Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-response vs http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-travel-history

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/Observation
copyright	Used by permission of HL7 International, all rights reserved Creative Commons License		Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date	2021-11-12	2022-01-18T12:57:33+00:00	Values Differ
description	Profile for observations that represent question and answer pairs from from surveys/questionnaires such as Social Determinants of Health (SDOH) screening instruments.	This Observation profile represents a patient's travel history. The following data for a patient can be recorded: * travel history as a string, an address, or a coded location * the date or period of time spent in the location (Observation.effectiveTime) * it is important to accurately capture the most accurate dates possible * the focus should be on date of arrival and date of departure * the concepts of dates as related to travel are especially useful for determining need for Federal Public Health Notifications (FPHNs) and these dates are used to alert foreign ministries of health about their residents who may have been contacts of cases, or if a flight that was outbound from the USA had an infectious traveler on it * most uses will involve a single location (Observation.component), however, it is possible to specify multiple locations (but there is only a single effectiveTime) * this allows for cases where a patient cannot remember exact dates of travel (e.g. I traveled to London, Paris, and Berlin in July and August 2016) * free text describing the travel history details and location (Observation.component.valueCodeableConcept.text element) * use Observation.component.codeableConcept to record a coded location * use Observationcomponent.extension to record a specific address * where a more granular address than state is known (e.g. city, street) it is appropriate to use the extension to record an address rather than using the coded location	Values Differ
experimental		false	Added the item 'false'
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreObservationScreeningResponse	USPublicHealthTravelHistory	Values Differ
publisher	HL7 International - Cross-Group Projects	HL7 Public Health Work Group (http://www.hl7.org/Special/committees/pher/index.cfm)	Values Differ
purpose
status	active
title	US Core Screening Response Observation Profile	US Public Health Travel History	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-response	http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-travel-history	Values Differ
version	4.1.0	2.0.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
Observation	I	0..*	Observation	questionnaire observations us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present	I	0..*	Observation	US Public Health Travel History	Elements differ in short: 'questionnaire observations' vs 'US Public Health Travel History' Elements differ in definition: 'For Observations derived from surveys/questionnaires.' vs 'Measurements and simple assertions made about a patient, device or other subject.' Elements differ in comments: 'Used for simple observations such as education status, food insecurity observations, etc. This profile allows the representation of SDOH observations based on SDOH screening questionnaire responses (which can also be represented using SDC QuestionnaireResponse).' vs '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 laboratory reports, etc.'
id	Σ	0..1	string	Logical id of this artifact	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.	Elements differ in definition for mustSupport: 'true' vs 'false'
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.	Elements differ in requirements: 'To identify that observation is derived from a questionnaire.' vs 'Used for filtering what observations are retrieved and displayed.' Elements differ in definition for mustSupport: 'true' vs 'false' Element minimum cardinalities differ: '1' vs '0'
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: US Core Common SDOH Assessments ValueSet (preferred)	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: {"coding":[{"system":"http://snomed.info/sct","code":"420008001"}]}	Example/preferred bindings differ at Observation.code using binding from USCoreObservationScreeningResponse
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who and/or what the observation is about	SΣ	1..1	Reference(US Public Health Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣI	0..1	dateTime S, Period, Timing, instant	Clinically relevant time/time-period for observation us-core-1: Datetime must be at least to day.	SΣ	0..1	dateTime, Period, Timing, instant	Date or period of time spent in the location	Elements differ in short: 'Clinically relevant time/time-period for observation' vs 'Date or period of time spent in the location' Elements differ in definition: '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 "physiologically relevant time".' vs 'It is important to accurately capture the most accurate dates possible. The focus should be on date of arrival and date of departure.' Elements differ in comments: 'At least a date should be present unless this observation is a historical report.' vs 'At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing] datatype which allow the measurement to be tied to regular life events.'
issued	Σ	0..1	instant	Date/Time this version was made available	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core Related Person)	Who is responsible for the observation	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation	Elements differ in definition for mustSupport: 'true' vs 'false'
value[x]	SΣI	0..1	Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result us-core-3: SHALL use UCUM for coded quantity units.	ΣI	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result	Elements differ in comments: '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.' vs '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] below.' Elements differ in definition for mustSupport: 'true' vs 'false'
dataAbsentReason	SI	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	I	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	Elements differ in comments: '"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. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.value. Where these concepts are not part of the value set for Observation.value, the Observation.dataAbsentReason can be used if necessary and appropriate.' vs 'Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.' Elements differ in definition for mustSupport: 'true' vs 'false'
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	I	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text	I	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	I	0..1	SimpleQuantity	Low Range, if relevant	I	0..1	SimpleQuantity	Low Range, if relevant
high	I	0..1	SimpleQuantity	High Range, if relevant	I	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group	SΣ	0..*	Reference(US Public Health Transportation Details | US Public Health Exposure Contact Information)	Related resource that belongs to the Observation group	Elements differ in definition for mustSupport: 'false' vs 'true'
derivedFrom	SΣ	0..*	Reference(US Core Screening Response Observation Profile S | http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse S | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence)	Related questionnaire responses or observations that the observation is made from	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from	Elements differ in short: 'Related questionnaire responses or observations that the observation is made from' vs 'Related measurements the observation is made from' Elements differ in definition: 'Questionnaire responses or observations from which this observation value is derived.' vs '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.' Elements differ in definition for mustSupport: 'true' vs 'false' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-response], CanonicalType[http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]])
component	SΣ	0..*	BackboneElement	Component results	SΣ	1..*	BackboneElement	Component results Slice: Unordered, Open by value:code	Elements differ in definition: 'Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples: Individuals may be multiracial. Component is used to capture one or more races.' vs '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.' Elements differ in comments: 'For questions represented in LOINC that specify “check all that apply”, the LOINC question should be used for Observation.code and for Observation.component.code. For “check all that apply” questions, the answers (regardless of whether one or more are selected) should only be represented using Observation.component.value and Observation.value should be empty.' vs 'For a discussion on the ways Observations can be assembled in groups together see [Notes] below.' Element minimum cardinalities differ: '0' vs '1'
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (extensible)	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.	Elements differ in definition for mustSupport: 'true' vs 'false'
value[x]	SΣI	0..1	Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result us-core-3: SHALL use UCUM for coded quantity units.	Σ	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result	Elements differ in comments: 'see `Observation.value[x]` comments' vs 'Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section] below.' Elements differ in definition for mustSupport: 'true' vs 'false'
dataAbsentReason	SI	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	I	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.	Elements differ in comments: 'see `Observation.dataAbsentReason` comments' vs '"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.' Elements differ in definition for mustSupport: 'true' vs 'false'
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
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