HL7 FHIR® Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment)
This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.1.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions 
The official URL for this profile is:
http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-EstrogenReceptorStatus
Estrogen receptor alpha is the predominant estrogen receptor expressed in breast tissue and is overexpressed in around 50% of breast carcinomas. ER status (positive=present or overexpressed; negative=absent) is a factor in determining prognosis and treatment options.
We are seeking feedback if it is better to put the positive/negative status in Value or Interpretation. The current approach is that positive/negative designation is a value, even though that value is (in fact) an interpretation of evidence (NuclearPositivity and AverageStainingIntensity).
This profile builds on US Core Results Profile.
This profile was published on Sun Apr 01 00:00:00 AEDT 2018 as a draft by The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC).
View the corresponding EstrogenReceptorStatusModel logical model.
Summary
Mandatory: 0 element (4 nested mandatory elements)
Fixed Value: 9 elements
Prohibited: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
BC Mapping Source
This structure represents the following BC mapping definition:
oncology.EstrogenReceptorStatus maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults: EvaluationResultTopic.Category maps to category EvaluationResultTopic.FindingMethod maps to method EvaluationResultTopic.Quantity maps to value[x] EvaluationResultTopic.CodeableConcept maps to value[x] EvaluationResultTopic.string maps to value[x] EvaluationResultTopic.boolean maps to value[x] EvaluationResultTopic.Range maps to value[x] EvaluationResultTopic.Ratio maps to value[x] EvaluationResultTopic.time maps to value[x] EvaluationResultTopic.dateTime maps to value[x] EvaluationResultTopic.TimePeriod maps to value[x] EvaluationResultTopic.TopicCode maps to code EvaluationResultTopic.AnatomicalLocation maps to bodySite EvaluationResultTopic.Specimen maps to specimen EvaluationResultTopic.Interpretation maps to interpretation RecordedContext.RelevantTime maps to effective[x] RecordedContext.FindingStatus maps to status RecordedContext.ExceptionValue maps to dataAbsentReason EvaluationResultTopic.ReferenceRange maps to referenceRange EvaluationResultTopic.ReferenceRange.Range.LowerBound maps to referenceRange.low EvaluationResultTopic.ReferenceRange.Range.UpperBound maps to referenceRange.high EvaluationResultTopic.ReferenceRange.Type maps to referenceRange.type EvaluationResultTopic.ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo EvaluationResultTopic.ReferenceRange.ApplicableAgeRange maps to referenceRange.age fix related.type to #has-member EvaluationResultTopic.EvaluationComponent maps to component (slice on = coding.code; slice strategy = includes) EvaluationResultTopic.EvaluationComponent._Concept maps to component.code EvaluationResultTopic.EvaluationComponent.Quantity maps to component.value[x] EvaluationResultTopic.EvaluationComponent.CodeableConcept maps to component.value[x] EvaluationResultTopic.EvaluationComponent.string maps to component.value[x] EvaluationResultTopic.EvaluationComponent.Range maps to component.value[x] EvaluationResultTopic.EvaluationComponent.Ratio maps to component.value[x] EvaluationResultTopic.EvaluationComponent.time maps to component.value[x] EvaluationResultTopic.EvaluationComponent.dateTime maps to component.value[x] EvaluationResultTopic.EvaluationComponent.TimePeriod maps to component.value[x] EvaluationResultTopic.EvaluationComponent.ExceptionValue maps to component.dataAbsentReason EvaluationResultTopic.EvaluationComponent.Interpretation maps to component.interpretation EvaluationResultTopic.EvaluationComponent.ReferenceRange maps to component.referenceRange Members.EvaluationResultRecorded maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes) constrain related to 0..0
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Observation | BC EstrogenReceptorStatus Profile | |||
  cimi-Encounter-extension | 0..1 | (Complex) | BC Encounter Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension | |
| cimi-statement-DiagnosticService-extension | 0..* | CodeableConcept | BC DiagnosticService Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension Binding: DiagnosticServiceVS (extensible) | |
  valueCodeableConcept | ||||
  coding | Slice: Unordered, Open by value:code | |||
  coding | Σ | 1..1 | Coding | |
 system | Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS | |||
| code | Fixed Value: pathology | |||
| category | Binding: Observation Category Codes (extensible) | |||
| coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | |
| system | Fixed Value: http://hl7.org/fhir/observation-category | |||
| code | Fixed Value: laboratory | |||
| code | ||||
| coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | |
| system | Fixed Value: http://loinc.org | |||
| code | Fixed Value: 16112-5 | |||
| valueCodeableConcept | CodeableConcept | Binding: PositiveNegativeVS (required) | ||
| dataAbsentReason | Binding: ExceptionValueVS (required) | |||
| bodySite | 0..0 | |||
| method | Binding: LOINC Codes (preferred) | |||
 specimen | Reference(BC BreastSpecimen Profile) | |||
| referenceRange | 0..0 | |||
| related | 0..0 | |||
| component | Slice: Unordered, Open by value:coding.code | |||
 value[x] | Quantity, CodeableConcept, string, RangeProfile, RatioProfile, time, dateTime, Period | Slice: Unordered, Open by type:$this | ||
 valueCodeableConcept | CodeableConcept | Binding: PositiveNegativeVS (required) | ||
| component | 0..1 | NuclearPositivity | ||
| code | Binding: PositiveNegativeVS (required) | |||
| valueRange | PercentageRangeProfile | |||
| dataAbsentReason | Binding: ExceptionValueVS (required) | |||
| referenceRange | 0..0 | |||
| component | 0..1 | AverageStainingIntensity | ||
| code | Binding: PositiveNegativeVS (required) | |||
 coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | Average intensity of positive staining neoplastic cells (observable entity) |
| system | Fixed Value: http://snomed.info/sct | |||
| code | Fixed Value: 444775005 | |||
| valueCodeableConcept | CodeableConcept | Binding: PositiveNegativeVS (required) | ||
| dataAbsentReason | Binding: ExceptionValueVS (required) | |||
| referenceRange | 0..0 | |||
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | I | 0..* | BC EstrogenReceptorStatus Profile us-core-2: If there is no component or related element then either a value[x] or a data absent reason must be present | |
 id | Σ | 0..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: Common Languages (extensible) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
 contained | 0..* | Resource | Contained, inline Resources | |
| cimi-Encounter-extension | 0..1 | (Complex) | BC Encounter Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension | |
| cimi-statement-DiagnosticService-extension | 0..* | CodeableConcept | BC DiagnosticService Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension Binding: DiagnosticServiceVS (extensible) | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension" | |
| valueCodeableConcept | 1..1 | CodeableConcept | Value of extension Binding: DiagnosticServiceVS (extensible) | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: pathology |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | Business Identifier for observation |
| basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest) | Fulfills plan, proposal or order |
| status | ?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required) |
| category | SI | 1..* | CodeableConcept | Classification of type of observation Binding: Observation Category Codes (extensible) us-core-5: Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category' |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/observation-category |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| code | SΣ | 1..1 | CodeableConcept | Laboratory Test Name Binding: LOINC Codes (extensible) |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 16112-5 |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who and/or what this is about |
| context | 0..1 | Reference(Encounter | EpisodeOfCare) | Healthcare event during which this observation is made | |
 effective[x] | SΣI | 0..1 | dateTime, Period | Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day. |
| issued | Σ | 0..1 | instant | Date/Time this was made available |
| performer | Σ | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation |
| valueCodeableConcept | Σ | 0..1 | CodeableConcept | Result Value Binding: PositiveNegativeVS (required) |
| dataAbsentReason | SI | 0..1 | CodeableConcept | Why the result is missing Binding: ExceptionValueVS (required) |
| interpretation | 0..1 | CodeableConcept | High, low, normal, etc. Binding: Observation Interpretation Codes (extensible) | |
| comment | 0..1 | string | Comments about result | |
| method | 0..1 | CodeableConcept | How it was done Binding: LOINC Codes (preferred) | |
| specimen | 0..1 | Reference(BC BreastSpecimen Profile) | Specimen used for this observation | |
| device | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device | |
| component | ΣI | BackboneElement | Component results Slice: Unordered, Open by value:coding.code | |
| value[x] | Σ | Quantity, CodeableConcept, string, RangeProfile, RatioProfile, time, dateTime, Period | Actual component result Slice: Unordered, Open by type:$this | |
| valueCodeableConcept | Σ | 0..1 | CodeableConcept | Actual component result Binding: PositiveNegativeVS (required) |
| component | ΣI | 0..1 | BackboneElement | NuclearPositivity |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: PositiveNegativeVS (required) |
| valueRange | Σ | 0..1 | PercentageRangeProfile | Actual component result |
| dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: ExceptionValueVS (required) |
| interpretation | 0..1 | CodeableConcept | High, low, normal, etc. Binding: Observation Interpretation Codes (extensible) | |
| component | ΣI | 0..1 | BackboneElement | AverageStainingIntensity |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: PositiveNegativeVS (required) |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | Average intensity of positive staining neoplastic cells (observable entity) |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 444775005 |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| valueCodeableConcept | Σ | 0..1 | CodeableConcept | Actual component result Binding: PositiveNegativeVS (required) |
| dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: ExceptionValueVS (required) |
| interpretation | 0..1 | CodeableConcept | High, low, normal, etc. Binding: Observation Interpretation Codes (extensible) | |
| Documentation for this format | ||||
Summary
Mandatory: 0 element (4 nested mandatory elements)
Fixed Value: 9 elements
Prohibited: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
BC Mapping Source
This structure represents the following BC mapping definition:
oncology.EstrogenReceptorStatus maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults: EvaluationResultTopic.Category maps to category EvaluationResultTopic.FindingMethod maps to method EvaluationResultTopic.Quantity maps to value[x] EvaluationResultTopic.CodeableConcept maps to value[x] EvaluationResultTopic.string maps to value[x] EvaluationResultTopic.boolean maps to value[x] EvaluationResultTopic.Range maps to value[x] EvaluationResultTopic.Ratio maps to value[x] EvaluationResultTopic.time maps to value[x] EvaluationResultTopic.dateTime maps to value[x] EvaluationResultTopic.TimePeriod maps to value[x] EvaluationResultTopic.TopicCode maps to code EvaluationResultTopic.AnatomicalLocation maps to bodySite EvaluationResultTopic.Specimen maps to specimen EvaluationResultTopic.Interpretation maps to interpretation RecordedContext.RelevantTime maps to effective[x] RecordedContext.FindingStatus maps to status RecordedContext.ExceptionValue maps to dataAbsentReason EvaluationResultTopic.ReferenceRange maps to referenceRange EvaluationResultTopic.ReferenceRange.Range.LowerBound maps to referenceRange.low EvaluationResultTopic.ReferenceRange.Range.UpperBound maps to referenceRange.high EvaluationResultTopic.ReferenceRange.Type maps to referenceRange.type EvaluationResultTopic.ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo EvaluationResultTopic.ReferenceRange.ApplicableAgeRange maps to referenceRange.age fix related.type to #has-member EvaluationResultTopic.EvaluationComponent maps to component (slice on = coding.code; slice strategy = includes) EvaluationResultTopic.EvaluationComponent._Concept maps to component.code EvaluationResultTopic.EvaluationComponent.Quantity maps to component.value[x] EvaluationResultTopic.EvaluationComponent.CodeableConcept maps to component.value[x] EvaluationResultTopic.EvaluationComponent.string maps to component.value[x] EvaluationResultTopic.EvaluationComponent.Range maps to component.value[x] EvaluationResultTopic.EvaluationComponent.Ratio maps to component.value[x] EvaluationResultTopic.EvaluationComponent.time maps to component.value[x] EvaluationResultTopic.EvaluationComponent.dateTime maps to component.value[x] EvaluationResultTopic.EvaluationComponent.TimePeriod maps to component.value[x] EvaluationResultTopic.EvaluationComponent.ExceptionValue maps to component.dataAbsentReason EvaluationResultTopic.EvaluationComponent.Interpretation maps to component.interpretation EvaluationResultTopic.EvaluationComponent.ReferenceRange maps to component.referenceRange Members.EvaluationResultRecorded maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes) constrain related to 0..0
Differential View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | BC EstrogenReceptorStatus Profile | |||
| cimi-Encounter-extension | 0..1 | (Complex) | BC Encounter Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension | |
| cimi-statement-DiagnosticService-extension | 0..* | CodeableConcept | BC DiagnosticService Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension Binding: DiagnosticServiceVS (extensible) | |
| valueCodeableConcept | ||||
| coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | |
| system | Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS | |||
| code | Fixed Value: pathology | |||
| category | Binding: Observation Category Codes (extensible) | |||
| coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | |
| system | Fixed Value: http://hl7.org/fhir/observation-category | |||
| code | Fixed Value: laboratory | |||
| code | ||||
| coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | |
| system | Fixed Value: http://loinc.org | |||
| code | Fixed Value: 16112-5 | |||
| valueCodeableConcept | CodeableConcept | Binding: PositiveNegativeVS (required) | ||
| dataAbsentReason | Binding: ExceptionValueVS (required) | |||
| bodySite | 0..0 | |||
| method | Binding: LOINC Codes (preferred) | |||
| specimen | Reference(BC BreastSpecimen Profile) | |||
| referenceRange | 0..0 | |||
| related | 0..0 | |||
| component | Slice: Unordered, Open by value:coding.code | |||
| value[x] | Quantity, CodeableConcept, string, RangeProfile, RatioProfile, time, dateTime, Period | Slice: Unordered, Open by type:$this | ||
| valueCodeableConcept | CodeableConcept | Binding: PositiveNegativeVS (required) | ||
| component | 0..1 | NuclearPositivity | ||
| code | Binding: PositiveNegativeVS (required) | |||
| valueRange | PercentageRangeProfile | |||
| dataAbsentReason | Binding: ExceptionValueVS (required) | |||
| referenceRange | 0..0 | |||
| component | 0..1 | AverageStainingIntensity | ||
| code | Binding: PositiveNegativeVS (required) | |||
| coding | Slice: Unordered, Open by value:code | |||
| coding | Σ | 1..1 | Coding | Average intensity of positive staining neoplastic cells (observable entity) |
| system | Fixed Value: http://snomed.info/sct | |||
| code | Fixed Value: 444775005 | |||
| valueCodeableConcept | CodeableConcept | Binding: PositiveNegativeVS (required) | ||
| dataAbsentReason | Binding: ExceptionValueVS (required) | |||
| referenceRange | 0..0 | |||
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | I | 0..* | BC EstrogenReceptorStatus Profile us-core-2: If there is no component or related element then either a value[x] or a data absent reason must be present | |
| id | Σ | 0..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: Common Languages (extensible) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
| contained | 0..* | Resource | Contained, inline Resources | |
| cimi-Encounter-extension | 0..1 | (Complex) | BC Encounter Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension | |
| cimi-statement-DiagnosticService-extension | 0..* | CodeableConcept | BC DiagnosticService Extension URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension Binding: DiagnosticServiceVS (extensible) | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension" | |
| valueCodeableConcept | 1..1 | CodeableConcept | Value of extension Binding: DiagnosticServiceVS (extensible) | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: pathology |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | Business Identifier for observation |
| basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest) | Fulfills plan, proposal or order |
| status | ?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required) |
| category | SI | 1..* | CodeableConcept | Classification of type of observation Binding: Observation Category Codes (extensible) us-core-5: Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category' |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/observation-category |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| code | SΣ | 1..1 | CodeableConcept | Laboratory Test Name Binding: LOINC Codes (extensible) |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 16112-5 |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who and/or what this is about |
| context | 0..1 | Reference(Encounter | EpisodeOfCare) | Healthcare event during which this observation is made | |
| effective[x] | SΣI | 0..1 | dateTime, Period | Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day. |
| issued | Σ | 0..1 | instant | Date/Time this was made available |
| performer | Σ | 0..* | Reference(Practitioner | Organization | Patient | RelatedPerson) | Who is responsible for the observation |
| valueCodeableConcept | Σ | 0..1 | CodeableConcept | Result Value Binding: PositiveNegativeVS (required) |
| dataAbsentReason | SI | 0..1 | CodeableConcept | Why the result is missing Binding: ExceptionValueVS (required) |
| interpretation | 0..1 | CodeableConcept | High, low, normal, etc. Binding: Observation Interpretation Codes (extensible) | |
| comment | 0..1 | string | Comments about result | |
| method | 0..1 | CodeableConcept | How it was done Binding: LOINC Codes (preferred) | |
| specimen | 0..1 | Reference(BC BreastSpecimen Profile) | Specimen used for this observation | |
| device | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device | |
| component | ΣI | BackboneElement | Component results Slice: Unordered, Open by value:coding.code | |
| value[x] | Σ | Quantity, CodeableConcept, string, RangeProfile, RatioProfile, time, dateTime, Period | Actual component result Slice: Unordered, Open by type:$this | |
| valueCodeableConcept | Σ | 0..1 | CodeableConcept | Actual component result Binding: PositiveNegativeVS (required) |
| component | ΣI | 0..1 | BackboneElement | NuclearPositivity |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: PositiveNegativeVS (required) |
| valueRange | Σ | 0..1 | PercentageRangeProfile | Actual component result |
| dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: ExceptionValueVS (required) |
| interpretation | 0..1 | CodeableConcept | High, low, normal, etc. Binding: Observation Interpretation Codes (extensible) | |
| component | ΣI | 0..1 | BackboneElement | AverageStainingIntensity |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: PositiveNegativeVS (required) |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| coding | Σ | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code | |
| coding | Σ | 1..1 | Coding | Average intensity of positive staining neoplastic cells (observable entity) |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 444775005 |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | Σ | 0..1 | string | Plain text representation of the concept |
| valueCodeableConcept | Σ | 0..1 | CodeableConcept | Actual component result Binding: PositiveNegativeVS (required) |
| dataAbsentReason | I | 0..1 | CodeableConcept | Why the component result is missing Binding: ExceptionValueVS (required) |
| interpretation | 0..1 | CodeableConcept | High, low, normal, etc. Binding: Observation Interpretation Codes (extensible) | |
| Documentation for this format | ||||
Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron
| Path | Name | Conformance | ValueSet |
| Observation.language | Common Languages | extensible | Common Languages |
| Observation.extension.valueCodeableConcept | DiagnosticServiceVS | extensible | DiagnosticServiceVS |
| Observation.status | ObservationStatus | required | ObservationStatus |
| Observation.category | Observation Category Codes | extensible | Observation Category Codes |
| Observation.code | LOINC Codes | extensible | LOINC Codes |
| Observation.valueCodeableConcept | PositiveNegativeVS | required | PositiveNegativeVS |
| Observation.dataAbsentReason | ExceptionValueVS | required | ExceptionValueVS |
| Observation.interpretation | Observation Interpretation Codes | extensible | Observation Interpretation Codes |
| Observation.method | LOINC Codes | preferred | LOINC Codes |
| Observation.referenceRange.type | Observation Reference Range Meaning Codes | extensible | Observation Reference Range Meaning Codes |
| Observation.referenceRange.appliesTo | Observation Reference Range Applies To Codes | extensible | Observation Reference Range Applies To Codes |
| Observation.related.type | ObservationRelationshipType | required | ObservationRelationshipType |
| Observation.component.valueCodeableConcept | PositiveNegativeVS | required | PositiveNegativeVS |
| Observation.component.code | PositiveNegativeVS | required | PositiveNegativeVS |
| Observation.component.dataAbsentReason | ExceptionValueVS | required | ExceptionValueVS |
| Observation.component.interpretation | Observation Interpretation Codes | extensible | Observation Interpretation Codes |
| Observation.component.referenceRange.type | Observation Reference Range Meaning Codes | extensible | Observation Reference Range Meaning Codes |
| Observation.component.referenceRange.appliesTo | Observation Reference Range Applies To Codes | example | Observation Reference Range Applies To Codes |
| Observation.component.code | PositiveNegativeVS | required | PositiveNegativeVS |
| Observation.component.valueCodeableConcept | PositiveNegativeVS | required | PositiveNegativeVS |
| Observation.component.dataAbsentReason | ExceptionValueVS | required | ExceptionValueVS |
| Observation.component.interpretation | Observation Interpretation Codes | extensible | Observation Interpretation Codes |
| Observation.component.referenceRange.type | Observation Reference Range Meaning Codes | extensible | Observation Reference Range Meaning Codes |
| Observation.component.referenceRange.appliesTo | Observation Reference Range Applies To Codes | example | Observation Reference Range Applies To Codes |
| Id | Path | Details | Requirements |
| dom-2 | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-1 | Observation | If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty() | |
| dom-4 | Observation | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-3 | Observation | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty() | |
| obs-7 | Observation | If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or code!=component.code | |
| obs-6 | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty() | |
| us-core-2 | Observation | If there is no component or related element then either a value[x] or a data absent reason must be present : (component.empty() and related.empty()) implies (dataAbsentReason or value) | |
| us-core-5 | Observation.category | Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category' : where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='laboratory').exists() | |
| us-core-1 | Observation.effective[x] | Datetime must be at least to day. : ($this as dateTime).toString().length() >= 8 | |
| ele-1 | Observation.component | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) | |
| ele-1 | Observation.component | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) | |
| ele-1 | Observation.component | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) |