{ "resourceType": "StructureDefinition", "id": "access-observation-gen-pat", "text": { "status": "generated", "div": "
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\"ObservationACCESS Observation General Lab (Patient) Profile
\".\"\".\"\".\"identifierIdentifierBusiness Identifier for observation
\".\"\".\"\".\"partOfReference(Procedure)Part of referenced event
\".\"\".\"\".\"statusScoderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
\".\"\".\"\".\"categorySCodeableConceptClassification of type of observation
Slice: Unordered, Open by value:pattern
Binding: ObservationCategoryCodes (preferred)
\".\"\".\"\".\"\".\"laboratoryS1..1CodeableConceptRequired Pattern: {\"coding\":[{\"system\":\"http://terminology.hl7.org/CodeSystem/observation-category\",\"code\":\"laboratory\"}]}
\".\"\".\"\".\"codeSCodeableConceptType of observation (code / type)
Binding: http://ehealthontario.ca/fhir/ValueSet/lab/observation-codes (preferred)
\".\"\".\"\".\"subjectS1..1Reference(http://hl7.org/fhir/ca/core/StructureDefinition/profile-patient)Who and/or what the observation is about
\".\"\".\"\".\"effectiveDateTimeSdateTimeClinically relevant time/time-period for observation
\".\"\".\"\".\"issuedDate/Time this version was made available
\".\"\".\"\".\"performerReference(Practitioner | Organization)Who is responsible for the observation
Slice: Unordered, Open by value:profile
\".\"\".\"\".\"\".\"practitionerReference(http://hl7.org/fhir/ca/core/StructureDefinition/profile-practitioner)Practitioner responsible for the observation
\".\"\".\"\".\"\".\"organizationReference(http://hl7.org/fhir/ca/core/StructureDefinition/profile-organization)Organization responsible for the observation
\".\"\".\"\".\"value[x]SQuantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual result
\".\"\".\"\".\"dataAbsentReasonSCodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
\".\"\".\"\".\"interpretationSCodeableConceptCodes signifying whether result is high, low, normal, compared to reference range
Binding: ObservationInterpretationCodes (extensible)
\".\"\".\"\".\"noteAnnotationComments about the observation
\".\"\".\"\".\"specimenReference(Specimen)Specimen used for this observation
\".\"\".\"\".\"referenceRangeBackboneElementProvides guide for interpretation
\".\"\".\"\".\"\".\"appliesToCodeableConceptReference range population
Binding: v2 NATURE OF ABNORMAL TESTING (example)
\".\"\".\"\".\"\".\"textstringText based reference range in an observation
\".\"\".\"\".\"hasMemberReference(http://infoway-inforoute.ca/fhir/StructureDefinition/access-observation-gen-pat)Related resource that belongs to the Observation group. 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.

\"doco\" Documentation for this format
" }, "url": "http://infoway-inforoute.ca/fhir/StructureDefinition/access-observation-gen-pat", "version": "0.1.0", "name": "AccessObservationGeneralLabPatient", "title": "ACCESS Observation General Lab (Patient) Profile", "status": "draft", "experimental": false, "date": "2019-03-21T04:00:00+00:00", "publisher": "Canada Health Infoway", "contact": [ { "telecom": [ { "system": "url", "value": "http://infoway-inforoute.ca" } ] } ], "description": "Constraints on the Observation resource to reflect source data mappings for the ACCESS Health project. Focus of this profile is on display of general lab information to citizen/patient viewers.", "fhirVersion": "4.0.0", "mapping": [ { "identity": "vendor-agnostic-v2", "uri": "http://unknown.org/Vendor Agnostic v2", "name": "Vendor Agnostic v2" }, { "identity": "ontario--olis", "uri": "http://unknown.org/Ontario- OLIS", "name": "Ontario- OLIS" }, { "identity": "prince-edward-island--cerner-millennium", "uri": "http://unknown.org/Prince Edward Island- Cerner Millennium", "name": "Prince Edward Island- Cerner Millennium" }, { "identity": "nova-scotia--meditech-magic", "uri": "http://unknown.org/Nova Scotia- Meditech Magic", "name": "Nova Scotia- Meditech Magic" }, { "identity": "nove-scotia--cerner-millennium", "uri": "http://unknown.org/Nove Scotia- Cerner Millennium", "name": "Nove Scotia- Cerner Millennium" }, { "identity": "nova-scotia--meditech-c/s", "uri": "http://unknown.org/Nova Scotia- Meditech C/S", "name": "Nova Scotia- Meditech C/S" }, { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "identity": "sct-concept", "uri": "http://snomed.info/conceptdomain", "name": "SNOMED CT Concept Domain Binding" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" }, { "identity": "sct-attr", "uri": "http://snomed.org/attributebinding", "name": "SNOMED CT Attribute Binding" } ], "kind": "resource", "abstract": false, "type": "Observation", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation", "derivation": "constraint", "differential": { "element": [ { "id": "Observation", "path": "Observation", "short": "ACCESS Observation General Lab (Patient) Profile", "definition": "Expected requirements for the observation resource when reflecting general lab data based on existing source mappings.", "comment": "Note for implementors: This profile focuses on general lab results. It excludes pathology, microbiology, serotology, etc for two reasons: 1) The density and content of information in the various lab types are dramatically different from each other, these differences drive different information and interaction requirements from patients, and 2) there is a large degree of variance in how general lab results are formatted (more structured) and how other types of labs like pathology are structured (largely text based). Additional analysis required for microbiology, serotology, and pathology lab result types to determine level of structured data available.", "mustSupport": false, "isModifier": false }, { "id": "Observation.identifier", "path": "Observation.identifier", "short": "Business Identifier for observation", "type": [ { "code": "Identifier" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-21 (Observation Instance Identifier)\nOther suggested options if OBX-21 is not available: OBR-2 (Placer Order Number) + OBR-3(Filler Order Number) + OBX-3 (Observation Identifier)" }, { "identity": "ontario--olis", "map": "OBR-3.1" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-3.1 + OBR-4.1" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-3.1 + OBR-4.1" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-20 + OBR-4.1" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-3.1 + OBR-4.1" } ] }, { "id": "Observation.partOf", "path": "Observation.partOf", "short": "Part of referenced event", "comment": "SME Note: This is an important element to aid in the visualization of tests that are related. Tests that are related MUST be displayed together in the viewer to maintain clinical significance. \n\nData Mapping Note: Some LIS have the capacity to have a very complex hierarchy of tests. Example A clinician ordered a panel ' Transplant panel' . This panel contains 3 group tests (OBR). Each of these 3 groups contains in turn multiples atomic tests (OBX). To maintain the link between all the groups, the LIS send a value in the OBR -26 (parent result) and OBR-29 ( parent number) . This is specially important when the multiples HL7 messages are sent for the results. \n\nThis is also a special concept for microbiology message (currently out of scope of this profile).", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Procedure" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-26 + OBR-29" }, { "identity": "ontario--olis", "map": "OBR-26 + OBR-29" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-26 + OBR-29" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-26 + OBR-29" } ] }, { "id": "Observation.status", "path": "Observation.status", "short": "registered | preliminary | final | amended +", "comment": "Mapping Note: The LIS that were examined in Nova Scotia included some additional codes that were unique to the LIS (i.e. FOUT). See the notes in the mapping document discussing the need to map the HL7 v2 codes used by the LIS (shorthand often single-digit codes) to the codes used by the FHIR value set (usually full word code).", "type": [ { "code": "code" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "required", "description": "Observation Status", "valueSet": "http://hl7.org/fhir/ValueSet/observation-status" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-11 (Observation Result Status)" }, { "identity": "ontario--olis", "map": "OBX-11 (Codes supported: P, F, C, N, W, X, Z)" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-11 (Codes upported: P, F, C, D, R, S, D, U, I)" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-11 (Codes supported: P, F, D, A*)" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-11 (Codes supported: P, F, C)" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-11 (Codes supported: P, F, C, D, A*, FOUT*)" } ] }, { "id": "Observation.category", "path": "Observation.category", "slicing": { "discriminator": [ { "type": "value", "path": "pattern" } ], "rules": "open" }, "short": "Classification of type of observation", "comment": "Laboratory should be the default code used in this general lab profile. Other profiles may support other codes. \n\nMapping/Implementor Note: There is no absolute semantic match in v2 that identifies the category of the ORU message, however the element was made must-support under the assumption that the category could be populated during the conversion process through a variety of means (primarily by source information in the message header- some Nova Scotia labs even send lab module). Unlike the US Core, laboratory was not set as a fixed value to avoid over-constraining the profile to the point of counteracting jurisdictional designs already in place (OLIS observationCategory value set supports both exam and laboratory codes). US Core Observation Results Profile requires the first use of category to default to 'laboratory' using the code system 'http://hl7.org/fhir/observation-category'. Additional codes can be used to provide more detail on the type of laboratory test.", "min": 1, "max": "*", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "preferred", "description": "Observation Category Codes", "valueSet": "http://hl7.org/fhir/ValueSet/observation-category" } }, { "id": "Observation.category.laboratory", "path": "Observation.category.laboratory", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" } ], "patternCodeableConcept": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory" } ] }, "mustSupport": true, "isModifier": false }, { "id": "Observation.code", "path": "Observation.code", "short": "Type of observation (code / type)", "comment": "Mapping Note: Every LIS has its own data dictionary. Some LIS dictionaries use nomenclature that has 1:1 mapping to LOINC codes (example: OLIS) others do not. Some LIS vendors (example: Cerner Millennium) may reuse a foundational data dictionary but LIS sites often opt to add additional codes as a supplement to the data dictionary which leads to inconsistency across sites. These codes can be numeric, alpha-numeric, text, or some combination (seen frequently in the test data from Nova Scotia). Occasionally codes may be retired by the vendor or LIS master file but the codes are kept for a period of time to ensure the transition accounts for tests that have not been completed.", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "preferred", "description": "OLIS Observation Codes", "valueSet": "http://ehealthontario.ca/fhir/ValueSet/lab/observation-codes" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-3.1 (Observation Identifier ID/Print Number)\nOther suggested options if OBX-3 is not available: OBR-4 (Universal Service Identifier)" }, { "identity": "ontario--olis", "map": "OBX-3.1" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-3.1 (Code set 72 with some ability to send LOINC if site selects \"send nomenclature identifier\")" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-3.1" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-3.1" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-3.1" } ] }, { "id": "Observation.subject", "path": "Observation.subject", "short": "Who and/or what the observation is about", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/ca/core/StructureDefinition/profile-patient" ] } ], "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "PID-3 (Patient Identifier List) Other suggested options if PID-3 is not available or the patient resource is tied to provincial identifiers: PID-2" }, { "identity": "ontario--olis", "map": "PID-3" }, { "identity": "prince-edward-island--cerner-millennium", "map": "PID-3 (if v2.3.1 and above), PID-4 (if v2.3 or below)" }, { "identity": "nova-scotia--meditech-magic", "map": "PID-3" }, { "identity": "nove-scotia--cerner-millennium", "map": "PID-3" }, { "identity": "nova-scotia--meditech-c/s", "map": "PID-3" } ] }, { "id": "Observation.effectiveDateTime", "path": "Observation.effectiveDateTime", "short": "Clinically relevant time/time-period for observation", "comment": "SME/Mapping Note: This element refers to the date the specimen was collected which is usually found in OBR-7. In some lab test such as Timed test, multiples samples are collected at various time (same date). In this case, the date of specimen collection can be included in the OBX segment. However, this has been found to be an issue with many LIS since they do not provide the information in the messages. \n\nThe patient/physician may refer to this date to distinguish from the other blood collection.", "type": [ { "code": "dateTime" } ], "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-14 (Date/Time of the Observation) Other suggested options if OBX-14 is not available: OBR-7" }, { "identity": "ontario--olis", "map": "OBX-14 \n\nOther suggested options if OBX-14 is not available: OBR-7" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-14" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-14 \n\nOther suggested options if OBX-14 is not available: OBR-7" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-14 \n\nOther suggested options if OBX-14 is not available: OBR-7" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-14 \n\nOther suggested options if OBX-14 is not available: OBR-7" } ] }, { "id": "Observation.issued", "path": "Observation.issued", "short": "Date/Time this version was made available", "comment": "SME Note: This refers to the date the result was released aka result are made available. \n\nMapping/Implementor Note: Pay special attention to situation with a group test (containing multiple atomic tests) .If the test result of only one atomic test is changed after the initial release, then the date in the OBX segment will be updated. Most LIS will also update the date in the OBR segment. Some LIS will update the date of all the atomic tests regardless if the result was changed or remains the same. This can be an issue if the displaying application/viewer has a trigger to warn the user of the change base of the issued date.", "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-22 (Results Rpt/Status Chng - Date/Time +)\n\nOther suggested options if OBR-22 is not available: OBR-7 or OBX-19 (if LIS is HL7 v2.4 or higher)" }, { "identity": "ontario--olis", "map": "OBR-7" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-22" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-22\n\nOther suggested options if OBR-22 is not available: OBR-7 or OBX-19 (if LIS is HL7 v2.4 or higher)" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-22\n\nOther suggested options if OBR-22 is not available: OBR-7 or OBX-19 (if LIS is HL7 v2.4 or higher)" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-7" } ] }, { "id": "Observation.performer", "path": "Observation.performer", "slicing": { "discriminator": [ { "type": "value", "path": "profile" } ], "rules": "open" }, "short": "Who is responsible for the observation", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization" ] } ], "mustSupport": false, "isModifier": false }, { "id": "Observation.performer.practitioner", "path": "Observation.performer.practitioner", "short": "Practitioner responsible for the observation", "comment": "SME Note: Very rare in general labs to have physicians that sign the lab result. Lab performing practitioner is usually internal information that gets stored by LIS for operational purposes, but not likely of value to patients or clinicians. In pathology (out of scope of this profile) there might be information that is used for f/u with the performing agent.", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/ca/core/StructureDefinition/profile-practitioner" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-32 (Principal Result Interpreter) or OBX-16 (Responsible Observer)" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-32" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-16 (not sent for all results)" } ] }, { "id": "Observation.performer.organization", "path": "Observation.performer.organization", "short": "Organization responsible for the observation", "comment": "SME Note: Most commonly, performing organization will be available (more frequently than performing practitioner).", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/ca/core/StructureDefinition/profile-organization" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-23 (when v2.5.1 or higher), OBX-15 (Producer's ID) if supported, otherwise Z segments" }, { "identity": "ontario--olis", "map": "ZBR-6" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-23" }, { "identity": "nova-scotia--meditech-magic", "map": "ZPS-2" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-15" } ] }, { "id": "Observation.value[x]", "path": "Observation.value[x]", "short": "Actual result", "type": [ { "code": "Quantity" }, { "code": "CodeableConcept" }, { "code": "string" }, { "code": "boolean" }, { "code": "integer" }, { "code": "Range" }, { "code": "Ratio" }, { "code": "SampledData" }, { "code": "time" }, { "code": "dateTime" }, { "code": "Period" } ], "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX.2 (Value Type), OBX.5 (Observation Value), OBX.6 (Units)" }, { "identity": "ontario--olis", "map": "OBX.2, OBX.5, OBX.6" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX.2, OBX.5, OBX.6" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX.2, OBX.5, OBX.6" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX.2, OBX.5, OBX.6" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX.2, OBX.5, OBX.6" } ] }, { "id": "Observation.dataAbsentReason", "path": "Observation.dataAbsentReason", "short": "Why the result is missing", "comment": "Implementor Note: While this is an important FHIR element to support (provides meaning for patients) it has a weak semantic mapping to available HL7 v2 ORU fields (utilized by the Nova Scotia & PEI LIS analyzed). Considered must support for the CA Baseline and US Core profiles, however there is no structured v2 field/code set outside of observation result status (cancel code) that addresses data absent reason. Likely to be addressed in notes which present their own set of challenges in automatic extraction. \n\nKey area of consideration given the value that this element has in reducing confusion in patients expecting to see a result that do not receive one. Unless further intervention occurs on behalf of the labs or converter, dataAbsentReason would likely only be populated when the ObservationResultStatus = cancelled.", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "extensible", "description": "Data Absent Reason", "valueSet": "http://hl7.org/fhir/ValueSet/data-absent-reason" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-11* (Observation Result Status)" }, { "identity": "ontario--olis", "map": "OBX-11*" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-11*" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-11*" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-11*" } ] }, { "id": "Observation.interpretation", "path": "Observation.interpretation", "short": "Codes signifying whether result is high, low, normal, compared to reference range", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "extensible", "description": "Observation Interpretation", "valueSet": "http://hl7.org/fhir/ValueSet/observation-interpretation" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-8 (Interpretation Codes)" }, { "identity": "ontario--olis", "map": "OBX-8" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-8" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-8" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-8" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-8" } ] }, { "id": "Observation.note", "path": "Observation.note", "short": "Comments about the observation", "comment": "SME Note: Notes are entered by the lab staff to justify, clarify, or aid the interpretation of the result. It can be a few words to paragraphs. Usually sent in an NTE type of segment. \n\nImplementor Note: One consideration that needs to be explored with LIS sites is whether there is any risk of exposing data that is inappropriate for the patient in this field. Another consideration if expecting lossless 2-way conversion, is that there are two places where notes can occur in HL7 v2 ORU messages: linked to the OBR (observation) and the OBX (result). Once the note is in FHIR, it will be difficult to identify whether or not it is tied to observation or result using existing structured data. If lossless 2-way for notes is deemed critical, one method of approach would be extensions, but discussions with LIS & end-users recommended to determine feasibility.", "type": [ { "code": "Annotation" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "NTE-3 (Comment)" }, { "identity": "ontario--olis", "map": "NTE-3" }, { "identity": "prince-edward-island--cerner-millennium", "map": "NTE-3" }, { "identity": "nova-scotia--meditech-magic", "map": "NTE-3" }, { "identity": "nove-scotia--cerner-millennium", "map": "NTE-3" }, { "identity": "nova-scotia--meditech-c/s", "map": "NTE-3" } ] }, { "id": "Observation.specimen", "path": "Observation.specimen", "short": "Specimen used for this observation", "comment": "Mapping Note: Cerner Millennium NS specifications do not support specimen number, the synonymous accession number is used. Accession number is an unique number given to a tube of blood, urine container. In that sense, specimen number and accession are the same.", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Specimen" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-3.1 (Filler Order Number ID) , SPM-2 (Specimen ID) can be used in interfaces that are HL7 v2.5.1 and higher" }, { "identity": "ontario--olis", "map": "OBR-3.1" }, { "identity": "prince-edward-island--cerner-millennium", "map": "SPM-2" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-3.1" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-20 (Filler Field 1+..Unformatted Millennium accension number)" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-3.1" } ] }, { "id": "Observation.referenceRange", "path": "Observation.referenceRange", "short": "Provides guide for interpretation", "type": [ { "code": "BackboneElement" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-7 (Reference Range)" }, { "identity": "ontario--olis", "map": "OBX-7" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-7" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-7" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-7" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-7" } ] }, { "id": "Observation.referenceRange.appliesTo", "path": "Observation.referenceRange.appliesTo", "short": "Reference range population", "comment": "Mapping Note: One thing implementors should keep in mind is that the HL7 v2 ORU field allows for multiple values to be supplied (example: age based population, sex based population). When more than one value is present they are separated by ^ in the message (ex: A^S) . \n\nSME Note: This element allows for distinction of abnormal testing (age, race, sex, species, strain) but is not typically displayed in existing clinician lab viewers today.", "type": [ { "code": "CodeableConcept" } ], "mustSupport": false, "isModifier": false, "binding": { "strength": "example", "description": "v2 Nature of abnormal test", "valueSet": "http://terminology.hl7.org/ValueSet/v2-0080" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-10 (Nature of Abnormal Test)" }, { "identity": "ontario--olis", "map": "OBX-10" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-10" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-10" } ] }, { "id": "Observation.referenceRange.text", "path": "Observation.referenceRange.text", "short": "Text based reference range in an observation", "type": [ { "code": "string" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-7 (Reference Range)" }, { "identity": "ontario--olis", "map": "OBX-7" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-7" }, { "identity": "nova-scotia--meditech-magic", "map": "OBX-7" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-7" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-7" } ] }, { "id": "Observation.hasMember", "path": "Observation.hasMember", "short": "Related resource that belongs to the Observation group. 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.", "comment": "Mapping Note: Consistent semantic equivalent mapping difficult to determine at existing LIS sites.", "type": [ { "code": "Reference", "targetProfile": [ "http://infoway-inforoute.ca/fhir/StructureDefinition/access-observation-gen-pat" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "Relationships established by OBX-4 usage" } ] } ] } }