GP Connect Data Model | FHIR STU3 Representation

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.meta.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.meta.versionId

Short Version specific identifier

Definition

The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.

Cardinality 0..1

Summary True

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.meta.lastUpdated

Short When the resource version last changed

Definition

When the resource last changed - e.g. when the version changed.

Cardinality 0..1

instant

Summary True

Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.meta.profile

Short Profiles this resource claims to conform to

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Cardinality 1..*

Summary True

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.meta.security

Short Security Labels applied to this resource

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Cardinality 0..*

All Security Labels (extensible)

Security Labels from the Healthcare Privacy and Security Classification System.

Summary True

Comments

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

Observation.meta.tag

Short Tags applied to this resource

Definition

Cardinality 0..*

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"

Common Tags (example)

Summary True

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

Observation.implicitRules

Short A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Cardinality 0..1

Modifier True

Summary True

Comments

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.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.language

Short Language of the resource content

Definition

The base language in which the resource is written.

Cardinality 0..1

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.text

Short Text summary of the resource, for human interpretation

Definition

Cardinality 0..1

Narrative

Alias narrative, html, xhtml, display

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1, dom-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

Observation.contained

Short Contained, inline Resources

Definition

Cardinality 0..*

Resource

Alias inline resources, anonymous resources, contained resources

Comments

This 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.

Mappings

rim: Entity. Role, or Act
rim: N/A

Observation.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.extension:reason

Short Reason resource added/performed/given

Definition

Reason resource added/performed/given.

Cardinality 0..*

Type Extension(CodeableConcept | Reference(CareConnect-Condition-1))

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.modifierExtension

Short Extensions that cannot be ignored

Definition

Cardinality 0..*

Modifier True

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.identifier

Short Business Identifier for observation

Definition

A unique identifier assigned to this observation.

Cardinality 1..*

Identifier

Summary True

Requirements

Allows observations to be distinguished and referenced.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
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

Observation.identifier.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.identifier.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.identifier.use

Short usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

Observation.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

Identifier Type Codes (extensible)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

Observation.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 1..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

Observation.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 1..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples

General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

Observation.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Period

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

Observation.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference(CareConnect-GPC-Organization-1)

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

Observation.basedOn

Short Fulfills plan, proposal or order

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event.

Cardinality 0..*

Summary True

Alias Fulfills

Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: ORC
rim: .outboundRelationship[typeCode=FLFS].target

Observation.status

Short registered | preliminary | final | amended +

Definition

Cardinality 1..1

Codes providing the status of an observation.

ObservationStatus (required)

Modifier True

Summary True

Requirements

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
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

Observation.category

Short Classification of type of observation

Definition

A code that classifies the general type of observation being made.

Cardinality 0..*

Observation Category Codes (preferred)

Codes for high level observation categories.

Requirements

Used for filtering what observations are retrieved and displayed.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
w5: class

Observation.category.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.category.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.category.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Unordered, Open, by system(Value)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.category.coding:snomedCT

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.category.coding:snomedCT.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.category.coding:snomedCT.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.category.coding:snomedCT.extension:snomedCTDescriptionID

Short The SNOMED CT Description ID for the display

Definition

The SNOMED CT Description ID for the display.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.category.coding:snomedCT.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed Value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Observation.category.coding:snomedCT.version

Short Version of the system - if relevant

Definition

Cardinality 0..0

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Observation.category.coding:snomedCT.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Observation.category.coding:snomedCT.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 1..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Observation.category.coding:snomedCT.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Observation.category.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Observation.code

Short Type of observation (code / type)

Definition

Describes what was observed. Sometimes this is called the observation "name".

Cardinality 1..1

Codes identifying names of simple observations.

LOINC Codes (example)

Summary True

Alias Name

Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
v2: OBX-3
rim: code
sct-attr: 116680003 |Is a|
w5: what

Observation.code.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.code.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.code.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Unordered, Open, by system(Value)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.code.coding:snomedCT

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.code.coding:snomedCT.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.code.coding:snomedCT.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.code.coding:snomedCT.extension:snomedCTDescriptionID

Short The SNOMED CT Description ID for the display

Definition

The SNOMED CT Description ID for the display.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.code.coding:snomedCT.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed Value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Observation.code.coding:snomedCT.version

Short Version of the system - if relevant

Definition

Cardinality 0..0

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Observation.code.coding:snomedCT.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Observation.code.coding:snomedCT.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 1..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Observation.code.coding:snomedCT.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Observation.code.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Observation.subject

Short Who and/or what this is about

Definition

Cardinality 1..1

Type Reference(CareConnect-GPC-Patient-1)

Must Support True

Summary True

Requirements

Observations have no value if you don't know who or what they're about.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
v2: PID-3
rim: participation[typeCode=SBJ]
w5: who.focus

Observation.context

Short Healthcare event during which this observation is made

Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

Cardinality 0..1

Type Reference(CareConnect-GPC-Encounter-1)

Must Support True

Alias Encounter

Requirements

For some observations it may be important to know the link between an observation and a particular encounter.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
v2: PV1
rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
w5: context

Observation.effective[x]

Short Clinically relevant time/time-period for observation

Definition

Cardinality 0..1

Type dateTime | Period

Must Support True

Summary True

Alias Occurrence

Requirements

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

Comments

At least a date should be present unless this observation is a historical report.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.occurrence[x]
v2: OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
rim: effectiveTime
w5: when.done

Observation.issued

Short Date/Time this was made available

Definition

The date and time this observation was made available to providers, typically after the results have been reviewed and verified.

Cardinality 1..1

instant

Must Support True

Summary True

Comments

Updated when the result is updated.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
rim: participation[typeCode=AUT].time
w5: when.recorded

Observation.performer

Short Who is responsible for the observation

Definition

Who was responsible for asserting the observed value as "true".

Cardinality 0..*

Type Reference(CareConnect-RelatedPerson-1 | CareConnect-GPC-Organization-1 | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1)

Must Support True

Summary True

Requirements

May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
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

Observation.value[x]

Short Actual result

Definition

The information determined as a result of making the observation, if the information has a simple value.

Cardinality 0..1

Must Support True

Summary True

Requirements

An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1, obs-7

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
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|

Observation.dataAbsentReason

Short Why the result is missing

Definition

Provides a reason why the expected value in the element Observation.value[x] is missing.

Cardinality 0..1

Observation Value Absent Reason (extensible)

Codes specifying why the result (Observation.value[x]) is missing.

Must Support True

Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1, obs-6

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)
v2: N/A
rim: value.nullFlavor

Observation.interpretation

Short High, low, normal, etc.

Definition

A human readable clinical summary relating to a test result and/or additional notes provided by the laboratory e.g. the specimen has haemolysed or has leaked

Cardinality 0..1

CareConnect Observation Interpretation (extensible)

Codes identifying interpretations of observations.

Must Support True

Alias Abnormal Flag

Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
sct-concept: < 260245000 |Findings values|
v2: OBX-8
rim: interpretationCode
sct-attr: 363713009 |Has interpretation|

Observation.comment

Short Comments about result

Definition

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.

Cardinality 0..1

Must Support True

Requirements

Need to be able to provide free text additional information.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.note
v2: NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
rim: subjectOf.observationEvent[code="annotation"].value

Observation.bodySite

Short Observed body part

Definition

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Cardinality 0..1

SNOMED CT Body Structures (example)

Codes describing anatomical locations. May include laterality.

Must Support True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
sct-concept: < 123037004 |Body structure|
v2: OBX-20
rim: targetSiteCode
sct-attr: 718497002 |Inherent location|

Observation.bodySite.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.bodySite.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.bodySite.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Unordered, Open, by system(Value)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.bodySite.coding:snomedCT

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

Care Connect Body Site (preferred)

A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|).

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.bodySite.coding:snomedCT.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.bodySite.coding:snomedCT.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.bodySite.coding:snomedCT.extension:snomedCTDescriptionID

Short The SNOMED CT Description ID for the display

Definition

The SNOMED CT Description ID for the display.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.bodySite.coding:snomedCT.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed Value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Observation.bodySite.coding:snomedCT.version

Short Version of the system - if relevant

Definition

Cardinality 0..0

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Observation.bodySite.coding:snomedCT.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Observation.bodySite.coding:snomedCT.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 1..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Observation.bodySite.coding:snomedCT.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Observation.bodySite.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Observation.method

Short How it was done

Definition

Indicates the mechanism used to perform the observation.

Cardinality 0..1

Methods for simple observations.

Observation Methods (example)

Must Support True

Requirements

In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

Comments

Only used if not implicit in code for Observation.code.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBX-17
rim: methodCode

Observation.method.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.method.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.method.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Unordered, Open, by system(Value)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.method.coding:snomedCT

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.method.coding:snomedCT.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.method.coding:snomedCT.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.method.coding:snomedCT.extension:snomedCTDescriptionID

Short The SNOMED CT Description ID for the display

Definition

The SNOMED CT Description ID for the display.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.method.coding:snomedCT.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed Value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Observation.method.coding:snomedCT.version

Short Version of the system - if relevant

Definition

Cardinality 0..0

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Observation.method.coding:snomedCT.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Observation.method.coding:snomedCT.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 1..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Observation.method.coding:snomedCT.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Observation.method.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Observation.specimen

Short Specimen used for this observation

Definition

The specimen that was used when this observation was made.

Cardinality 0..1

Type Reference(CareConnect-GPC-Specimen-1)

Must Support True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
sct-concept: < 123038009 |Specimen|
v2: SPM segment
rim: participation[typeCode=SPC].specimen
sct-attr: 704319004 |Inherent in|

Observation.device

Short (Measurement) Device

Definition

The device used to generate the observation data.

Cardinality 0..1

Type Reference(DeviceMetric | GPConnect-Device-1)

Must Support True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
sct-concept: < 49062001 |Device|
v2: OBX-17 / PRT -10
rim: participation[typeCode=DEV]
sct-attr: 424226004 |Using device|

Observation.referenceRange

Short Provides guide for interpretation

Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Cardinality 0..*

BackboneElement

Must Support True

Requirements

Knowing 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.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
obs-3: Must have at least a low or a high or text
low.exists() or high.exists() or text.exists()

Mappings

rim: n/a
v2: OBX.7
rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

Observation.referenceRange.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.referenceRange.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.referenceRange.modifierExtension

Short Extensions that cannot be ignored

Definition

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.referenceRange.low

Short Low Range, if relevant

Definition

Cardinality 0..1

SimpleQuantity

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1, obs-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
v2: OBX-7
rim: value:IVL_PQ.low

Observation.referenceRange.high

Short High Range, if relevant

Definition

Cardinality 0..1

SimpleQuantity

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1, obs-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
v2: OBX-7
rim: value:IVL_PQ.high

Observation.referenceRange.type

Short Reference range qualifier

Definition

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

Cardinality 0..1

Observation Reference Range Meaning Codes (extensible)

Code for the meaning of a reference range.

Requirements

Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc, - for proper interpretation.

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
sct-concept: < 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
v2: OBX-10
rim: interpretationCode

Observation.referenceRange.appliesTo

Short Reference range population

Definition

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race.

Cardinality 0..*

Observation Reference Range Applies To Codes (example)

Codes identifying the population the reference range applies to.

Requirements

Need to be able to identify the target population for proper interpretation.

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
sct-concept: < 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
v2: OBX-10
rim: interpretationCode

Observation.referenceRange.age

Short Applicable age range, if relevant

Definition

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.

Cardinality 0..1

Range

Requirements

Some analytes vary greatly over age.

Comments

The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
rng-2: If present, low SHALL have a lower value than high
low.empty() or high.empty() or (low <= high)

Mappings

rim: n/a
v2: NR and also possibly SN (but see also quantity)
rim: IVL<QTY[not(type="TS")]> [lowClosed="true" and highClosed="true"]or URG<QTY[not(type="TS")]>
rim: outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value

Observation.referenceRange.text

Short Text based reference range in an observation

Definition

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX-7
rim: value:ST

Observation.related

Short Resource related to this observation

Definition

A reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.

Cardinality 0..*

BackboneElement

Must Support True

Summary True

Requirements

Comments

For a discussion on the ways Observations can assembled in groups together see Notes below.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Relationships established by OBX-4 usage
rim: outBoundRelationship

Observation.related.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.related.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.related.modifierExtension

Short Extensions that cannot be ignored

Definition

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.related.type

Definition

A code specifying the kind of relationship that exists with the target resource.

Cardinality 0..1

ObservationRelationshipType (required)

Codes specifying how two observations are related.

Must Support True

Requirements

A relationship type SHOULD be provided.

Comments

The "derived-from" type is the only logical choice when referencing the QuestionnaireAnswer resource.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: .typeCode

Observation.related.target

Short Resource that is related to this one

Definition

A reference to the observation or QuestionnaireResponse resource that is related to this observation.

Cardinality 1..1

Type Reference(QuestionnaireResponse | Sequence | CareConnect-GPC-Observation-1)

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .targetObservation

Observation.component

Short Component results

Definition

Cardinality 0..*

BackboneElement

Must Support True

Summary True

Requirements

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: containment by OBX-4?
rim: outBoundRelationship[typeCode=COMP]

Observation.component.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.component.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.component.modifierExtension

Short Extensions that cannot be ignored

Definition

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.component.code

Short Type of component observation (code / type)

Definition

Describes what was observed. Sometimes this is called the observation "code".

Cardinality 1..1

Codes identifying names of simple observations.

LOINC Codes (example)

Summary True

Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
v2: OBX-3
rim: code
w5: what

Observation.component.code.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.component.code.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.component.code.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Unordered, Open, by system(Value)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.component.code.coding:snomedCT

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

Summary True

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

Observation.component.code.coding:snomedCT.id

Short xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Observation.component.code.coding:snomedCT.extension

Short Additional Content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.component.code.coding:snomedCT.extension:snomedCTDescriptionID

Short The SNOMED CT Description ID for the display

Definition

The SNOMED CT Description ID for the display.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Observation.component.code.coding:snomedCT.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed Value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

Observation.component.code.coding:snomedCT.version

Short Version of the system - if relevant

Definition

Cardinality 0..0

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

Observation.component.code.coding:snomedCT.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

Observation.component.code.coding:snomedCT.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 1..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

Observation.component.code.coding:snomedCT.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Observation.component.code.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

Observation.component.value[x]

Short Actual component result

Definition

The information determined as a result of making the observation, if the information has a simple value.

Cardinality 0..1

Summary True

Requirements

An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
sct-concept: 363714003 |Interprets| < 441742003 |Evaluation finding|
v2: OBX.2, OBX.5, OBX.6
rim: value
sct-attr: 363714003 |Interprets|

Observation.component.dataAbsentReason

Short Why the component result is missing

Definition

Provides a reason why the expected value in the element Observation.value[x] is missing.

Cardinality 0..1

Observation Value Absent Reason (extensible)

Codes specifying why the result (Observation.value[x]) is missing.

Must Support True

Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1, obs-6

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: N/A
rim: value.nullFlavor

Observation.component.interpretation

Short High, low, normal, etc.

Definition

Cardinality 0..1