CareConnect Delta

This section highlights any changes that have been made in the UK Core Profiles against the CareConnect Profiles.

Note 1: Only the changes are listed, elements that are unchanged are not provided due to table size. Changes to references from a CareConnect profile to the UK Core replacement are also not shown.
Note 2: There is a comparison of extensions section.
Note 3: The UK Core FHIR assets follow a set of UK Core design principles. These principles were created based on feedback from implementers and NHS England SMEs and are used for the creation of all the current UK Core FHIR assets. The principles are open to challenge in this C&TA sprint.

Observation Delta

Important

Note: The UKCore-Observation profile already exists, and underwent discussion and revision during the Clinical and Technical Assurance sprint 6. It has been included in Clinical and Technicial Assurance sprint 7 for discussion and revision under new use cases.

Base R4 Observation	Profile UKCore-Observation	CareConnect-Observation	Notes
Observation.identifier.assigner 0..1 Reference (Organization)	Observation.identifier.assigner 0..1 Reference (UKCore-Organization)	Observation.identifier.assigner 0..1 Reference (CareConnect-Organization-1)	Change: Reference change to UKCore-profile
Observation.basedOn 0..* Reference (CarePlan \| DeviceRequest \| ImmunizationRecommendation \| MedicationRequest \| NutritionOrder \| ServiceRequest)	Observation.basedOn 0..* Reference (DeviceRequest \| ImmunizationRecommendation \| NutritionOrder \| UKCore-CarePlan \| UKCore-MedicationRequest \| UKCore-ServiceRequest)	Observation.basedOn 0..* Reference (CareConnect-CarePlan-1 \| DeviceRequest \| ImmunizationRecommendation \| NutritionOrder \| CareConnect-ReferralRequest-1 \| CareConnect-MedicationRequest-1 \| CareConnect-ProcedureRequest-1)	Target Type Reference changes for R4: Added: ServiceRequest Removed: ProcedureRequest, ReferralRequest
Observation.partOf 0..* Reference (MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Immunization \| ImagingStudy)	Observation.partOf 0..* Reference (UKCore-ImagingStudy \| UKCore-Immunization \| UKCore-MedicationAdministration \| UKCore-MedicationDispense \| UKCore-MedicationStatement \| UKCore-Procedure)		R4 Changes: Added Element in R4
Observation.code.coding 0..* LOINC Codes (Example)	Observation.code.coding:snomedCT 0..* UKCoreObservationType (preferred)	Observation.code.coding:snomedCT 0..1 Care Connect Observation Type (extensible)	ValueSet Changes: Sliced to carry SNOMED CT (preferred) and LOINC ValueSets in UK Core
Observation.status 1..1 ObservationStatus (Required)	Observation.status 1..1 ObservationStatus (Required)	Observation.status 1..1 ObservationStatus (Required)	R4 Change: Changed value set from http://hl7.org/fhir/ValueSet/observation-status to http://hl7.org/fhir/ValueSet/observation-status\|4.0.1/
Observation.subject 0..1 Reference (Patient \| Group \| Device \| Location)	Observation.subject 0..1 Reference (Group \| UKCore-Device \| UKCore-Location \| UKCore-Patient)	Observation.subject 0..1 Reference (Group \| Device \| CareConnect-Patient-1 \| CareConnect-Location-1)	Changes: Reference changes to UKCore-profile
Observation.focus 0..* Reference (Any)	Observation.focus 0..* Reference (Resource)		R4 Change: Added Element
Observation.encounter 0..1 Reference (Encounter)	Observation.encounter 0..1 Reference (UKCore-Encounter)	Observation.context 0..1 Reference (CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1)	R4 Changes: Renamed from context to encounter Type Reference: Removed Target Type EpisodeOfCare
Observation.effective[x] 0..1 effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant	Observation.effective[x] 0..1 effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant	Observation.effective[x] 0..1 effectiveDateTime, effectivePeriod	Added Types for R4: Timing Instant
Observation.performer 0..* Reference (Practitioner \| PractitionerRole \| Organization \| CareTeam \| Patient \| RelatedPerson)	Observation.performer 0..* Reference (UKCore-CareTeam \| UKCore-Organization \| UKCore-Patient \| UKCore-Practitioner \| UKCore-PractitionerRole \| UKCore-RelatedPerson)	Observation.performer 0..* Reference (CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Organization-1 \| CareConnect-Practitioner-1)	Added Target Type References for R4: PractitionerRole CareTeam
Observation.value[x] 0..1 Quantity \|CodeableConcept \|string \|boolean \|integer \|Range \|Ratio \|SampledData \|time \|dateTime \|Period	Observation.value[x] 0..1 Quantity \|CodeableConcept \|string \|boolean \|integer \|Range \|Ratio \|SampledData \|time \|dateTime \|Period	Observation.value[x] 0..1 Quantity \|CodeableConcept \|string \|boolean \|Range \|Ratio \|SampledData \|Attachment \|time \|dateTime \|Period	R4 Changes: Add Type: Integer Remove Type: Attachment
Observation.dataAbsentReason 0..1 DataAbsentReason (Extensible)	Observation.dataAbsentReason 0..1 DataAbsentReason (Extensible)	Observation.dataAbsentReason 0..1 Observation Value Absent Reason (extensible)	R4 ValueSet and CodeSystem changes: Change value set from http://hl7.org/fhir/ValueSet/observation-valueabsentreason to http://hl7.org/fhir/ValueSet/data-absent-reason Change code system for extensibly bound codes from "http://hl7.org/fhir/data-absent-reason" to "http://terminology.hl7.org/CodeSystem/data-absent-reason"
Observation.interpretation 0..* Observation Interpretation Codes (Extensible)	Observation.interpretation 0..* ObservationInterpretationCodes (extensible)	Observation.interpretation 0..1 Observation Interpretation Codes (extensible)	R4 Changes: Max Cardinality changed from 1 to * Change code system for extensibly bound codes from "http://terminology.hl7.org/CodeSystem/v2-0078" to "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"
Observation.note 0..* Annotation	Observation.note 0..* Annotation	Observation.comment 0..1 string	R4 Changes: Renamed from comment to note Max Cardinality changed from 1 to * Type changed from string to Annotation
Observation.note.author[x].authorReference 0..1 Reference (Practitioner \| Patient \| RelatedPerson \| Organization)	Observation.note.author[x].authorReference 0..1 Reference (UKCore-Organization \| UKCore-Patient \| UKCore-Practitioner \| UKCore-RelatedPerson)	Observation.comment 0..1 string	Changes: References not present in Care Connect
Observation.bodySite.coding 0..* SNOMED CT Body Structures (Example)	Observation.bodySite.coding:snomedCT 0..1 UKCoreBodySite (preferred)	Observation.bodySite.coding:snomedCT 0..1 Care Connect Body Site (preferred)	Changes: Sliced in UKCore-to carry SNOMED CT ((preferred) ValueSet
Observation.method 0..1 Observation Methods (Example)	Observation.method 0..1 ObservationMethods (extensible)	Observation.method 0..1 Observation Methods (example)	Changes: ValueSet binding strength changed to Extensible in the UK Core
Observation.specimen 0..1 Reference (Specimen)	Observation.specimen 0..1 Reference (UKCore-Specimen)	Observation.specimen 0..1 Reference (CareConnect-Specimen-1)	Change: Reference change to UKCore-profile
Observation.device 0..1 Reference (Device \| DeviceMetric)	Observation.device 0..1 Reference (DeviceMetric \| UKCore-Device)	Observation.device 0..1 Reference (Device \| DeviceMetric)	Change: Reference change to UKCore-profile
Observation.referenceRange.type 0..1 Observation Reference Range Meaning Codes (preferred)	Observation.referenceRange.type 0..1 ObservationReferenceRangeMeaningCodes (preferred)	Observation.referenceRange.type 0..1 Observation Reference Range Meaning Codes (extensible)	R4 Changed Binding Strength: From extensible to preferred
Observation.hasMember 0..* Reference (Observation \| QuestionnaireResponse \| MolecularSequence)	Observation.hasMember 0..* Reference (MolecularSequence \| UKCore-Observation \| UKCore-QuestionnaireResponse)		R4 Changes: Added Element
Observation.derivedFrom 0..* Reference (DocumentReference \| ImagingStudy \| Media \| QuestionnaireResponse \| Observation \| MolecularSequence)	Observation.derivedFrom 0..* Reference (Media \| MolecularSequence \| UKCore-DocumentReference \| UKCore-ImagingStudy \| UKCore-Observation \| UKCore-QuestionnaireResponse)		R4 Changes: Added Element
Observation.component.code 1..1 LOINC Codes (Example)	Observation.component.code.coding:snomedCT 0..* UKCoreObservationType ((preferred))	Observation.component.code.coding:snomedCT 0..1 Care Connect Observation Type (preferred)	Changes: Sliced in UKCore-to carry SNOMED CT (preferred) ValueSet
Observation.component.value[x] 0..1 Quantity \| CodeableConcept \| string \| boolean \| integer \| Range\| Ratio \| SampledData \|time \| dateTime \|Period	Observation.component.value[x] 0..1 Quantity \| CodeableConcept \| string \| boolean \| integer \| Range\| Ratio \| SampledData \|time \| dateTime \|Period	Observation.component.value[x] 0..1 Quantity \| CodeableConcept \| string \| Range\| Ratio \| SampledData \| Attachment \| time \| dateTime \| Period	R4 Type changes: Added: boolean Added: integer Removed: Attachment
Observation.component.dataAbsentReason 0..1 DataAbsentReason (Extensible)	Observation.component.dataAbsentReason 0..1 DataAbsentReason (extensible)	Observation.component.dataAbsentReason 0..1 Observation Value Absent Reason (extensible)	R4 Changes: Change value set from http://hl7.org/fhir/ValueSet/observation-valueabsentreason to http://hl7.org/fhir/ValueSet/data-absent-reason Change code system for extensibly bound codes from "http://hl7.org/fhir/data-absent-reason" to "http://terminology.hl7.org/CodeSystem/data-absent-reason"
Observation.interpretation 0..* Observation Interpretation Codes (Extensible)	Observation.interpretation 0..* ObservationInterpretationCodes (extensible)	Observation.interpretation 0..1 Observation Interpretation Codes (extensible)	R4 Changes: Max Cardinality changed from 1 to * Change code system for extensibly bound codes from "http://terminology.hl7.org/CodeSystem/v2-0078" to "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"
		Observation.related 0..* BackboneElement	R4 Changes: Deleted element