Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history-assessment vs http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse

Messages

Metadata

Name	Value		Comments
abstract	true	false	Values Differ
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	2021-12-07T14:30:02+00:00	Values Differ
description	Profile for simple observations made by an individual about a patient's social history status such as education, food insecurity, etc. These observation involve assessment by a provider, payer, etc. as opposed to being derived only from screening surveys which should be represented using the [US Core Screening Response Observation Profile](StructureDefinition-us-core-observation-screening-response.html)	Profile for observations that represent question and answer pairs from Social Determinants of Health (SDOH) screening instruments that are represented in LOINC. The Cross-Group Projects work group granted an exception to US Core on 12/03/2020 - Jira ticket 29795.	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreObservationSocialHistoryAssessment	SDOHCCObservationScreeningResponse	Values Differ
publisher	HL7 International - Cross-Group Projects	HL7 International - Patient Care WG	Values Differ
purpose
status	active	draft	Values Differ
title	US Core Social History Assessment Observation Profile	SDOHCC Observation Screening Response	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-social-history-assessment	http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse	Values Differ
version	4.1.0	1.1.0	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				I				Elements differ in short: "assessment observation" "SDOH screening questionnaire observations" Elements differ in definition: "Simple observations made by an individual about a patient's social history." "For Observations derived from SDOH screening surveys/questionnaires." Elements differ in comments: "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." "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."
id	Σ				Σ
meta	Σ				Σ
implicitRules	?!Σ				?!Σ
language
text
contained
extension			Extension				Extension
modifierExtension	?!				?!
identifier	Σ				Σ
basedOn	Σ				Σ
partOf	Σ				Σ
status	?!SΣ				?!SΣ				Elements differ in short: "registered | preliminary | final | amended +" "final | corrected | entered-in-error | unknown" Elements differ in definition: "The status of the result value." "The status of the observation value." 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."
Slices for category	S								Elements differ in requirements: "Used for filtering what observations are retrieved and displayed." "To identify that an SDOH screening response observation is derived from an SDOH questionnaire, the “social-history” and “survey” codes are required." Elements differ in definition for mustSupport: "true" "false"
code	SΣ				SΣ				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]" 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."
subject	SΣ				SΣ				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."
focus	Σ				Σ
encounter	Σ				Σ
effective[x]	Σ				SΣ				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". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself." "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"." Elements differ in comments: "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." "At least a date should be present unless this observation is a historical report." Elements differ in definition for mustSupport: "false" "true"
issued	Σ				Σ
performer	SΣ				SΣ				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)." 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]])
value[x]	SΣI				SΣI
dataAbsentReason	I				SI				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. 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." ""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." Elements differ in definition for mustSupport: "false" "true"
interpretation
note
bodySite
method
specimen
device
referenceRange	I				I
id
extension			Extension				Extension
modifierExtension	?!Σ				?!Σ
low	I				I
high	I				I
type
appliesTo
age
text
hasMember	Σ				Σ				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."
derivedFrom	Σ				SΣ				Elements differ in definition for mustSupport: "false" "true"
component	Σ				SΣ				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 include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations." "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." Elements differ in comments: "For a discussion on the ways Observations can be assembled in groups together see [Notes] below." "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." Elements differ in definition for mustSupport: "false" "true"
id
extension			Extension				Extension
modifierExtension	?!Σ				?!Σ
code	Σ				SΣ				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]" 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." Elements differ in definition for mustSupport: "false" "true"
value[x]	Σ				SΣ				Elements differ in definition for mustSupport: "false" "true"
dataAbsentReason	I				SI				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. 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." ""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." Elements differ in definition for mustSupport: "false" "true"
interpretation
referenceRange
Documentation for this format