| Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-response' vs 'http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse' |
| Error | StructureDefinition.version | Values for version differ: '4.1.0' vs '1.1.0' |
| Information | StructureDefinition.name | Values for name differ: 'USCoreObservationScreeningResponse' vs 'SDOHCCObservationScreeningResponse' |
| Information | StructureDefinition.title | Values for title differ: 'US Core Screening Response Observation Profile' vs 'SDOHCC Observation Screening Response' |
| Information | StructureDefinition.status | Values for status differ: 'active' vs 'draft' |
| Information | StructureDefinition.date | Values for date differ: '2021-11-12' vs '2021-12-07T14:30:02+00:00' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - Cross-Group Projects' vs 'HL7 International - Patient Care WG' |
| Warning | Observation | Elements differ in short:
'questionnaire observations'
'SDOH screening questionnaire observations' |
| Warning | Observation | Elements differ in definition:
'For Observations derived from surveys/questionnaires.'
'For Observations derived from SDOH screening surveys/questionnaires.' |
| Warning | Observation | 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).'
'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).
Many of the SDOHCC profiles reference one another. One flow supported by this IG is that QuestionnaireResponses result in Observations that can be used as evidence for Conditions that can lead to Goals, ServiceRequests and Procedures. However, alternatives paths are also possible.' |
| Warning | Observation.status | Elements differ in short:
'registered | preliminary | final | amended +'
'final | corrected | entered-in-error | unknown' |
| Warning | Observation.status | Elements differ in definition:
'The status of the result value.'
'The status of the observation value.' |
| Warning | Observation.status | Elements differ in requirements:
'Need to track the status of individual results. Some results are finalized before the whole report is finalized.'
'Further constrained to values that are relevant for SDOH.' |
| Warning | Observation.category | Elements differ in requirements:
'To identify that observation is derived from a questionnaire.'
'To identify that an SDOH screening response observation is derived from an SDOH questionnaire, the “social-history” and “survey” codes are required.' |
| Error | Observation.category | Elements differ in definition for mustSupport:
'true'
'false' |
| Warning | Observation.code | Elements differ in comments:
'*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
'*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
For SDOH 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.
As the Gravity Project continues to refine content for the SDOH categories (e.g., food, housing, transportation, etc.), this value set will be refined to codes that pertain to SDOH categories. For further guidance on external value sets vetted by the Gravity Project see: [Supplemental Guide]' |
| Warning | Observation.code | Elements differ in requirements:
'Knowing what kind of observation is being made is essential to understanding the observation.'
'Knowing what kind of observation is being made is essential to understanding the observation.
The Gravity implemenation guide restricts questionnaire/survey observations to LOINC to move the industry to the use of LOINC panels/surveys (structures that are not available in other terminology systems) to standardize the coding of SDOH related risk assessment instruments. In addition, USCDI and US Core have standardized on the use of LOINC to represent Observations in general.' |
| Warning | Observation.subject | Elements differ in comments:
'One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.'
'Cardinality is 1..1.' |
| Warning | Observation.performer | Elements differ in requirements:
'May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.'
'Some questions on an SDOH screening questionnaire are not answered directly (e.g., asserted) by the individual completing the questionnaire. Rather, the answer to some questions (e.g., the Hunger Vital Sign 88124-3 “Food insecurity risk”) may be derived from answers to one or more other questions. For a Screening Response Observation that is derived, as opposed to answered directly, Observation.performer should not be specified and Observation.derivedFrom should reference the relevant Screening Response Observation(s).' |
| Error | Observation.performer | Type Mismatch:
Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/StructureDefinition/PractitionerRole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson]])
Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam]]) |
| Warning | Observation.value[x] | 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.'
'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.' |
| Warning | Observation.hasMember | Elements differ in definition:
'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.'
'Used when an observation is a group observation (e.g., the LOINC 88121-9 Hunger Vital Sign [HVS] panel) that includes the target as a member of the group.' |
| Warning | Observation.derivedFrom | Elements differ in short:
'Related questionnaire responses or observations that the observation is made from'
'Related measurements the observation is made from' |
| Warning | Observation.derivedFrom | Elements differ in definition:
'Questionnaire responses or observations from which this observation value is derived.'
'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.' |
| Error | Observation.derivedFrom | 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]])
Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation]]) |
| Warning | Observation.component | 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.'
'Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples:
1) Individuals may be multiracial. Component is used to capture one or more races.
2) “Material hardship” can be assessed based on a number of factors (adequate food, clothing, utilities, etc.). One, or all, of which can be captured using Component.' |
| Warning | Observation.component | 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.'
'For SDOH 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.' |
| Warning | Observation.component.code | Elements differ in comments:
'*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
'*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
As the Gravity Project continues to refine content for the SDOH categories (e.g., food, housing, transportation, etc.), this value set will be refined to codes that pertain to SDOH categories. For further guidance on external value sets vetted by the Gravity Project see: [Supplemental Guide]' |
| Warning | Observation.component.code | Elements differ in requirements:
'Knowing what kind of observation is being made is essential to understanding the observation.'
'Knowing what kind of observation is being made is essential to understanding the observation.
LOINC codes are required because Gravity intends to use only LOINC encoded Questionnaires to generate QuestionnaireResponses which, in turn, will generate Screening Response Observations.' |
| Warning | Observation.component.value[x] | Elements differ in comments:
'see `Observation.value[x]` comments'
'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.' |
| Warning | Observation.component.dataAbsentReason | Elements differ in comments:
'see `Observation.dataAbsentReason` 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 'check all that apply' LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.component.value. Where these concepts are not part of the value set for Observation.component.value, the Observation.component.dataAbsentReason can be used if necessary and appropriate.' |
abstract
jurisdiction[0]
Observation 
extension 
modifierExtension 
referenceRange