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{
  "resourceType": "StructureDefinition",
  "id": "1dd6f087-4c10-4fd8-93a2-8a96b628a0fa",
  "url": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Observation",
  "name": "NHSDigitalObservation",
  "status": "draft",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation.extension",
        "path": "Observation.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Observation.extension:covid19Testing",
        "path": "Observation.extension",
        "sliceName": "covid19Testing",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-COVID19-TestResult"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.identifier",
        "path": "Observation.identifier",
        "definition": "A unique identifier assigned to this observation.\r\n\r\nFor COVID-19 Test History this will be The identifier will be the specimen id.\r\n\r\n```json\r\n\r\n    \"identifier\":  [\r\n        {\r\n            \"system\": \"https://fhir.nhs.uk/Id/SpecimenId\",\r\n            \"value\": \"eb89a392-5b20-11eb-ae93-0242ac130002\"\r\n        }\r\n    ],\r\n```",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.identifier.system",
        "path": "Observation.identifier.system",
        "min": 1
      },
      {
        "id": "Observation.identifier.value",
        "path": "Observation.identifier.value",
        "min": 1
      },
      {
        "id": "Observation.status",
        "path": "Observation.status",
        "definition": "The status of the result value.\r\n\r\nFor COVID-19 Test History the status of the observation will always be `final`\r\n\r\n```json\r\n\r\n    \"status\": \"final\",\r\n```",
        "mustSupport": true
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "coding.system"
            }
          ],
          "rules": "open"
        },
        "definition": "This is an optional element. If used the category will always be `laboratory`\r\n\r\n```json\r\n\r\n    \"category\":  [\r\n        {\r\n            \"coding\":  [\r\n                {\r\n                    \"system\": \"http://terminology.hl7.org/CodeSystem/observation-category\",\r\n                    \"code\": \"laboratory\",\r\n                    \"display\": \"Laboratory\"\r\n                }\r\n            ],\r\n            \"text\": \"Laboratory\"\r\n        }\r\n    ],\r\n```\r\n\r\nFor COVID-19 Tests, the ValueSet **SHOULD** be used to indicate which test pillar the observation originated.\r\n\r\n```json\r\n\r\n     \"category\": [\r\n        {\r\n            \"coding\": [\r\n                {\r\n                    \"system\": \"https://fhir.nhs.uk/CodeSystem/covid-test-pillar\",\r\n                    \"code\": \"pillar-1\",\r\n                    \"display\": \"pillar 1\"\r\n                }\r\n            ]\r\n        }\r\n    ],\r\n```",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-Observation-category"
        }
      },
      {
        "id": "Observation.category.coding",
        "path": "Observation.category.coding",
        "min": 1
      },
      {
        "id": "Observation.category.coding.system",
        "path": "Observation.category.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.category.coding.code",
        "path": "Observation.category.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.category:COVID-TestPillar",
        "path": "Observation.category",
        "sliceName": "COVID-TestPillar",
        "max": "1"
      },
      {
        "id": "Observation.category:COVID-TestPillar.coding.system",
        "path": "Observation.category.coding.system",
        "fixedUri": "https://fhir.nhs.uk/CodeSystem/covid-test-pillar"
      },
      {
        "id": "Observation.category:UKCoreCategory",
        "path": "Observation.category",
        "sliceName": "UKCoreCategory"
      },
      {
        "id": "Observation.category:UKCoreCategory.coding.system",
        "path": "Observation.category.coding.system",
        "fixedUri": "http://terminology.hl7.org/CodeSystem/observation-category"
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "definition": "Type of observation, for COVID-10 see [Observation Definition](https://simplifier.net/guide/NHSDigital/Home/FHIRAssets/AllAssets/ObservationDefinition/ObservationDefinition.guide.md) for `code` values.\r\n\r\n```json\r\n    \"code\": {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"http://snomed.info/sct\",\r\n                \"code\": \"871555000\",\r\n                \"display\": \"Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2\"\r\n            }\r\n        ]\r\n    },\r\n```",
        "mustSupport": true
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "definition": "The NHS Number will be an identifier reference which can be used with PDS FHIR API to return Patient demographics. If a local Patient is available, a reference to this will be present (e.g. \"Patient/123\")\r\n\r\n```json\r\n\r\n    \"subject\": {\r\n        \"reference\": \"Patient/123\",\r\n        \"identifier\":  [\r\n            {\r\n                \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n                \"value\": \"987123456\"\r\n            }\r\n        ]\r\n    },\r\n```",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Group",
              "http://hl7.org/fhir/StructureDefinition/Device",
              "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient-Minimal"
            ]
          }
        ],
        "constraint": [
          {
            "key": "patient-reference",
            "severity": "warning",
            "human": "subject - An identifier reference or resource reference must be provided",
            "expression": "(reference.exists() or (identifier.exists()))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Observation"
          },
          {
            "key": "patient-nhs",
            "severity": "error",
            "human": "Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong.",
            "expression": "identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([456789]{1}[0-9]{9})$'))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Observation"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.subject.identifier.system",
        "path": "Observation.subject.identifier.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/Id/nhs-number"
      },
      {
        "id": "Observation.subject.identifier.value",
        "path": "Observation.subject.identifier.value",
        "min": 1
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "definition": "The date and time the result was asserted.\r\n\r\n```json\r\n\r\n    \"effectiveDateTime\": \"2020-09-23T13:00:08.476+00:00\"\r\n```",
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "definition": "Who was responsible for asserting the observed value as \"true\". \r\n\r\n```json\r\n\r\n\"performer\": [\r\n  {\r\n    \"type\": \"Organization\",\r\n    \"identifier\": {\r\n      \"type\": {\r\n        \"coding\": [\r\n          {\r\n            \"system\": \"https://fhir.nhs.uk/CodeSystem/organisation-role\",\r\n            \"code\": \"173\",\r\n            \"display\": \"PATHOLOGY LAB\"\r\n          }\r\n        ]\r\n      },\r\n      \"value\": \"LFD004\"\r\n    }\r\n  },\r\n  {\r\n    \"type\": \"Organization\",\r\n    \"identifier\": {\r\n      \"type\": {\r\n        \"coding\": [\r\n          {\r\n            \"system\": \"https://fhir.nhs.uk/Id/OrgType\",\r\n            \"code\": \"TestCentreId\",\r\n            \"display\": \"Testing Centre\"\r\n          }\r\n        ]\r\n      },\r\n      \"value\": \"WKE03\"\r\n    }\r\n  }\r\n]\r\n\r\n```",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Reference"
            ],
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization",
              "http://hl7.org/fhir/StructureDefinition/CareTeam",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient",
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole-Minimal"
            ]
          }
        ],
        "constraint": [
          {
            "key": "performer",
            "severity": "error",
            "human": "An identifier reference or resource reference must be provided",
            "expression": "(reference.exists() or identifier.exists())",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Observation"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "definition": "### COVID-19 valueCodeableConcept \r\n\r\nThe COVID 19 test result. This is a SNOMED CT from the valueSet associated with the `code`, see [Observation Definition](https://simplifier.net/guide/NHSDigital/Home/FHIRAssets/AllAssets/ObservationDefinition/ObservationDefinition.guide.md)\r\n\r\n```json \r\n\r\n    \"valueCodeableConcept\": {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"http://snomed.info/sct\",\r\n                \"code\": \"1240581000000104\",\r\n                \"display\": \"SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) detection result positive\"\r\n            }\r\n        ],\r\n        \"text\": \"SARS-CoV-2-ORGY\"\r\n    },\r\n```",
        "mustSupport": true
      },
      {
        "id": "Observation.method",
        "path": "Observation.method",
        "definition": "The name of the test that was performed, this is a SNOMED CT concept.\r\n\r\n```json\r\n\r\n    \"method\": {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"http://snomed.info/sct\",\r\n                \"code\": \"1240461000000109\",\r\n                \"display\": \"Measurement of SARS-CoV-2 antibody (procedure)\"\r\n            }\r\n        ]\r\n    },\r\n```",
        "mustSupport": true
      },
      {
        "id": "Observation.method.coding.system",
        "path": "Observation.method.coding.system",
        "min": 1
      },
      {
        "id": "Observation.method.coding.code",
        "path": "Observation.method.coding.code",
        "min": 1
      },
      {
        "id": "Observation.method.coding.display",
        "path": "Observation.method.coding.display",
        "min": 1
      },
      {
        "id": "Observation.specimen",
        "path": "Observation.specimen",
        "definition": "For COVID-19 Test History. The identifier of the specimen used for the test.\r\n \r\n```json\r\n\r\n    \"specimen\": {\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/SpecimenId\",\r\n            \"value\": \"eb89a392-5b20-11eb-ae93-0242ac130002\"\r\n        }\r\n    },\r\n```",
        "mustSupport": true
      },
      {
        "id": "Observation.specimen.identifier.system",
        "path": "Observation.specimen.identifier.system",
        "min": 1
      },
      {
        "id": "Observation.specimen.identifier.value",
        "path": "Observation.specimen.identifier.value",
        "min": 1
      },
      {
        "id": "Observation.device",
        "path": "Observation.device",
        "definition": "Details of the [COVID-19 test kit](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/Id/Covid19-TestKit) used.  \r\n\r\n```json\r\n\r\n    \"device\": {\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/Covid19-TestKit\",\r\n            \"value\": \"LFT\"\r\n        },\r\n        \"display\": \"Lateral Flow Test\"\r\n    }\r\n```",
        "mustSupport": true
      },
      {
        "id": "Observation.device.identifier.system",
        "path": "Observation.device.identifier.system",
        "min": 1
      },
      {
        "id": "Observation.device.identifier.value",
        "path": "Observation.device.identifier.value",
        "min": 1
      },
      {
        "id": "Observation.device.display",
        "path": "Observation.device.display",
        "min": 1
      }
    ]
  }
}

name : NHSDigitalObservation

{

}