Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs vs http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/vitalsigns	http://hl7.org/fhir/StructureDefinition/Observation	Values Differ
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	2020-11-17	2021-12-07T14:30:02+00:00	Values Differ
description	Defines constraints on the Observation resource to represent vital signs observations. This profile is used as the base definition for the other US Core Vital Signs Profiles and based on the FHIR VitalSigns Profile.	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	false		Removed the item 'false'
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreVitalSignsProfile	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 Vital Signs Profile	SDOHCC Observation Screening Response	Values Differ
type	Observation
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs	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: "US Core Vital Signs Profile" "SDOH screening questionnaire observations" Elements differ in definition: "Defines constraints on the Observation resource to represent vital signs observation. This profile is used as the base definition for the other US Core Vital Signs Profiles and based on the FHIR VitalSigns Profile." "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 short: "Coded Responses from C-CDA Vital Sign Results" "Type of observation (code / type)" Elements differ in definition: "Coded Responses from C-CDA Vital Sign Results." "Describes what was observed. Sometimes this is called the observation "name"." 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: "5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." "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]	SΣI				SΣ				Elements differ in short: "Often just a dateTime for Vital Signs" "Clinically relevant time/time-period for observation" Elements differ in definition: "Often just a dateTime for Vital Signs." "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."
issued	Σ				Σ
performer	Σ				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)." Elements differ in definition for mustSupport: "false" "true" Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Practitioner], CanonicalType[http://hl7.org/fhir/StructureDefinition/PractitionerRole], CanonicalType[http://hl7.org/fhir/StructureDefinition/Organization], CanonicalType[http://hl7.org/fhir/StructureDefinition/CareTeam], CanonicalType[http://hl7.org/fhir/StructureDefinition/Patient], CanonicalType[http://hl7.org/fhir/StructureDefinition/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				Elements differ in short: "Vital Signs Value" "Actual result" Elements differ in definition: "Vital Signs value are typically recorded using the Quantity data type." "The information determined as a result of making the observation, if the information has a simple value." Elements differ in requirements: "9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations."
dataAbsentReason	SI				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."
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 short: "Used when reporting vital signs panel components" "Related resource that belongs to the Observation group" Elements differ in definition: "Used when reporting vital signs panel components." "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." Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence], CanonicalType[http://hl7.org/fhir/StructureDefinition/vitalsigns]]) Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]])
derivedFrom	Σ				SΣ				Elements differ in definition for mustSupport: "false" "true"
component	SΣI				SΣ				Elements differ in short: "Component observations" "Component results" Elements differ in definition: "Used when reporting component observation such as systolic and diastolic blood pressure." "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."
id
extension			Extension				Extension
modifierExtension	?!Σ				?!Σ
code	SΣ				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."
value[x]	SΣI				SΣ				Elements differ in short: "Vital Sign Component Value" "Actual component result" Elements differ in definition: "Vital Signs value are typically recorded using the Quantity data type. For supporting observations such as cuff size could use other datatypes such as CodeableConcept." "The information determined as a result of making the observation, if the information has a simple value." Elements differ in requirements: "9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations."
dataAbsentReason	SI				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."
interpretation
referenceRange
Documentation for this format