding'. These bindings help to support:

  • Quality checking FHIR resources by ensuring that (a) the intended semantics of the instances matches the valid range of the corresponding SNOMED CT attribute, and (b) the intended value set is appropriate for the intended semantics of the instances
  • Semantic checking of data instances by helping to detect potential inconsistencies caused by overlap between the semantics incorporated in two concept domains
Example Lipid Profile
Observation< 363787002 |Observable entity|
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   basedOn
   partOf
   status< 445584004 |Report by finality status|
   category
   code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   subject
   focus
   encounter
   effective[x]
   issued
   performer
   value[x]< 441742003 |Evaluation finding|
   value[x]valueQuantity< 441742003 |Evaluation finding|
      id
      extension
      value
      unit
      system
      code
   dataAbsentReason
   interpretation< 260245000 |Findings values|
   note
   bodySite< 123037004 |Body structure|
   method
   specimen< 123038009 |Specimen|
   device< 49062001 |Device|
   referenceRange
      id
      extension
      modifierExtension
      high
      text
   component
      id
      extension
      modifierExtension
      code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
      dataAbsentReason
      interpretation< 260245000 |Findings values|
      referenceRange

10.3.13.11 HL7 v2 Mapping (http://hl7.org/v2)

Example Lipid Profile
ObservationOBX
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierOBX.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.
   basedOnORC
   partOfVaries by domain
   statusOBX-11
   category
   codeOBX-3
   subjectPID-3
   focusOBX-3
   encounterPV1
   effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
   performerOBX.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'
   value[x]OBX.2, OBX.5, OBX.6
   value[x]valueQuantityOBX.2, OBX.5, OBX.6
      id
      extension
      valueSN.2 / CQ - N/A
      unit(see OBX.6 etc.) / CQ.2
      system(see OBX.6 etc.) / CQ.2
      code(see OBX.6 etc.) / CQ.2
   dataAbsentReasonN/A
   interpretationOBX-8
   noteNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
   bodySiteOBX-20
   methodOBX-17
   specimenSPM segment
   deviceOBX-17 / PRT -10
   referenceRangeOBX.7
      id
      extension
      modifierExtension
      highSN (see also Range) or CQ
      textOBX-7
   componentcontainment by OBX-4?
      id
      extension
      modifierExtension
      codeOBX-3
      value[x]OBX.2, OBX.5, OBX.6
      dataAbsentReasonN/A
      interpretationOBX-8
      referenceRangeOBX.7

10.3.13.12 RIM Mapping (http://hl7.org/v3)

Example Lipid Profile
ObservationEntity. Role, or Act
   id
   meta
   implicitRules
   language
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifierid
   basedOn.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
   partOf.outboundRelationship[typeCode=FLFS].target
   statusstatus Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
   category.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   codecode
   subjectparticipation[typeCode=RTGT]
   focusparticipation[typeCode=SBJ]
   encounterinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
   effective[x]effectiveTime
   issuedparticipation[typeCode=AUT].time
   performerparticipation[typeCode=PRF]
   value[x]value
   value[x]valueQuantityvalue
      idn/a
      extensionn/a
      valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
      unitPQ.unit
      systemCO.codeSystem, PQ.translation.codeSystem
      codePQ.code, MO.currency, PQ.translation.code
   dataAbsentReasonvalue.nullFlavor
   interpretationinterpretationCode
   notesubjectOf.observationEvent[code="annotation"].value
   bodySitetargetSiteCode
   methodmethodCode
   specimenparticipation[typeCode=SPC].specimen
   deviceparticipation[typeCode=DEV]
   referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
      idn/a
      extensionn/a
      modifierExtensionN/A
      highn/a
      textvalue:ST
   componentoutBoundRelationship[typeCode=COMP]
      idn/a
      extensionn/a
      modifierExtensionN/A
      codecode
      value[x]value
      dataAbsentReasonvalue.nullFlavor
      interpretationinterpretationCode
      referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

10.3.13.13 FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

Example Lipid Profile
Observationclinical.diagnostics
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifierFiveWs.identifier
   basedOn
   partOf
   statusFiveWs.status
   categoryFiveWs.class
   codeFiveWs.what[x]
   subjectFiveWs.subject[x]
   focusFiveWs.subject[x]
   encounterFiveWs.context
   effective[x]FiveWs.done[x]
   issuedFiveWs.recorded
   performerFiveWs.actor
   value[x]
   value[x]valueQuantity
      id
      extension
      value
      unit
      system
      code
   dataAbsentReason
   interpretation
   note
   bodySite
   method
   specimen
   device
   referenceRange
      id
      extension
      modifierExtension
      high
      text
   component
      id
      extension
      modifierExtension
      codeFiveWs.what[x]
      value[x]
      dataAbsentReason
      interpretation
      referenceRange

10.3.13.14 SNOMED CT Attribute Binding (http://snomed.org/attributebinding)

Attribute bindings link coded data elements in FHIR resources to a corresponding attribute in the SNOMED CT concept model. These bindings help to support:

  • clarifying the intended meaning of the data element
  • Quality checking the alignment between FHIR resource design and any coresponding SNOMED CT concept model
  • Composition and decomposition of data instances by indicating the SNOMED CT concept model attribute whose value may be used to decompose a precoordinated concept into this data element
Example Lipid Profile
Observation
   id
   meta
   implicitRules
   language
   text
   contained
   extension
   modifierExtension
   identifier
   basedOn
   partOf
   status
   category
   code116680003 |Is a|
   subject
   focus
   encounter
   effective[x]
   issued
   performer
   value[x]363714003 |Interprets|
   value[x]valueQuantity363714003 |Interprets|
      id
      extension
      value
      unit
      system
      code
   dataAbsentReason
   interpretation363713009 |Has interpretation|
   note
   bodySite718497002 |Inherent location|
   method
   specimen704319004 |Inherent in|
   device424226004 |Using device|
   referenceRange
      id
      extension
      modifierExtension
      high
      text
   component
      id
      extension
      modifierExtension
      code
      value[x]363714003 |Interprets|
      dataAbsentReason
      interpretation363713009 |Has interpretation|
      referenceRange