QI-Core Implementation Guide: STU Ballot (v3.3.0 for FHIR 4.0.0)

Quality Improvement Core Framework (v3.3.0: STU 4 Ballot 1). The current version is 3.2.0 based on FHIR R4. See the Directory of published versions

D.4.1.4 StructureDefinition: qicore-observation - Mappings

Mappings for the StructureDefinition-qicore-observation Profile.

Mappings for Quality Data Model (http://www.healthit.gov/quality-data-model)

QICoreObservation
ObservationAssessment, Performed|Diagnostic Study, Performed (for non-imaging studies )|Laboratory Test, Performed|Patient Care Experience|Physical Exam, Performed|Provider Care Experience (Note: Diagnostic Study, Performed imaging is mapped to FHIR DiagnosticReport.)
   id("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|PatientCareExperience|"Physical Exam, Performed"|ProviderCareExperience).id
   basedOn("Assessment, Performed"|" "Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").reason|("Assessment, Performed").relatedTo
   status("Diagnostic Study, Performed"|"Laboratory Test, Performed").status
   code("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|PatientCareExperience|"Physical Exam, Performed"|ProviderCareExperience).code
   effective[x]("Assessment, Performed"|PatientCareExperience|ProviderCareExperience).authorDatetime|("Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").relevantPeriod
   issued("Diagnostic Study, Performed"|"Laboratory Test, Performed").resultDatetime
   performer("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|PatientCareExperience|"Physical Exam, Performed"|ProviderCareExperience).source
   value[x]("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").result
   dataAbsentReason("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").negationRationale
   bodySite"Physical Exam, Performed".anatomicalLocationSite
   method(“Laboratory Test, Performed”|”Diagnostic Study, Performed”).method
   referenceRange"Laboratory Test, Performed".components.(referenceRangeLow|referenceRangeHigh)
      low"Laboratory Test, Performed".referenceRangeLow
      high"Laboratory Test, Performed".referenceRangeHigh
   component("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").components
      code("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").components.code
      value[x]("Assessment, Performed"|"Diagnostic Study, Performed"|"Laboratory Test, Performed"|"Physical Exam, Performed").components.result
      referenceRange"Laboratory Test, Performed".components.(referenceRangeLow|referenceRangeHigh)

Mappings for Mapping to Quality Improvement Domain Analysis Model (http://hl7.org/qidam)

QICoreObservation
Observation
   extension (bodyPosition)Not in QIDAM, but recognized as important to intrepreting many observations for the purposes of CDS.

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

QICoreObservation
ObservationEvent
   identifierEvent.identifier
   basedOnEvent.basedOn
   partOfEvent.partOf
   statusEvent.status
   codeEvent.code
   subjectEvent.subject
   encounterEvent.context
   effective[x]Event.occurrence[x]
   performerEvent.performer.actor

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

QICoreObservation
Observation< 363787002 |Observable entity|
   status< 445584004 |Report by finality status|
   code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   value[x]< 441742003 |Evaluation finding|
   interpretation< 260245000 |Findings values|
   bodySite< 123037004 |Body structure|
   specimen< 123038009 |Specimen|
   device< 49062001 |Device|
   referenceRange
      type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
   component
      code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
      interpretation< 260245000 |Findings values|

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

QICoreObservation
ObservationOBX
   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
   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
   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
      lowOBX-7
      highOBX-7
      typeOBX-10
      appliesToOBX-10
      textOBX-7
   hasMemberRelationships established by OBX-4 usage
   derivedFromRelationships established by OBX-4 usage
   componentcontainment by OBX-4?
      codeOBX-3
      value[x]OBX.2, OBX.5, OBX.6
      dataAbsentReasonN/A
      interpretationOBX-8
      referenceRangeOBX.7

Mappings for RIM Mapping (http://hl7.org/v3)

QICoreObservation
ObservationEntity. Role, or Act
   textAct.text?
   containedN/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
   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
      lowvalue:IVL_PQ.low
      highvalue:IVL_PQ.high
      typeinterpretationCode
      appliesTointerpretationCode
      ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
      textvalue:ST
   hasMemberoutBoundRelationship
   derivedFrom.targetObservation
   componentoutBoundRelationship[typeCode=COMP]
      idn/a
      extensionn/a
      modifierExtensionN/A
      codecode
      value[x]value
      dataAbsentReasonvalue.nullFlavor
      interpretationinterpretationCode
      referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

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

QICoreObservation
Observation
   identifierFiveWs.identifier
   statusFiveWs.status
   categoryFiveWs.class
   codeFiveWs.what[x]
   subjectFiveWs.subject[x]
   focusFiveWs.subject[x]
   encounterFiveWs.context
   effective[x]FiveWs.done[x]
   issuedFiveWs.recorded
   performerFiveWs.actor
   component
      codeFiveWs.what[x]

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

QICoreObservation
Observation
   code116680003 |Is a|
   value[x]363714003 |Interprets|
   interpretation363713009 |Has interpretation|
   bodySite718497002 |Inherent location|
   specimen704319004 |Inherent in|
   device424226004 |Using device|
   component
      value[x]363714003 |Interprets|
      interpretation363713009 |Has interpretation|