Observation | C | | http://hl7.org/fhir/StructureDefinition/DomainResource | Element idObservation Short descriptionMeasurements and simple assertions Alternate namesVital Signs, Measurement, Results, Tests DefinitionMeasurements and simple assertions made about a patient, device or other subject.
CommentsUsed for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as lab reports, etc.
Data typehttp://hl7.org/fhir/StructureDefinition/DomainResource Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty() - obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present
value.empty() or code!=component.code - obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
dataAbsentReason.empty() or value.empty() Mappings- rim: Entity. Role, or Act
- workflow: Event
- sct-concept: < 363787002 |Observable entity|
- v2: OBX
- rim: Observation[classCode=OBS, moodCode=EVN]
- w5: clinical.diagnostics
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idObservation.id Short descriptionLogical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
CommentsThe only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Data typeid |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idObservation.meta Short descriptionMetadata about the resource DefinitionThe 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.
Data typeMeta |
implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idObservation.implicitRules Short descriptionA set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
CommentsAsserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.
This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Data typeuri |
language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idObservation.language Short descriptionLanguage of the resource content DefinitionThe base language in which the resource is written.
CommentsLanguage is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Data typecode BindingA human language. http://hl7.org/fhir/ValueSet/languages (extensible) Binding extensions |
text | C | 0..1 | Narrative | There are no (further) constraints on this element Element idObservation.text Short descriptionText summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
CommentsContained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
Data typeNarrative ConditionsThe cardinality or value of this element may be affected by these constraints: dom-1 Mappings |
contained | | 0..* | Resource | There are no (further) constraints on this element Element idObservation.contained Short descriptionContained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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.
CommentsThis should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
Data typeResource Mappings |
extension | | 0..* | Extension | There are no (further) constraints on this element Element idObservation.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
modifierExtension | ?! | 0..* | Extension | There are no (further) constraints on this element Element idObservation.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idObservation.identifier Short descriptionBusiness Identifier for observation DefinitionA unique identifier assigned to this observation.
RequirementsAllows observations to be distinguished and referenced.
Data typeIdentifier Mappings- workflow: Event.identifier
- v2: OBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
- rim: id
- w5: id
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basedOn | Σ | 0..* | Reference(http://hl7.org/fhir/StructureDefinition/CarePlan | http://hl7.org/fhir/StructureDefinition/DeviceRequest | http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation | http://hl7.org/fhir/StructureDefinition/MedicationRequest | http://hl7.org/fhir/StructureDefinition/NutritionOrder | http://hl7.org/fhir/StructureDefinition/ProcedureRequest | http://hl7.org/fhir/StructureDefinition/ReferralRequest) | There are no (further) constraints on this element Element idObservation.basedOn Short descriptionFulfills plan, proposal or order Alternate namesFulfills DefinitionA plan, proposal or order that is fulfilled in whole or in part by this event.
RequirementsAllows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.
Data typeReference(http://hl7.org/fhir/StructureDefinition/CarePlan | http://hl7.org/fhir/StructureDefinition/DeviceRequest | http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation | http://hl7.org/fhir/StructureDefinition/MedicationRequest | http://hl7.org/fhir/StructureDefinition/NutritionOrder | http://hl7.org/fhir/StructureDefinition/ProcedureRequest | http://hl7.org/fhir/StructureDefinition/ReferralRequest) Mappings- workflow: Event.basedOn
- v2: ORC
- rim: .outboundRelationship[typeCode=FLFS].target
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idObservation.status Short descriptionregistered | preliminary | final | amended + DefinitionThe status of the result value.
RequirementsNeed to track the status of individual results. Some results are finalized before the whole report is finalized.
CommentsThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Data typecode BindingCodes providing the status of an observation. http://hl7.org/fhir/ValueSet/observation-status (required) Mappings- workflow: Event.status
- sct-concept: < 445584004 |Report by finality status|
- v2: OBX-11
- rim: status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
- w5: status
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category | | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idObservation.category Short descriptionClassification of type of observation DefinitionA code that classifies the general type of observation being made.
RequirementsUsed for filtering what observations are retrieved and displayed.
CommentsIn addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Data typeCodeableConcept BindingCodes for high level observation categories. http://hl7.org/fhir/ValueSet/observation-category (preferred) Mappings- rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
- w5: class
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code | Σ | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idObservation.code Short descriptionType of observation (code / type) Alternate namesName DefinitionDescribes what was observed. Sometimes this is called the observation "name".
RequirementsKnowing what kind of observation is being made is essential to understanding the observation.
Data typeCodeableConcept BindingCodes identifying names of simple observations. http://hl7.org/fhir/ValueSet/observation-codes (example) Mappings- workflow: Event.code
- sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
- v2: OBX-3
- rim: code
- sct-attr: 116680003 |Is a|
- w5: what
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subject | Σ | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Group | http://hl7.org/fhir/StructureDefinition/Device | http://hl7.org/fhir/StructureDefinition/Location) | There are no (further) constraints on this element Element idObservation.subject Short descriptionWho and/or what this is about DefinitionThe 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.
RequirementsObservations have no value if you don't know who or what they're about.
CommentsOne would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.
If the target of the observation is different than the subject, the general extension observation-focal-subject. may be used. However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.
Data typeReference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Group | http://hl7.org/fhir/StructureDefinition/Device | http://hl7.org/fhir/StructureDefinition/Location) Mappings- workflow: Event.subject
- v2: PID-3
- rim: participation[typeCode=SBJ]
- w5: who.focus
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context | | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Encounter | http://hl7.org/fhir/StructureDefinition/EpisodeOfCare) | There are no (further) constraints on this element Element idObservation.context Short descriptionHealthcare event during which this observation is made Alternate namesEncounter DefinitionThe healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
RequirementsFor some observations it may be important to know the link between an observation and a particular encounter.
CommentsThis will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).
Data typeReference(http://hl7.org/fhir/StructureDefinition/Encounter | http://hl7.org/fhir/StructureDefinition/EpisodeOfCare) Mappings- workflow: Event.context
- v2: PV1
- rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
- w5: context
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effective[x] | Σ | 0..1 | | There are no (further) constraints on this element Element idObservation.effective[x] Short descriptionClinically relevant time/time-period for observation Alternate namesOccurrence DefinitionThe time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
RequirementsKnowing when an observation was deemed true is important to its relevance as well as determining trends.
CommentsAt least a date should be present unless this observation is a historical report.
Mappings- workflow: Event.occurrence[x]
- v2: OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
- rim: effectiveTime
- w5: when.done
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effectiveDateTime | | | dateTime | There are no (further) constraints on this element Data typedateTime |
effectivePeriod | | | Period | There are no (further) constraints on this element Data typePeriod |
issued | Σ | 0..1 | instant | There are no (further) constraints on this element Element idObservation.issued Short descriptionDate/Time this was made available DefinitionThe date and time this observation was made available to providers, typically after the results have been reviewed and verified.
CommentsUpdated when the result is updated.
Data typeinstant Mappings- v2: OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
- rim: participation[typeCode=AUT].time
- w5: when.recorded
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performer | Σ | 0..* | Reference(http://hl7.org/fhir/StructureDefinition/Practitioner | http://hl7.org/fhir/StructureDefinition/Organization | http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/RelatedPerson) | There are no (further) constraints on this element Element idObservation.performer Short descriptionWho is responsible for the observation DefinitionWho was responsible for asserting the observed value as "true".
RequirementsMay give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Data typeReference(http://hl7.org/fhir/StructureDefinition/Practitioner | http://hl7.org/fhir/StructureDefinition/Organization | http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/RelatedPerson) Mappings- workflow: Event.performer
- v2: OBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
- rim: participation[typeCode=PRF]
- w5: who.actor
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value[x] | Σ C | 0..1 | | There are no (further) constraints on this element Element idObservation.value[x] Short descriptionActual result DefinitionThe information determined as a result of making the observation, if the information has a simple value.
RequirementsAn observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.
CommentsNormally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type).
If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the notes section below.
ConditionsThe cardinality or value of this element may be affected by these constraints: obs-7 Mappings- workflow: Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
- sct-concept: < 441742003 |Evaluation finding|
- v2: OBX.2, OBX.5, OBX.6
- rim: value
- sct-attr: 363714003 |Interprets|
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valueQuantity | | | Quantity | There are no (further) constraints on this element Data typeQuantity |
valueCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data typeCodeableConcept |
valueString | | | string | There are no (further) constraints on this element Data typestring |
valueBoolean | | | boolean | There are no (further) constraints on this element Data typeboolean |
valueRange | | | Range | There are no (further) constraints on this element Data typeRange |
valueRatio | | | Ratio | There are no (further) constraints on this element Data typeRatio |
valueSampledData | | | SampledData | There are no (further) constraints on this element Data typeSampledData |
valueAttachment | | | Attachment | There are no (further) constraints on this element Data typeAttachment |
valueTime | | | time | There are no (further) constraints on this element Data typetime |
valueDateTime | | | dateTime | There are no (further) constraints on this element Data typedateTime |
valuePeriod | | | Period | There are no (further) constraints on this element Data typePeriod |
dataAbsentReason | C | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idObservation.dataAbsentReason Short descriptionWhy the result is missing DefinitionProvides a reason why the expected value in the element Observation.value[x] is missing.
RequirementsFor many results it is necessary to handle exceptional values in measurements.
CommentsNull or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.
Data typeCodeableConcept BindingCodes specifying why the result (Observation.value[x]) is missing. http://hl7.org/fhir/ValueSet/observation-valueabsentreason (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: obs-6 Mappings- workflow: Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
- v2: N/A
- rim: value.nullFlavor
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interpretation | | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idObservation.interpretation Short descriptionHigh, low, normal, etc. Alternate namesAbnormal Flag DefinitionThe 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.
RequirementsFor some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Data typeCodeableConcept BindingCodes identifying interpretations of observations. http://hl7.org/fhir/ValueSet/observation-interpretation (extensible) Mappings- sct-concept: < 260245000 |Findings values|
- v2: OBX-8
- rim: interpretationCode
- sct-attr: 363713009 |Has interpretation|
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bodySite | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idObservation.bodySite Short descriptionObserved body part DefinitionIndicates the site on the subject's body where the observation was made (i.e. the target site).
CommentsOnly used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension body-site-instance.
Data typeCodeableConcept BindingCodes describing anatomical locations. May include laterality. http://hl7.org/fhir/ValueSet/body-site (example) Mappings- sct-concept: < 123037004 |Body structure|
- v2: OBX-20
- rim: targetSiteCode
- sct-attr: 718497002 |Inherent location|
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method | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idObservation.method Short descriptionHow it was done DefinitionIndicates the mechanism used to perform the observation.
RequirementsIn some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.
CommentsOnly used if not implicit in code for Observation.code.
Data typeCodeableConcept BindingMethods for simple observations. http://hl7.org/fhir/ValueSet/observation-methods (example) Mappings- v2: OBX-17
- rim: methodCode
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specimen | | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Specimen) | There are no (further) constraints on this element Element idObservation.specimen Short descriptionSpecimen used for this observation DefinitionThe specimen that was used when this observation was made.
CommentsShould only be used if not implicit in code found in Observation.code . Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).
Data typeReference(http://hl7.org/fhir/StructureDefinition/Specimen) Mappings- sct-concept: < 123038009 |Specimen|
- v2: SPM segment
- rim: participation[typeCode=SPC].specimen
- sct-attr: 704319004 |Inherent in|
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device | | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Device | http://hl7.org/fhir/StructureDefinition/DeviceMetric) | There are no (further) constraints on this element Element idObservation.device Short description(Measurement) Device DefinitionThe device used to generate the observation data.
CommentsAn extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.
Data typeReference(http://hl7.org/fhir/StructureDefinition/Device | http://hl7.org/fhir/StructureDefinition/DeviceMetric) Mappings- sct-concept: < 49062001 |Device|
- v2: OBX-17 / PRT -10
- rim: participation[typeCode=DEV]
- sct-attr: 424226004 |Using device|
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referenceRange | C | 0..* | BackboneElement | There are no (further) constraints on this element Element idObservation.referenceRange Short descriptionProvides guide for interpretation DefinitionGuidance on how to interpret the value by comparison to a normal or recommended range.
RequirementsKnowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
CommentsMost observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
Data typeBackboneElement Constraints- obs-3: Must have at least a low or a high or text
low.exists() or high.exists() or text.exists() Mappings- v2: OBX.7
- rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
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related | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idObservation.related Short descriptionResource related to this observation DefinitionA reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.
RequirementsNormally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.
CommentsFor a discussion on the ways Observations can assembled in groups together see Notes below.
Data typeBackboneElement Mappings- v2: Relationships established by OBX-4 usage
- rim: outBoundRelationship
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component | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idObservation.component Short descriptionComponent results DefinitionSome observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
RequirementsComponent 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 separable). 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.
CommentsFor a discussion on the ways Observations can be assembled in groups together see Notes below.
Data typeBackboneElement Mappings- v2: containment by OBX-4?
- rim: outBoundRelationship[typeCode=COMP]
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