R5 Delta

This section is a look ahead and highlights any changes that have been made in FHIR R5 in comparison to the equivalent UK Core Profiles for this C&TA sprint. This may be used to propose the backporting of new features into R4 via extensions, as per the offical guidance on using new element in older versions of FHIR.

Note 1: Only the changes are listed, elements that are unchanged are not provided due to table size. Changes to references from a base 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.

R5 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.

Profile UKCore-Observation	R5 Snapshot Observation	Notes
	Observation.instantiates[x] 0..1 canonical (ObservationDefinition) Reference (ObservationDefinition)	New element added in R5
	Observation.triggeredBy 0..* BackboneElement	New element added in R5
Observation.partOf 0..* Reference (UKCore-ImagingStudy \| UKCore-Immunization \| UKCore-MedicationAdministration \| UKCore-MedicationDispense \| UKCore-MedicationStatement \| UKCore-Procedure)	Observation.partOf 0..* Reference (GenomicStudy \| ImagingStudy \| Immunization \| MedicationAdministration \| MedicationDispense \| MedicationUsage \| Procedure)	Removed reference to: MedicationStatement Added references to: GenomicStudy, MedicationUsage
Observation.subject 0..1 Reference (UKCore-Device \| Group \| UKCore-Location \| UKCore-Patient)	Observation.subject 0..1 Reference (BiologicallyDerivedProduct \| Device \| Group \| Location \| Medication \| NutritionProduct \| Organization \| Patient \| Practitioner \| Procedure \| Substance)	Added references to: Organization, Procedure, Practitioner, Medication, Substance, BiologicallyDerivedProduct, NutritionProduct
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 \| Attachment	Added type Attachment
	Observation.bodyStructure 0..1 Reference (BodyStructure)	New element added in R5
Observation.specimen 0..1 Reference (Specimen)	Observation.specimen 0..1 Reference (Specimen \| Group)	Added reference to Group
	Observation.referenceRange.normalValue 0..1 CodeableConcept http://hl7.org/fhir/valueset observation-referencerange-normalvalue (extensible)	New element added in R5
Observation.derivedFrom 0..* Reference (UKCore-DocumentReference \| UKCore-ImagingStudy \| Media \| MolecularSequence \| UKCore-Observation \| UKCore-QuestionnaireResponse)	Observation.derivedFrom 0..* Reference (DocumentReference \| GenomicStudy \| ImagingSelection \| ImagingStudy \| MolecularSequence \| Observation \| QuestionnaireResponse)	Removed reference to Media Added references to GenomicStudy, ImagingSelection
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 \| Attachment	Added type Attachment