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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="spark650" />
  <meta>
    <versionId value="spark689" />
    <lastUpdated value="2015-10-02T14:11:45.443+00:00" />
  </meta>
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/hspc-bmi" />
  <name value="HSPC Body Mass Index" />
  <status value="draft" />
  <publisher value="HSPC" />
  <contact>
    <telecom>
      <system value="other" />
      <value value="http://healthcaresoa.org" />
    </telecom>
  </contact>
  <date value="2015-06-16" />
  <description value="The HSPC specific profile for a body mass index observation" />
  <kind value="resource" />
  <constrainedType value="Observation" />
  <abstract value="false" />
  <base value="http://hl7.org/fhir/StructureDefinition/Observation" />
  <snapshot>
    <element>
      <path value="Observation" />
      <name value="hspc-bmi" />
      <short value="Measurements and simple assertions" />
      <definition value="Measurements and simple assertions made about a patient, device or other subject." />
      <alias value="Vital Signs" />
      <alias value="Measurement" />
      <alias value="Results" />
      <alias value="Tests" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Observation" />
      </type>
      <constraint>
        <key value="obs-6" />
        <severity value="error" />
        <human value="Shall only be present if Observation.value[x] is not present" />
        <xpath value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))" />
      </constraint>
      <constraint>
        <key value="obs-7" />
        <severity value="error" />
        <human value="Component code Shall not be same as observation code" />
        <xpath value="not(exists(f:component.code/@value)) or (f:code/@value !=  f:component/f:code/@value)" />
      </constraint>
      <mapping>
        <identity value="v2" />
        <map value="OBX" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Observation[classCode=OBS, moodCode=EVN]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical" />
      </mapping>
    </element>
    <element>
      <path value="Observation.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the url for the resource. Once assigned, this value never changes." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <isSummary value="true" />
    </element>
    <element>
      <path value="Observation.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <isSummary value="true" />
    </element>
    <element>
      <path value="Observation.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
    </element>
    <element>
      <path value="Observation.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <binding>
        <strength value="required" />
        <description value="A human language" />
        <valueSetUri value="http://tools.ietf.org/html/bcp47" />
      </binding>
    </element>
    <element>
      <path value="Observation.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="dom-1" />
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element>
      <path value="Observation.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="Observation.extension" />
      <name value="DeltaFlag" />
      <short value="Extension" />
      <definition value="An Extension" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-delta" />
      </type>
      <binding>
        <strength value="preferred" />
        <description value="The codes that describe in what way a numeric result is significantly different from its predecesor" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-deltaFlag-numericNom" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Observation.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="Observation.identifier" />
      <short value="Unique Id for this particular observation" />
      <definition value="A unique identifier for the simple observation instance." />
      <requirements value="Allows observations to be distinguished and referenced." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX.21" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="id" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="default: final" />
      </extension>
      <path value="Observation.status" />
      <short value="registered | preliminary | final | amended +" />
      <definition value="The status of the result value." />
      <requirements value="Need to track the status of individual results - some results are finalised before the whole report is finalised." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Observation.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A set of codes that describe the state of the observation" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-observationstatusbasic" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-11-observation result status" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="status  Amended &amp; Final are differentiated by whether it is the subject of a ControlAct event with a type of &quot;revise&quot;" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element>
      <path value="Observation.category" />
      <short value="Classification of  type of observation" />
      <definition value="A code that classifies the the general type of observation being made.  This is used  for searching, sorting and display purposes." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.category" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="example" />
        <description value="Codes for high level observation categories" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-category" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quot;].code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="class" />
      </mapping>
    </element>
    <element>
      <path value="Observation.code" />
      <short value="Type of observation (code / type)" />
      <definition value="Describes what was observed. Sometimes this is called the observation &quot;name&quot;." />
      <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Observation.code" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <fixedCodeableConcept>
        <coding>
          <system value="http://loinc.org/" />
          <code value="39156-5" />
          <display value="Body mass index (BMI) [Ratio]" />
        </coding>
      </fixedCodeableConcept>
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="Codes identifying names of simple observations" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-3-observation identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
    </element>
    <element>
      <path value="Observation.subject" />
      <short value="Who and/or what this is about" />
      <definition value="The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject." />
      <requirements value="Observations have no value if you don't know who or what they're about." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.subject" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Device" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Location" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="PID-3-patient ID list" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=SBJ]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.focus" />
      </mapping>
    </element>
    <element>
      <path value="Observation.encounter" />
      <short value="Healthcare event during which this observation is made" />
      <definition value="The healthcare event  ( e.g. a patient and healthcare provider interaction ) during which this observation is made." />
      <requirements value="For some observations it may be important to know the link between an observation and a particular encounter." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.encounter" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="PV1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="context" />
      </mapping>
    </element>
    <element>
      <path value="Observation.effective[x]" />
      <short value="Clinically Relevant time/time-period for observation" />
      <definition value="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 &quot;physiologically relevant time&quot;. 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." />
      <requirements value="Knowing when an observation was deemed true is important to its relevance as well as determining trends." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.effective[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX-14-date/time of the observation, and/or OBX-19 after v2.4  (depends on who observation made)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="effectiveTime" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.done" />
      </mapping>
    </element>
    <element>
      <path value="Observation.issued" />
      <short value="Date/Time this was made available" />
      <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Observation.issued" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="instant" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=AUT].time" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.recorded" />
      </mapping>
    </element>
    <element>
      <path value="Observation.performer" />
      <short value="Who is responsible for the observation" />
      <definition value="Who was responsible for asserting the observed value as &quot;true&quot;." />
      <requirements value="May give a degree of confidence in the observation and also indicates where follow-up questions should be directed." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.performer" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-provpract" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-organization" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-patient" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX.15 / (Practitioner)  OBX-16-responsible observer,  PRT-5-participation person:PRT-4-participation='RO' /  (Device)  OBX-18-equipment instance identifier , PRT-10-participation device:PRT-4-participation='EQUIP' / (Organization)  OBX-23-performing organization name,  PRT-8-participation organization:PRT-4-participation='PO'" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=PRF]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.actor" />
      </mapping>
    </element>
    <element>
      <path value="Observation.value[x]" />
      <short value="Actual result" />
      <definition value="The information determined as a result of making the observation, if the information has a simple value." />
      <requirements value="An observation exists to have a value, though it may not if it is in error, or it represents a group of observations." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Observation.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="SampledData" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX.2, OBX.5, OBX.6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value" />
      </mapping>
    </element>
    <element>
      <path value="Observation.dataAbsentReason" />
      <short value="Why the result is missing" />
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." />
      <requirements value="For many results it is necessary to handle exceptional values in measurements." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Observation.dataAbsentReason" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="obs-6" />
      <binding>
        <strength value="extensible" />
        <description value="Codes specifying why the result (Observation.value[x]) is missing" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value.nullFlavor" />
      </mapping>
    </element>
    <element>
      <path value="Observation.interpretation" />
      <short value="High, low, normal, etc." />
      <definition value="The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." />
      <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." />
      <alias value="Abnormal Flag" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.interpretation" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="preferred" />
        <description value="The codes that describe in what way a result is abnormal" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-abnInt-NumericNom" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-8-interpretation codes" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="interpretationCode" />
      </mapping>
    </element>
    <element>
      <path value="Observation.comments" />
      <short value="Comments about result" />
      <definition value="May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result." />
      <requirements value="Need to be able to provide free text additional information." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.comments" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="subjectOf.observationEvent[code=&quot;annotation&quot;].value" />
      </mapping>
    </element>
    <element>
      <path value="Observation.bodySite" />
      <short value="Observed body part" />
      <definition value="Indicates the site on the subject's body where the observation was made ( i.e. the target site)." />
      <requirements value="Knowing where the observation is made is important for tracking if multiple sites are possible." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Observation.bodySite" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="example" />
        <description value="Codes describing anatomical locations. May include laterality" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-20-observation site" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="targetSiteCode" />
      </mapping>
    </element>
    <element>
      <path value="Observation.method" />
      <short value="How it was done" />
      <definition value="Indicates the mechanism used to perform the observation." />
      <requirements value="In some cases, method can impact results and is thus for determining whether results can be compared or determining significance of results." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Observation.method" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="example" />
        <description value="Methods for simple observations" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-methods" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-17-observation method" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="methodCode" />
      </mapping>
    </element>
    <element>
      <path value="Observation.specimen" />
      <short value="Specimen used for this observation" />
      <definition value="The specimen that was used when this observation was made." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Observation.specimen" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Specimen" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="SPM segment" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=SPC].specimen" />
      </mapping>
    </element>
    <element>
      <path value="Observation.device" />
      <short value="(Measurement) Device" />
      <definition value="The device used to generate the observation data." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Observation.device" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Device" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX-17 / PRT -10" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=DEV]" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange" />
      <name value="referenceRange" />
      <short value="Provides guide for interpretation" />
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." />
      <requirements value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.referenceRange" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <constraint>
        <key value="obs-3" />
        <severity value="error" />
        <human value="Must have at least a low or a high or text" />
        <xpath value="(exists(f:low) or exists(f:high)or exists(f:text))" />
      </constraint>
      <mapping>
        <identity value="v2" />
        <map value="OBX.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.referenceRange.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.extension" />
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.referenceRange.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.referenceRange.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.low" />
      <short value="Low Range, if relevant" />
      <definition value="The value of the low bound of the reference range. If this element is omitted, the low bound of the reference range is assumed to be meaningless. (e.g. reference range is &lt;2.3)  If the low.comparator element is missing, it is assumed to be '&gt;'." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.referenceRange.low" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <condition value="obs-3" />
      <condition value="obs-4" />
      <constraint>
        <key value="obs-4" />
        <severity value="error" />
        <human value="Low range comparators can only be '&gt;' or '&gt;=' or empty" />
        <xpath value="not(exists(f:comparator)) or boolean(f:comparator/@value = '&lt;') or boolean(f:comparator/@value = '&lt;=')" />
      </constraint>
      <mapping>
        <identity value="v2" />
        <map value="OBX-7-references range" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value:IVL_PQ.low" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.high" />
      <short value="High Range, if relevant" />
      <definition value="The value of the high bound of the reference range. If this element is omitted, the high bound of the reference range is assumed to be meaningless. (e.g. reference range is &gt; 5)  If the low.comparator element is missing , it is assumed to be '&lt;'." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.referenceRange.high" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <condition value="obs-3" />
      <condition value="obs-5" />
      <constraint>
        <key value="obs-5" />
        <severity value="error" />
        <human value="High range comparators can only be '&lt;' or '&lt;=' or empty" />
        <xpath value="not(exists(f:comparator)) or boolean(f:comparator/@value = '&gt;') or boolean(f:comparator/@value = '&gt;=')" />
      </constraint>
      <mapping>
        <identity value="v2" />
        <map value="OBX-7-references range" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value:IVL_PQ.high" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.meaning" />
      <short value="Indicates the meaning/use of this range of this range" />
      <definition value="Code for the meaning of the reference range." />
      <requirements value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.referenceRange.meaning" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="example" />
        <description value="Code for the meaning of a reference range" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-10-nature of abnormal test?" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="interpretationCode" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.age" />
      <short value="Applicable age range, if relevant" />
      <definition value="The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so." />
      <requirements value="Some analytes vary greatly over age." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.referenceRange.age" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Range" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].value" />
      </mapping>
    </element>
    <element>
      <path value="Observation.referenceRange.text" />
      <short value="Text based reference range in an observation" />
      <definition value="Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of &quot;Negative&quot; or a list or table of 'normals'." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.referenceRange.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="OBX-7-references range" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value:ST" />
      </mapping>
    </element>
    <element>
      <path value="Observation.related" />
      <short value="Resource related to this observation" />
      <definition value="A  reference to another resource ( usally another Observation but could  also be a QuestionnaireAnswer) whose relationship is defined by the relationship type code." />
      <requirements value="Normally, an observation will have either a value or a set of related observations. A few observations (e.g. apgar store) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.related" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Relationships established by OBX-4 usage" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="outBoundRelationship" />
      </mapping>
    </element>
    <element>
      <path value="Observation.related.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.related.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="Observation.related.extension" />
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.related.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="Observation.related.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.related.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="Observation.related.type" />
      <short value="has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by" />
      <definition value="A code specifying the kind of relationship that exists with the target resource." />
      <requirements value="A relationship type SHOULD be provided." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.related.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <binding>
        <strength value="required" />
        <description value="Codes specifying how two observations are related" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-relationshiptypes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".typeCode" />
      </mapping>
    </element>
    <element>
      <path value="Observation.related.target" />
      <short value="Resource that is related to this one" />
      <definition value="A reference to the observation or questionnaireanswer that is related to this observation." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Observation.related.target" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".targetObservation" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component" />
      <short value="Component results" />
      <definition value="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 for genetics observations." />
      <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation ( they are not seperable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.component" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="outBoundRelationship[typeCode=COMP]" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.component.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.extension" />
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.component.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.component.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.code" />
      <short value="Type of component observation (code / type)" />
      <definition value="Describes what was observed. Sometimes this is called the observation &quot;code&quot;." />
      <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Observation.component.code" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="obs-7" />
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="Codes identifying names of simple observations" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX-3-observation identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.value[x]" />
      <short value="Actual component result" />
      <definition value="The information determined as a result of making the observation, if the information has a simple value." />
      <requirements value="An observation exists to have a value, though it may not if it is in error, or it represents a group of observations." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.component.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="SampledData" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX.2, OBX.5, OBX.6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.dataAbsentReason" />
      <short value="Why the component result is missing" />
      <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." />
      <requirements value="For many results it is necessary to handle exceptional values in measurements." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Observation.component.dataAbsentReason" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="obs-6" />
      <binding>
        <strength value="extensible" />
        <description value="Codes specifying why the result (Observation.value[x]) is missing" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="value.nullFlavor" />
      </mapping>
    </element>
    <element>
      <path value="Observation.component.referenceRange" />
      <short value="Provides guide for interpretation ofcomponent result" />
      <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." />
      <requirements value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Observation.component.referenceRange" />
        <min value="0" />
        <max value="*" />
      </base>
      <nameReference value="referenceRange" />
      <mapping>
        <identity value="v2" />
        <map value="OBX.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Observation" />
      <name value="hspc-bmi" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Observation" />
      </type>
    </element>
    <element>
      <path value="Observation.extension" />
      <name value="DeltaFlag" />
      <slicing>
        <discriminator value="url" />
        <ordered value="false" />
        <rules value="open" />
      </slicing>
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-delta" />
      </type>
      <binding>
        <strength value="preferred" />
        <description value="The codes that describe in what way a numeric result is significantly different from its predecesor" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-deltaFlag-numericNom" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Observation.status" />
      <binding>
        <strength value="preferred" />
        <description value="A set of codes that describe the state of the observation" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-observationstatusbasic" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Observation.code" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <fixedCodeableConcept>
        <coding>
          <system value="http://loinc.org/" />
          <code value="39156-5" />
          <display value="Body mass index (BMI) [Ratio]" />
        </coding>
      </fixedCodeableConcept>
    </element>
    <element>
      <path value="Observation.issued" />
      <min value="0" />
      <max value="0" />
    </element>
    <element>
      <path value="Observation.performer" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-provpract" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-organization" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/hspc-patient" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
    </element>
    <element>
      <path value="Observation.valueQuantity" />
      <min value="1" />
      <max value="1" />
    </element>
    <element>
      <path value="Observation.valueQuantity.system" />
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://unitsofmeasure.org/" />
    </element>
    <element>
      <path value="Observation.valueQuantity.code" />
      <type>
        <code value="code" />
      </type>
      <fixedCode value="kg/m2" />
    </element>
    <element>
      <path value="Observation.dataAbsentReason" />
      <min value="0" />
      <max value="0" />
    </element>
    <element>
      <path value="Observation.interpretation" />
      <binding>
        <strength value="preferred" />
        <description value="The codes that describe in what way a result is abnormal" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/hspc-abnInt-NumericNom" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Observation.bodySite" />
      <min value="0" />
      <max value="0" />
    </element>
    <element>
      <path value="Observation.method" />
      <min value="0" />
      <max value="0" />
    </element>
    <element>
      <path value="Observation.specimen" />
      <min value="0" />
      <max value="0" />
    </element>
    <element>
      <path value="Observation.device" />
      <min value="0" />
      <max value="0" />
    </element>
  </differential>
</StructureDefinition>

name : HSPC Body Mass Index

{

}

<name value="HSPC Body Mass Index" />