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    1. Index
    2. FHIR Artifacts
    3. Profiles
    4. Observation Blood Pressure

dft-preBallot - This is the first draft of the P-Care IG. For a full list of available versions, see the Directory of published versions

Observation Blood Pressure

Links

Profile

observation-blood-pressure

Derived from

http://hl7.org/fhir/StructureDefinition/bp

Examples

Observation Blood Pressure Example 1, Observation Blood Pressure Example 2, Observation Blood Pressure Example 3

Description

This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure.

References to this resource

PCareCompositionPatientSummary

Resource Content

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PCareObservationBloodPressure (Observation)Cobservation-bp
There are no (further) constraints on this element
Element id
Observation
Short description

FHIR Blood Pressure Profile

Alternate names

Vital Signs, Measurement, Results, Tests

Definition

This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure. This is a grouping structure. It has no value in Observation.valueQuantity but contains at least one component (systolic and/or diastolic).

Comments

Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

Data type

observation-bp

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
  • obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    dataAbsentReason.empty() or value.empty()
  • vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • sct-concept: < 363787002 |Observable entity|
  • v2: OBX
  • rim: Observation[classCode=OBS, moodCode=EVN]
idΣ0..1id
There are no (further) constraints on this element
Element id
Observation.id
Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

id

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() or (children().count() > id.count())
Mappings
  • rim: n/a
metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Observation.meta
Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Observation.implicitRules
Short description

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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

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() or (children().count() > id.count())
Mappings
  • rim: n/a
language0..1codeBinding
There are no (further) constraints on this element
Element id
Observation.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
MaxValueSetAllLanguages
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() or (children().count() > id.count())
Mappings
  • rim: n/a
text0..1Narrative
There are no (further) constraints on this element
Element id
Observation.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Observation.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
Observation.identifier
Short description

Business Identifier for observation

Definition

A unique identifier assigned to this observation.

Requirements

Allows observations to be distinguished and referenced.

Data type

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() or (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 - 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
  • w5: FiveWs.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
basedOnΣ C0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
There are no (further) constraints on this element
Element id
Observation.basedOn
Short description

Fulfills plan, proposal or order

Alternate names

Fulfills

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Requirements

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

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Data type

Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
partOfΣ C0..*Reference(ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationStatement | Procedure)
There are no (further) constraints on this element
Element id
Observation.partOf
Short description

Part of referenced event

Alternate names

Container

Definition

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

Comments

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

Data type

Reference(ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationStatement | Procedure)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.partOf
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=FLFS].target
statusSO Σ ?!1..1codeBindingElement id
Observation.status
Short description

registered | preliminary | final | amended +

Definition

The status of the result value.

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.

Data type

code

Binding

Codes providing the status of an observation.

ObservationStatus (required)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.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"
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
categorySO1..*CodeableConceptBindingElement id
Observation.category
Short description

Classification of type of observation

Definition

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

Requirements

Used for filtering what observations are retrieved and displayed.

Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Data type

CodeableConcept

Slicing

Unordered, Open, by coding.code(Value), coding.system(Value)

Binding

Codes for high level observation categories.

ObservationCategoryCodes (preferred)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
VSCatSO1..1CodeableConceptBindingElement id
Observation.category:VSCat
Short description

Classification of type of observation

Definition

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

Requirements

Used for filtering what observations are retrieved and displayed.

Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Data type

CodeableConcept

Binding

Codes for high level observation categories.

ObservationCategoryCodes (preferred)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.category:VSCat.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
codingSO Σ1..*CodingElement id
Observation.category:VSCat.coding
Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

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() or (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
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
systemSO Σ1..1uriFixed ValueElement id
Observation.category:VSCat.coding.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

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() or (children().count() > id.count())
Fixed value
http://terminology.hl7.org/CodeSystem/observation-category
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeSO Σ1..1codeFixed ValueElement id
Observation.category:VSCat.coding.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

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() or (children().count() > id.count())
Fixed value
vital-signs
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.display
Short description

Representation defined by the system

Definition

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

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 SHALL NOT exceed 1MB in size

Data type

string

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() or (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
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

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() or (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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

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() or (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
codeSO Σ1..1CodeableConceptBindingElement id
Observation.code
Short description

Blood Pressure

Alternate names

Name, Test

Definition

Blood Pressure.

Requirements
  1. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).
Comments

additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
  • sct-attr: 116680003 |Is a|
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.code.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.code.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
codingΣ1..*Coding
There are no (further) constraints on this element
Element id
Observation.code.coding
Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by code(Value), 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() or (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
BPCodeΣ1..1Coding
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode
Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

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() or (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
id0..1string
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
systemΣ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

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() or (children().count() > id.count())
Fixed value
http://loinc.org
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

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() or (children().count() > id.count())
Fixed value
85354-9
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.display
Short description

Representation defined by the system

Definition

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

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 SHALL NOT exceed 1MB in size

Data type

string

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() or (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
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

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() or (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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.code.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

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() or (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
subjectSO Σ C1..1Reference(PCarePatient)Element id
Observation.subject
Short description

Who and/or what the observation is about

Definition

The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

Requirements

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

Comments

One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

Data type

Reference(PCarePatient)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: participation[typeCode=RTGT]
  • w5: FiveWs.subject
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
focusΣ C0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Observation.focus
Short description

What the observation is about, when it is not about the subject of record

Definition

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Comments

Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

Data type

Reference(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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.subject[x]
  • v2: OBX-3
  • rim: participation[typeCode=SBJ]
  • w5: FiveWs.subject
encounterΣ C0..1Reference(Encounter)
There are no (further) constraints on this element
Element id
Observation.encounter
Short description

Healthcare event during which this observation is made

Alternate names

Context

Definition

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

Requirements

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

Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

Data type

Reference(Encounter)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.context
  • w5: FiveWs.context
  • v2: PV1
  • rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
effective[x]SO Σ C1..1Element id
Observation.effective[x]
Short description

Often just a dateTime for Vital Signs

Alternate names

Occurrence

Definition

Often just a dateTime for Vital Signs.

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. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    $this is dateTime implies $this.toString().length() >= 10
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
  • rim: effectiveTime
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
effectiveDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

effectivePeriodPeriod
There are no (further) constraints on this element
Data type

Period

issuedΣ0..1instant
There are no (further) constraints on this element
Element id
Observation.issued
Short description

Date/Time this version was made available

Definition

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

Comments

For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

Data type

instant

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.recorded
  • v2: OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
  • rim: participation[typeCode=AUT].time
performerΣ C0..*Reference(CareTeam | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Observation.performer
Short description

Who is responsible for the observation

Definition

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

Requirements

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

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Data type

Reference(CareTeam | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • 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]
value[x]SO Σ C0..1Element id
Observation.value[x]
Short description

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Definition

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, obs-7, vs-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • sct-concept: < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valuePeriodPeriod
There are no (further) constraints on this element
Data type

Period

valueRangeRange
There are no (further) constraints on this element
Data type

Range

valueRatioRatio
There are no (further) constraints on this element
Data type

Ratio

valueSampledDataSampledData
There are no (further) constraints on this element
Data type

SampledData

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueQuantityS Σ C0..0Quantity
There are no (further) constraints on this element
Element id
Observation.value[x]:valueQuantity
Short description

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Definition

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Data type

Quantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, obs-7, vs-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • sct-concept: < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
dataAbsentReasonSO C0..1CodeableConceptBindingElement id
Observation.dataAbsentReason
Short description

Why the result is missing

Definition

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

Requirements

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

Comments

Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, obs-6, vs-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

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() or (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|
note0..*Annotation
There are no (further) constraints on this element
Element id
Observation.note
Short description

Comments about the observation

Definition

Comments about the observation or the results.

Requirements

Need to be able to provide free text additional information.

Comments

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Data type

Annotation

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • v2: NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
  • rim: subjectOf.observationEvent[code="annotation"].value
bodySite0..1CodeableConcept
There are no (further) constraints on this element
Element id
Observation.bodySite
Short description

Observed body part

Definition

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

Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

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() or (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|
method0..1CodeableConcept
There are no (further) constraints on this element
Element id
Observation.method
Short description

How it was done

Definition

Indicates the mechanism used to perform the observation.

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.

Data type

CodeableConcept

Binding

Methods for simple observations.

ObservationMethods (example)

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() or (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
specimenC0..1Reference(Specimen)
There are no (further) constraints on this element
Element id
Observation.specimen
Short description

Specimen used for this observation

Definition

The specimen that was used when this observation was made.

Comments

Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

Data type

Reference(Specimen)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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|
deviceC0..1Reference(Device | DeviceMetric)
There are no (further) constraints on this element
Element id
Observation.device
Short description

(Measurement) Device

Definition

The device used to generate the observation data.

Comments

Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

Data type

Reference(Device | DeviceMetric)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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|
referenceRangeC0..*BackboneElement
There are no (further) constraints on this element
Element id
Observation.referenceRange
Short description

Provides guide for interpretation

Definition

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Data type

BackboneElement

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() or (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]
id0..1string
There are no (further) constraints on this element
Element id
Observation.referenceRange.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.referenceRange.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.referenceRange.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

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() or (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
lowC0..1SimpleQuantity
There are no (further) constraints on this element
Element id
Observation.referenceRange.low
Short description

Low Range, if relevant

Definition

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

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.

Data type

SimpleQuantity

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() or (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
highC0..1SimpleQuantity
There are no (further) constraints on this element
Element id
Observation.referenceRange.high
Short description

High Range, if relevant

Definition

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

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.

Data type

SimpleQuantity

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() or (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
type0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.referenceRange.type
Short description

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.

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.

Data type

CodeableConcept

Binding

Code for the meaning of a reference range.

ObservationReferenceRangeMeaningCodes (preferred)

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() or (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
appliesTo0..*CodeableConcept
There are no (further) constraints on this element
Element id
Observation.referenceRange.appliesTo
Short description

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. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

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.

Data type

CodeableConcept

Binding

Codes identifying the population the reference range applies to.

ObservationReferenceRangeAppliesToCodes (example)

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() or (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
ageC0..1Range
There are no (further) constraints on this element
Element id
Observation.referenceRange.age
Short description

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.

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.

Data type

Range

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() or (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
text0..1string
There are no (further) constraints on this element
Element id
Observation.referenceRange.text
Short description

Text based reference range in an observation

Definition

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: OBX-7
  • rim: value:ST
hasMemberΣ C0..*Reference(MolecularSequence | QuestionnaireResponse | observation-vitalsigns)
There are no (further) constraints on this element
Element id
Observation.hasMember
Short description

Used when reporting vital signs panel components

Definition

Used when reporting vital signs panel components.

Comments

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

Data type

Reference(MolecularSequence | QuestionnaireResponse | observation-vitalsigns)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: Relationships established by OBX-4 usage
  • rim: outBoundRelationship
derivedFromΣ C0..*Reference(DocumentReference | ImagingStudy | Media | MolecularSequence | QuestionnaireResponse | observation-vitalsigns)
There are no (further) constraints on this element
Element id
Observation.derivedFrom
Short description

Related measurements the observation is made from

Definition

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Comments

All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

Data type

Reference(DocumentReference | ImagingStudy | Media | MolecularSequence | QuestionnaireResponse | observation-vitalsigns)

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() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: Relationships established by OBX-4 usage
  • rim: .targetObservation
componentSO Σ C2..*BackboneElementElement id
Observation.component
Short description

Used when reporting systolic and diastolic blood pressure.

Definition

Used when reporting systolic and diastolic blood pressure.

Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

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

Data type

BackboneElement

Slicing

Unordered, Open, by code.coding.code(Value), code.coding.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() or (children().count() > id.count())
  • vs-3: If there is no a value a data absent reason must be present
    value.exists() or dataAbsentReason.exists()
Mappings
  • rim: n/a
  • v2: containment by OBX-4?
  • rim: outBoundRelationship[typeCode=COMP]
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Observation.component.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.component.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

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() or (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
codeSO Σ1..1CodeableConceptBindingElement id
Observation.component.code
Short description

Type of component observation (code / type)

Definition

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

Requirements

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

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
value[x]SO Σ C0..1BindingElement id
Observation.component.value[x]
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (required)

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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|
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valuePeriodPeriod
There are no (further) constraints on this element
Data type

Period

valueQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

valueRangeRange
There are no (further) constraints on this element
Data type

Range

valueRatioRatio
There are no (further) constraints on this element
Data type

Ratio

valueSampledDataSampledData
There are no (further) constraints on this element
Data type

SampledData

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

dataAbsentReasonSO C0..1CodeableConceptBindingElement id
Observation.component.dataAbsentReason
Short description

Why the component result is missing

Definition

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

Requirements

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

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, obs-6, vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

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() or (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|
referenceRange0..*see (referenceRange)
There are no (further) constraints on this element
Element id
Observation.component.referenceRange
Short description

Provides guide for interpretation of component result

Definition

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

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Mappings
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
SystolicBPSO Σ C1..1BackboneElementElement id
Observation.component:SystolicBP
Short description

Used when reporting systolic and diastolic blood pressure.

Definition

Used when reporting systolic and diastolic blood pressure.

Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

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

Data type

BackboneElement

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() or (children().count() > id.count())
  • vs-3: If there is no a value a data absent reason must be present
    value.exists() or dataAbsentReason.exists()
Mappings
  • rim: n/a
  • v2: containment by OBX-4?
  • rim: outBoundRelationship[typeCode=COMP]
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

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() or (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
codeSO Σ1..1CodeableConceptBindingElement id
Observation.component:SystolicBP.code
Short description

Type of component observation (code / type)

Alternate names

Component Test, Component Name

Definition

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

Requirements

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

Comments

additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
codingΣ1..*Coding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding
Short description

Systolic Blood Pressure

Definition

Systolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by code(Value), 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() or (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
SBPCodeΣ1..1Coding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode
Short description

Systolic Blood Pressure

Definition

Systolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

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() or (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
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
systemΣ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

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() or (children().count() > id.count())
Fixed value
http://loinc.org
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

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() or (children().count() > id.count())
Fixed value
8480-6
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.display
Short description

Representation defined by the system

Definition

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

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 SHALL NOT exceed 1MB in size

Data type

string

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() or (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
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

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() or (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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

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() or (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
value[x]SO Σ C0..1BindingElement id
Observation.component:SystolicBP.value[x]
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Slicing

Unordered, Open, by $this(Type)

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (required)

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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|
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
valueO
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].value
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
unitO
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].unit
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
systemO
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].system
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
codeO
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valuePeriodPeriod
There are no (further) constraints on this element
Data type

Period

valueRangeRange
There are no (further) constraints on this element
Data type

Range

valueRatioRatio
There are no (further) constraints on this element
Data type

Ratio

valueSampledDataSampledData
There are no (further) constraints on this element
Data type

SampledData

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueQuantityS Σ C0..1QuantityBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Data type

Quantity

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (required)

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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|
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
valueS Σ1..1decimal
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.value
Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

decimal

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparatorΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.comparator
Short description

< | <= | >= | > - how to understand the value

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

code

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
unitS Σ1..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.unit
Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
systemS Σ C1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.system
Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Comments

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

Data type

uri

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://unitsofmeasure.org
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
codeS Σ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]:valueQuantity.code
Short description

Coded responses from the common UCUM units for vital signs value set.

Definition

Coded responses from the common UCUM units for vital signs value set.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

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() or (children().count() > id.count())
Fixed value
mm[Hg]
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
dataAbsentReasonSO C0..1CodeableConceptBindingElement id
Observation.component:SystolicBP.dataAbsentReason
Short description

Why the component result is missing

Definition

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

Requirements

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

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, obs-6, vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

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() or (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|
referenceRange0..*see (referenceRange)
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.referenceRange
Short description

Provides guide for interpretation of component result

Definition

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

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Mappings
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
DiastolicBPSO Σ C1..1BackboneElementElement id
Observation.component:DiastolicBP
Short description

Used when reporting systolic and diastolic blood pressure.

Definition

Used when reporting systolic and diastolic blood pressure.

Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

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

Data type

BackboneElement

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() or (children().count() > id.count())
  • vs-3: If there is no a value a data absent reason must be present
    value.exists() or dataAbsentReason.exists()
Mappings
  • rim: n/a
  • v2: containment by OBX-4?
  • rim: outBoundRelationship[typeCode=COMP]
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

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() or (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
codeSO Σ1..1CodeableConceptBindingElement id
Observation.component:DiastolicBP.code
Short description

Type of component observation (code / type)

Definition

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

Requirements

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

Comments

additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
codingΣ1..*Coding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding
Short description

Diastolic Blood Pressure

Definition

Diastolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by code(Value), 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() or (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
DBPCodeΣ1..1Coding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode
Short description

Diastolic Blood Pressure

Definition

Diastolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

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() or (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
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
systemΣ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

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() or (children().count() > id.count())
Fixed value
http://loinc.org
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

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() or (children().count() > id.count())
Fixed value
8462-4
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.display
Short description

Representation defined by the system

Definition

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

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 SHALL NOT exceed 1MB in size

Data type

string

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() or (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
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

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() or (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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

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() or (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
value[x]SO Σ C0..1BindingElement id
Observation.component:DiastolicBP.value[x]
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Slicing

Unordered, Open, by $this(Type)

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (required)

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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|
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
valueO
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].value
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
unitO
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].unit
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
systemO
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].system
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
codeO
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].code
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valuePeriodPeriod
There are no (further) constraints on this element
Data type

Period

valueRangeRange
There are no (further) constraints on this element
Data type

Range

valueRatioRatio
There are no (further) constraints on this element
Data type

Ratio

valueSampledDataSampledData
There are no (further) constraints on this element
Data type

SampledData

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueQuantityS Σ C0..1QuantityBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Data type

Quantity

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (required)

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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|
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

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() or (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
valueS Σ1..1decimal
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.value
Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

decimal

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparatorΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.comparator
Short description

< | <= | >= | > - how to understand the value

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

code

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
unitS Σ1..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.unit
Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

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() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
systemS Σ C1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.system
Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Comments

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

Data type

uri

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://unitsofmeasure.org
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
codeS Σ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]:valueQuantity.code
Short description

Coded responses from the common UCUM units for vital signs value set.

Definition

Coded responses from the common UCUM units for vital signs value set.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

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() or (children().count() > id.count())
Fixed value
mm[Hg]
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
dataAbsentReasonSO C0..1CodeableConceptBindingElement id
Observation.component:DiastolicBP.dataAbsentReason
Short description

Why the component result is missing

Definition

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

Requirements

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

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, obs-6, vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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
Obligations
NameCodeDocumentationActor
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

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() or (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|
referenceRange0..*see (referenceRange)
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.referenceRange
Short description

Provides guide for interpretation of component result

Definition

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

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Mappings
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
PCareObservationBloodPressure (Observation)Cobservation-bp
There are no (further) constraints on this element
Element id
Observation
Short description

FHIR Blood Pressure Profile

Alternate names

Vital Signs, Measurement, Results, Tests

Definition

This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure. This is a grouping structure. It has no value in Observation.valueQuantity but contains at least one component (systolic and/or diastolic).

Comments

Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

Data type

observation-bp

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    dataAbsentReason.empty() or value.empty()
  • obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
  • vs-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present.
    (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • sct-concept: < 363787002 |Observable entity|
  • v2: OBX
  • rim: Observation[classCode=OBS, moodCode=EVN]
idΣ0..1id
There are no (further) constraints on this element
Element id
Observation.id
Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

id

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Observation.meta
Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Observation.implicitRules
Short description

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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
language0..1codeBinding
There are no (further) constraints on this element
Element id
Observation.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
MaxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
text0..1Narrative
There are no (further) constraints on this element
Element id
Observation.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Observation.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: N/A
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
Observation.identifier
Short description

Business Identifier for observation

Definition

A unique identifier assigned to this observation.

Requirements

Allows observations to be distinguished and referenced.

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.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
basedOnΣ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
There are no (further) constraints on this element
Element id
Observation.basedOn
Short description

Fulfills plan, proposal or order

Alternate names

Fulfills

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Requirements

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

Data type

Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.basedOn
  • v2: ORC
  • rim: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
partOfΣ0..*Reference(ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationStatement | Procedure)
There are no (further) constraints on this element
Element id
Observation.partOf
Short description

Part of referenced event

Alternate names

Container

Definition

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

Comments

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

Data type

Reference(ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationStatement | Procedure)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.partOf
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=FLFS].target
statusSO Σ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
Observation.status
Short description

registered | preliminary | final | amended +

Definition

The status of the result value.

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.

Data type

code

Binding

ObservationStatus (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.status
  • w5: FiveWs.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"
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
categorySO1..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.category
Short description

Classification of type of observation

Definition

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

Requirements

Used for filtering what observations are retrieved and displayed.

Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Data type

CodeableConcept

Slicing

Unordered, Open, by coding.code(Value), coding.system(Value)

Binding

Codes for high level observation categories.

ObservationCategoryCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
VSCatSO1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.category:VSCat
Short description

Classification of type of observation

Definition

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

Requirements

Used for filtering what observations are retrieved and displayed.

Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Data type

CodeableConcept

Binding

Codes for high level observation categories.

ObservationCategoryCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.category:VSCat.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingSO Σ1..*Coding
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding
Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemSO Σ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://terminology.hl7.org/CodeSystem/observation-category
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeSO Σ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
vital-signs
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.display
Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.category:VSCat.coding.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.category:VSCat.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
codeSO Σ1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.code
Short description

Blood Pressure

Alternate names

Name, Test

Definition

Blood Pressure.

Requirements
  1. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).
Comments

additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
  • sct-attr: 116680003 |Is a|
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.code.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.code.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingΣ1..*Coding
There are no (further) constraints on this element
Element id
Observation.code.coding
Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by code(Value), system(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
BPCodeΣ1..1Coding
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode
Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemΣ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://loinc.org
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
85354-9
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.display
Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.code.coding:BPCode.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.code.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
subjectSO Σ1..1Reference(PCarePatient)
There are no (further) constraints on this element
Element id
Observation.subject
Short description

Who and/or what the observation is about

Definition

The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

Requirements

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

Comments

One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

Data type

Reference(PCarePatient)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: participation[typeCode=RTGT]
  • w5: FiveWs.subject
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
focusΣ0..*Reference(Resource)
There are no (further) constraints on this element
Element id
Observation.focus
Short description

What the observation is about, when it is not about the subject of record

Definition

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Comments

Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

Data type

Reference(Resource)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.subject[x]
  • v2: OBX-3
  • rim: participation[typeCode=SBJ]
  • w5: FiveWs.subject
encounterΣ0..1Reference(Encounter)
There are no (further) constraints on this element
Element id
Observation.encounter
Short description

Healthcare event during which this observation is made

Alternate names

Context

Definition

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

Requirements

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

Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

Data type

Reference(Encounter)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.context
  • w5: FiveWs.context
  • v2: PV1
  • rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
effective[x]SO Σ C1..1
There are no (further) constraints on this element
Element id
Observation.effective[x]
Short description

Often just a dateTime for Vital Signs

Alternate names

Occurrence

Definition

Often just a dateTime for Vital Signs.

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. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • vs-1: if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day
    $this is dateTime implies $this.toString().length() >= 10
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
  • rim: effectiveTime
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
effectiveDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

effectivePeriodPeriod
There are no (further) constraints on this element
Data type

Period

issuedΣ0..1instant
There are no (further) constraints on this element
Element id
Observation.issued
Short description

Date/Time this version was made available

Definition

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

Comments

For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

Data type

instant

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.recorded
  • v2: OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
  • rim: participation[typeCode=AUT].time
performerΣ0..*Reference(CareTeam | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Observation.performer
Short description

Who is responsible for the observation

Definition

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

Requirements

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

Data type

Reference(CareTeam | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • 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]
value[x]SO Σ C0..1
There are no (further) constraints on this element
Element id
Observation.value[x]
Short description

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Definition

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Slicing

Unordered, Closed, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: obs-7, vs-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
valueQuantityS Σ C0..0Quantity
There are no (further) constraints on this element
Element id
Observation.value[x]:valueQuantity
Short description

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Definition

Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Data type

Quantity

Conditions

The cardinality or value of this element may be affected by these constraints: obs-7, vs-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
dataAbsentReasonSO C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.dataAbsentReason
Short description

Why the result is missing

Definition

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

Requirements

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

Comments

Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: obs-6, vs-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: value.nullFlavor
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 260245000 |Findings values|
  • v2: OBX-8
  • rim: interpretationCode
  • sct-attr: 363713009 |Has interpretation|
note0..*Annotation
There are no (further) constraints on this element
Element id
Observation.note
Short description

Comments about the observation

Definition

Comments about the observation or the results.

Requirements

Need to be able to provide free text additional information.

Comments

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

Data type

Annotation

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
  • rim: subjectOf.observationEvent[code="annotation"].value
bodySite0..1CodeableConcept
There are no (further) constraints on this element
Element id
Observation.bodySite
Short description

Observed body part

Definition

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

Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 123037004 |Body structure|
  • v2: OBX-20
  • rim: targetSiteCode
  • sct-attr: 718497002 |Inherent location|
method0..1CodeableConcept
There are no (further) constraints on this element
Element id
Observation.method
Short description

How it was done

Definition

Indicates the mechanism used to perform the observation.

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.

Data type

CodeableConcept

Binding

Methods for simple observations.

ObservationMethods (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-17
  • rim: methodCode
specimen0..1Reference(Specimen)
There are no (further) constraints on this element
Element id
Observation.specimen
Short description

Specimen used for this observation

Definition

The specimen that was used when this observation was made.

Comments

Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

Data type

Reference(Specimen)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 123038009 |Specimen|
  • v2: SPM segment
  • rim: participation[typeCode=SPC].specimen
  • sct-attr: 704319004 |Inherent in|
device0..1Reference(Device | DeviceMetric)
There are no (further) constraints on this element
Element id
Observation.device
Short description

(Measurement) Device

Definition

The device used to generate the observation data.

Comments

Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

Data type

Reference(Device | DeviceMetric)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 49062001 |Device|
  • v2: OBX-17 / PRT -10
  • rim: participation[typeCode=DEV]
  • sct-attr: 424226004 |Using device|
referenceRangeC0..*BackboneElement
There are no (further) constraints on this element
Element id
Observation.referenceRange
Short description

Provides guide for interpretation

Definition

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (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
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
id0..1string
There are no (further) constraints on this element
Element id
Observation.referenceRange.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.referenceRange.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.referenceRange.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
lowC0..1SimpleQuantity
There are no (further) constraints on this element
Element id
Observation.referenceRange.low
Short description

Low Range, if relevant

Definition

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

Data type

SimpleQuantity

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • v2: OBX-7
  • rim: value:IVL_PQ.low
highC0..1SimpleQuantity
There are no (further) constraints on this element
Element id
Observation.referenceRange.high
Short description

High Range, if relevant

Definition

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Data type

SimpleQuantity

Conditions

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • v2: OBX-7
  • rim: value:IVL_PQ.high
type0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.referenceRange.type
Short description

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.

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.

Data type

CodeableConcept

Binding

Code for the meaning of a reference range.

ObservationReferenceRangeMeaningCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
appliesTo0..*CodeableConcept
There are no (further) constraints on this element
Element id
Observation.referenceRange.appliesTo
Short description

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. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

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.

Data type

CodeableConcept

Binding

Codes identifying the population the reference range applies to.

ObservationReferenceRangeAppliesToCodes (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
age0..1Range
There are no (further) constraints on this element
Element id
Observation.referenceRange.age
Short description

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.

Requirements

Some analytes vary greatly over age.

Data type

Range

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
text0..1string
There are no (further) constraints on this element
Element id
Observation.referenceRange.text
Short description

Text based reference range in an observation

Definition

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-7
  • rim: value:ST
hasMemberΣ0..*Reference(MolecularSequence | QuestionnaireResponse | observation-vitalsigns)
There are no (further) constraints on this element
Element id
Observation.hasMember
Short description

Used when reporting vital signs panel components

Definition

Used when reporting vital signs panel components.

Comments

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

Data type

Reference(MolecularSequence | QuestionnaireResponse | observation-vitalsigns)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Relationships established by OBX-4 usage
  • rim: outBoundRelationship
derivedFromΣ0..*Reference(DocumentReference | ImagingStudy | Media | MolecularSequence | QuestionnaireResponse | observation-vitalsigns)
There are no (further) constraints on this element
Element id
Observation.derivedFrom
Short description

Related measurements the observation is made from

Definition

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Comments

All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

Data type

Reference(DocumentReference | ImagingStudy | Media | MolecularSequence | QuestionnaireResponse | observation-vitalsigns)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Relationships established by OBX-4 usage
  • rim: .targetObservation
componentSO Σ C2..*BackboneElement
There are no (further) constraints on this element
Element id
Observation.component
Short description

Used when reporting systolic and diastolic blood pressure.

Definition

Used when reporting systolic and diastolic blood pressure.

Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

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

Data type

BackboneElement

Slicing

Unordered, Open, by code.coding.code(Value), code.coding.system(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • vs-3: If there is no a value a data absent reason must be present
    value.exists() or dataAbsentReason.exists()
Mappings
  • v2: containment by OBX-4?
  • rim: outBoundRelationship[typeCode=COMP]
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Observation.component.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.component.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeSO Σ1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component.code
Short description

Type of component observation (code / type)

Definition

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

Requirements

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

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
value[x]SO Σ C0..1Binding
There are no (further) constraints on this element
Element id
Observation.component.value[x]
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: 363714003 |Interprets| < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valuePeriodPeriod
There are no (further) constraints on this element
Data type

Period

valueQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

valueRangeRange
There are no (further) constraints on this element
Data type

Range

valueRatioRatio
There are no (further) constraints on this element
Data type

Ratio

valueSampledDataSampledData
There are no (further) constraints on this element
Data type

SampledData

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

dataAbsentReasonSO C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component.dataAbsentReason
Short description

Why the component result is missing

Definition

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

Requirements

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

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: obs-6, vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: value.nullFlavor
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 260245000 |Findings values|
  • v2: OBX-8
  • rim: interpretationCode
  • sct-attr: 363713009 |Has interpretation|
referenceRange0..*see (referenceRange)
There are no (further) constraints on this element
Element id
Observation.component.referenceRange
Short description

Provides guide for interpretation of component result

Definition

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

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
SystolicBPSO Σ C1..1BackboneElement
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP
Short description

Used when reporting systolic and diastolic blood pressure.

Definition

Used when reporting systolic and diastolic blood pressure.

Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

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

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • vs-3: If there is no a value a data absent reason must be present
    value.exists() or dataAbsentReason.exists()
Mappings
  • v2: containment by OBX-4?
  • rim: outBoundRelationship[typeCode=COMP]
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeSO Σ1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code
Short description

Type of component observation (code / type)

Alternate names

Component Test, Component Name

Definition

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

Requirements

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

Comments

additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingΣ1..*Coding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding
Short description

Systolic Blood Pressure

Definition

Systolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by code(Value), system(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
SBPCodeΣ1..1Coding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode
Short description

Systolic Blood Pressure

Definition

Systolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemΣ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://loinc.org
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
8480-6
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.display
Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.coding:SBPCode.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.code.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
value[x]SO Σ C0..1QuantityBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x]
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Data type

Quantity

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: 363714003 |Interprets| < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
valueSO Σ1..1decimal
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].value
Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

decimal

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
comparatorΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].comparator
Short description

< | <= | >= | > - how to understand the value

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

code

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
unitSO Σ1..1string
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].unit
Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
systemSO Σ C1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].system
Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://unitsofmeasure.org
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
codeSO Σ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.value[x].code
Short description

Coded responses from the common UCUM units for vital signs value set.

Definition

Coded responses from the common UCUM units for vital signs value set.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
mm[Hg]
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
dataAbsentReasonSO C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.dataAbsentReason
Short description

Why the component result is missing

Definition

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

Requirements

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

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: obs-6, vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: value.nullFlavor
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 260245000 |Findings values|
  • v2: OBX-8
  • rim: interpretationCode
  • sct-attr: 363713009 |Has interpretation|
referenceRange0..*see (referenceRange)
There are no (further) constraints on this element
Element id
Observation.component:SystolicBP.referenceRange
Short description

Provides guide for interpretation of component result

Definition

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

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
DiastolicBPSO Σ C1..1BackboneElement
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP
Short description

Used when reporting systolic and diastolic blood pressure.

Definition

Used when reporting systolic and diastolic blood pressure.

Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

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

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • vs-3: If there is no a value a data absent reason must be present
    value.exists() or dataAbsentReason.exists()
Mappings
  • v2: containment by OBX-4?
  • rim: outBoundRelationship[typeCode=COMP]
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
codeSO Σ1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code
Short description

Type of component observation (code / type)

Definition

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

Requirements

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

Comments

additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.

Data type

CodeableConcept

Binding

This identifies the vital sign result type.

VitalSigns (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.what[x]
  • sct-concept: < 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
  • v2: OBX-3
  • rim: code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingΣ1..*Coding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding
Short description

Diastolic Blood Pressure

Definition

Diastolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by code(Value), system(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
DBPCodeΣ1..1Coding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode
Short description

Diastolic Blood Pressure

Definition

Diastolic Blood Pressure.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemΣ1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.system
Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://loinc.org
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.code
Short description

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).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
8462-4
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.display
Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.coding:DBPCode.userSelected
Short description

If this coding was chosen directly by the user

Definition

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

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

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.code.text
Short description

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.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
value[x]SO Σ C0..1QuantityBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x]
Short description

Vital Sign Value recorded with UCUM

Definition

Vital Sign Value recorded with UCUM.

Requirements
  1. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305).
Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Data type

Quantity

Binding

Common UCUM units for recording Vital Signs.

VitalSignsUnits (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: 363714003 |Interprets| < 441742003 |Evaluation finding|
  • v2: OBX.2, OBX.5, OBX.6
  • rim: value
  • sct-attr: 363714003 |Interprets|
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
id0..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
valueSO Σ1..1decimal
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].value
Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

decimal

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
comparatorΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].comparator
Short description

< | <= | >= | > - how to understand the value

Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

code

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
unitSO Σ1..1string
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].unit
Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
systemSO Σ C1..1uriFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].system
Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
http://unitsofmeasure.org
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
codeSO Σ1..1codeFixed Value
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.value[x].code
Short description

Coded responses from the common UCUM units for vital signs value set.

Definition

Coded responses from the common UCUM units for vital signs value set.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed value
mm[Hg]
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
dataAbsentReasonSO C0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.dataAbsentReason
Short description

Why the component result is missing

Definition

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

Requirements

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

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

Data type

CodeableConcept

Binding

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

DataAbsentReason (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: obs-6, vs-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: value.nullFlavor
Obligations
NameCodeDocumentationActorHttp://hl7.org/fhir/tools/StructureDefinition/snapshot-source
pcareSHALL:populate
SHOULD:persist
SHALL:no-error

P-Care server population, persistence, and acceptance requirements for this element.

http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverhttp://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0
interpretation0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.interpretation
Short description

High, low, normal, etc.

Alternate names

Abnormal Flag

Definition

A categorical assessment of an observation value. For example, high, low, normal.

Requirements

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

Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

Data type

CodeableConcept

Binding

Codes identifying interpretations of observations.

ObservationInterpretationCodes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • sct-concept: < 260245000 |Findings values|
  • v2: OBX-8
  • rim: interpretationCode
  • sct-attr: 363713009 |Has interpretation|
referenceRange0..*see (referenceRange)
There are no (further) constraints on this element
Element id
Observation.component:DiastolicBP.referenceRange
Short description

Provides guide for interpretation of component result

Definition

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

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

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX.7
  • rim: outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="observation-blood-pressure" />
<text>
<status value="extensions" />
--- We have skipped the narrative for better readability of the resource ---
</text>
<url value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure" />
<version value="0.1.0" />
<name value="PCareObservationBloodPressure" />
<title value="P-Care Observation Blood Pressure" />
<status value="draft" />
<date value="2026-10-19T22:14:59+00:00" />
<publisher value="Infoway" />
<description value="This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure." />
<fhirVersion value="4.0.1" />
<mapping>
<identity value="workflow" />
<uri value="http://hl7.org/fhir/workflow" />
<name value="Workflow Pattern" />
</mapping>
<mapping>
<identity value="sct-concept" />
<uri value="http://snomed.info/conceptdomain" />
<name value="SNOMED CT Concept Domain Binding" />
</mapping>
<mapping>
<identity value="v2" />
<uri value="http://hl7.org/v2" />
<name value="HL7 v2 Mapping" />
</mapping>
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<mapping>
<identity value="w5" />
<uri value="http://hl7.org/fhir/fivews" />
<name value="FiveWs Pattern Mapping" />
</mapping>
<mapping>
<identity value="sct-attr" />
<uri value="http://snomed.org/attributebinding" />
<name value="SNOMED CT Attribute Binding" />
</mapping>
<kind value="resource" />
<abstract value="false" />
<type value="Observation" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/bp" />
<derivation value="constraint" />
<snapshot>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
<valueString value="4.0.1" />
</extension>
<element id="Observation">
<path value="Observation" />
<short value="FHIR Blood Pressure Profile" />
<definition value="This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure. This is a grouping structure. It has no value in Observation.valueQuantity but contains at least one component (systolic and/or diastolic)." />
<comment value="Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc." />
<alias value="Vital Signs" />
<alias value="Measurement" />
<alias value="Results" />
<alias value="Tests" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation" />
<min value="0" />
<max value="*" />
</base>
<constraint>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-3" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="obs-6" />
<severity value="error" />
<human value="dataAbsentReason SHALL only be present if Observation.value[x] is not present" />
<expression value="dataAbsentReason.empty() or value.empty()" />
<xpath value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))" />
<source value="http://hl7.org/fhir/StructureDefinition/Observation" />
</constraint>
<constraint>
<key value="obs-7" />
<severity value="error" />
<human value="If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present" />
<expression value="value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()" />
<xpath value="not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@value]))" />
<source value="http://hl7.org/fhir/StructureDefinition/Observation" />
</constraint>
<constraint>
<key value="vs-2" />
<severity value="error" />
<human value="If there is no component or hasMember element then either a value[x] or a data absent reason must be present." />
<expression value="(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())" />
<xpath value="f:component or f:memberOF or f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason" />
<source value="http://hl7.org/fhir/StructureDefinition/vitalsigns" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event" />
</mapping>
<mapping>
<identity value="sct-concept" />
<map value="< 363787002 |Observable entity|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Observation[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="Observation.id">
<path value="Observation.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="true" />
</element>
<element id="Observation.meta">
<path value="Observation.meta" />
<short value="Metadata about the resource" />
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Meta" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
</element>
<element id="Observation.implicitRules">
<path value="Observation.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
</element>
<element id="Observation.language">
<path value="Observation.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1" />
</binding>
</element>
<element id="Observation.text">
<path value="Observation.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="Observation.contained">
<path value="Observation.contained" />
<short value="Contained, inline Resources" />
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Resource" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.extension">
<path value="Observation.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.modifierExtension">
<path value="Observation.modifierExtension" />
<short value="Extensions that cannot be ignored" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.identifier">
<path value="Observation.identifier" />
<short value="Business Identifier for observation" />
<definition value="A unique identifier assigned to this observation." />
<requirements value="Allows observations to be distinguished and referenced." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="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." />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
</element>
<element id="Observation.basedOn">
<path value="Observation.basedOn" />
<short value="Fulfills plan, proposal or order" />
<definition value="A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed." />
<requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon." />
<alias value="Fulfills" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.basedOn" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.basedOn" />
</mapping>
<mapping>
<identity value="v2" />
<map value="ORC" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]" />
</mapping>
</element>
<element id="Observation.partOf">
<path value="Observation.partOf" />
<short value="Part of referenced event" />
<definition value="A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure." />
<comment value="To link an Observation to an Encounter use `encounter`. See the [Notes](http://hl7.org/fhir/observation.html#obsgrouping) below for guidance on referencing another Observation." />
<alias value="Container" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.partOf" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Immunization|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.partOf" />
</mapping>
<mapping>
<identity value="v2" />
<map value="Varies by domain" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=FLFS].target" />
</mapping>
</element>
<element id="Observation.status">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
<valueString value="default: final" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.status" />
<short value="registered | preliminary | final | amended +" />
<definition value="The status of the result value." />
<comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
<requirements value="Need to track the status of individual results. Some results are finalized before the whole report is finalized." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.status" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Status" />
</extension>
<strength value="required" />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-status|4.0.1" />
</binding>
<mapping>
<identity value="workflow" />
<map value="Event.status" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<mapping>
<identity value="sct-concept" />
<map value="< 445584004 |Report by finality status|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-11" />
</mapping>
<mapping>
<identity value="rim" />
<map value="status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"" />
</mapping>
</element>
<element id="Observation.category">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.category" />
<slicing>
<discriminator>
<type value="value" />
<path value="coding.code" />
</discriminator>
<discriminator>
<type value="value" />
<path value="coding.system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Classification of type of observation" />
<definition value="A code that classifies the general type of observation being made." />
<comment value="In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set." />
<requirements value="Used for filtering what observations are retrieved and displayed." />
<min value="1" />
<max value="*" />
<base>
<path value="Observation.category" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCategory" />
</extension>
<strength value="preferred" />
<description value="Codes for high level observation categories." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-category|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code" />
</mapping>
</element>
<element id="Observation.category:VSCat">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.category" />
<sliceName value="VSCat" />
<short value="Classification of type of observation" />
<definition value="A code that classifies the general type of observation being made." />
<comment value="In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set." />
<requirements value="Used for filtering what observations are retrieved and displayed." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.category" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationCategory" />
</extension>
<strength value="preferred" />
<description value="Codes for high level observation categories." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-category|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code" />
</mapping>
</element>
<element id="Observation.category:VSCat.id">
<path value="Observation.category.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.category:VSCat.extension">
<path value="Observation.category.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.category.coding" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.id">
<path value="Observation.category.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.extension">
<path value="Observation.category.coding.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.category.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="http://terminology.hl7.org/CodeSystem/observation-category" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.version">
<path value="Observation.category.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.category.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="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)." />
<requirements value="Need to refer to a particular code in the system." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="vital-signs" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.category.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="Observation.category:VSCat.coding.userSelected">
<path value="Observation.category.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<mapping>
<identity value="orim" />
<map value="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 ]" />
</mapping>
</element>
<element id="Observation.category:VSCat.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.category.text" />
<short value="Plain text representation of the concept" />
<definition value="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." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="Observation.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.code" />
<short value="Blood Pressure" />
<definition value="Blood Pressure." />
<comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." />
<requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." />
<alias value="Name" />
<alias value="Test" />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.code" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSigns" />
</extension>
<strength value="extensible" />
<description value="This identifies the vital sign result type." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1" />
</binding>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="sct-concept" />
<map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="code" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="116680003 |Is a|" />
</mapping>
</element>
<element id="Observation.code.id">
<path value="Observation.code.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.code.extension">
<path value="Observation.code.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.code.coding">
<path value="Observation.code.coding" />
<slicing>
<discriminator>
<type value="value" />
<path value="code" />
</discriminator>
<discriminator>
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode">
<path value="Observation.code.coding" />
<sliceName value="BPCode" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="1" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.id">
<path value="Observation.code.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.extension">
<path value="Observation.code.coding.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.system">
<path value="Observation.code.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="http://loinc.org" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.version">
<path value="Observation.code.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.code">
<path value="Observation.code.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="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)." />
<requirements value="Need to refer to a particular code in the system." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="85354-9" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.code.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="Observation.code.coding:BPCode.userSelected">
<path value="Observation.code.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<mapping>
<identity value="orim" />
<map value="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 ]" />
</mapping>
</element>
<element id="Observation.code.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.code.text" />
<short value="Plain text representation of the concept" />
<definition value="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." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="Observation.subject">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.subject" />
<short value="Who and/or what the observation is about" />
<definition value="The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation." />
<comment value="One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated." />
<requirements value="Observations have no value if you don't know who or what they're about." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.subject" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/patient" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.subject" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PID-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=RTGT]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="Observation.focus">
<path value="Observation.focus" />
<short value="What the observation is about, when it is not about the subject of record" />
<definition value="The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus." />
<comment value="Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use `specimen` if a reference to a specimen is required. If a code is required instead of a resource use either `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/extension-observation-focuscode.html)." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.focus" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=SBJ]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="Observation.encounter">
<path value="Observation.encounter" />
<short value="Healthcare event during which this observation is made" />
<definition value="The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made." />
<comment value="This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests)." />
<requirements value="For some observations it may be important to know the link between an observation and a particular encounter." />
<alias value="Context" />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.encounter" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.context" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.context" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PV1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" />
</mapping>
</element>
<element id="Observation.effective[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.effective[x]" />
<short value="Often just a dateTime for Vital Signs" />
<definition value="Often just a dateTime for Vital Signs." />
<comment value="At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](http://hl7.org/fhir/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events." />
<requirements value="Knowing when an observation was deemed true is important to its relevance as well as determining trends." />
<alias value="Occurrence" />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.effective[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<type>
<code value="Period" />
</type>
<condition value="vs-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="vs-1" />
<severity value="error" />
<human value="if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day" />
<expression value="$this is dateTime implies $this.toString().length() >= 10" />
<xpath value="f:effectiveDateTime[matches(@value, '^\d{4}-\d{2}-\d{2}')]" />
<source value="http://hl7.org/fhir/StructureDefinition/bp" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="effectiveTime" />
</mapping>
</element>
<element id="Observation.issued">
<path value="Observation.issued" />
<short value="Date/Time this version was made available" />
<definition value="The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified." />
<comment value="For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/resource-definitions.html#Meta.lastUpdated) time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.issued" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="instant" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.recorded" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=AUT].time" />
</mapping>
</element>
<element id="Observation.performer">
<path value="Observation.performer" />
<short value="Who is responsible for the observation" />
<definition value="Who was responsible for asserting the observed value as "true"." />
<requirements value="May give a degree of confidence in the observation and also indicates where follow-up questions should be directed." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.performer" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="workflow" />
<map value="Event.performer.actor" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<mapping>
<identity value="v2" />
<map value="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'" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=PRF]" />
</mapping>
</element>
<element id="Observation.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.value[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="closed" />
</slicing>
<short value="Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept." />
<definition value="Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept." />
<comment value="An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
</type>
<condition value="obs-7" />
<condition value="vs-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="sct-concept" />
<map value="< 441742003 |Evaluation finding|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX.2, OBX.5, OBX.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363714003 |Interprets|" />
</mapping>
</element>
<element id="Observation.value[x]:valueQuantity">
<path value="Observation.value[x]" />
<sliceName value="valueQuantity" />
<short value="Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept." />
<definition value="Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept." />
<comment value="An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." />
<min value="0" />
<max value="0" />
<base>
<path value="Observation.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
</type>
<condition value="obs-7" />
<condition value="vs-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="sct-concept" />
<map value="< 441742003 |Evaluation finding|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX.2, OBX.5, OBX.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363714003 |Interprets|" />
</mapping>
</element>
<element id="Observation.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.dataAbsentReason" />
<short value="Why the result is missing" />
<definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." />
<comment value="Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values." />
<requirements value="For many results it is necessary to handle exceptional values in measurements." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.dataAbsentReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="obs-6" />
<condition value="vs-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason" />
</extension>
<strength value="extensible" />
<description value="Codes specifying why the result (`Observation.value[x]`) is missing." />
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value.nullFlavor" />
</mapping>
</element>
<element id="Observation.interpretation">
<path value="Observation.interpretation" />
<short value="High, low, normal, etc." />
<definition value="A categorical assessment of an observation value. For example, high, low, normal." />
<comment value="Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result." />
<requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." />
<alias value="Abnormal Flag" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.interpretation" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation" />
</extension>
<strength value="extensible" />
<description value="Codes identifying interpretations of observations." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 260245000 |Findings values|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="interpretationCode" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363713009 |Has interpretation|" />
</mapping>
</element>
<element id="Observation.note">
<path value="Observation.note" />
<short value="Comments about the observation" />
<definition value="Comments about the observation or the results." />
<comment value="May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation." />
<requirements value="Need to be able to provide free text additional information." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.note" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Annotation" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="subjectOf.observationEvent[code="annotation"].value" />
</mapping>
</element>
<element id="Observation.bodySite">
<path value="Observation.bodySite" />
<short value="Observed body part" />
<definition value="Indicates the site on the subject's body where the observation was made (i.e. the target site)." />
<comment value="Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. \n\nIf the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/extension-bodysite.html)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.bodySite" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodySite" />
</extension>
<strength value="example" />
<description value="Codes describing anatomical locations. May include laterality." />
<valueSet value="http://hl7.org/fhir/ValueSet/body-site|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 123037004 |Body structure|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-20" />
</mapping>
<mapping>
<identity value="rim" />
<map value="targetSiteCode" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="718497002 |Inherent location|" />
</mapping>
</element>
<element id="Observation.method">
<path value="Observation.method" />
<short value="How it was done" />
<definition value="Indicates the mechanism used to perform the observation." />
<comment value="Only used if not implicit in code for Observation.code." />
<requirements value="In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.method" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationMethod" />
</extension>
<strength value="example" />
<description value="Methods for simple observations." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-methods|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="OBX-17" />
</mapping>
<mapping>
<identity value="rim" />
<map value="methodCode" />
</mapping>
</element>
<element id="Observation.specimen">
<path value="Observation.specimen" />
<short value="Specimen used for this observation" />
<definition value="The specimen that was used when this observation was made." />
<comment value="Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.specimen" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="sct-concept" />
<map value="< 123038009 |Specimen|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SPM segment" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=SPC].specimen" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="704319004 |Inherent in|" />
</mapping>
</element>
<element id="Observation.device">
<path value="Observation.device" />
<short value="(Measurement) Device" />
<definition value="The device used to generate the observation data." />
<comment value="Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.device" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="sct-concept" />
<map value="< 49062001 |Device|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-17 / PRT -10" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=DEV]" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="424226004 |Using device|" />
</mapping>
</element>
<element id="Observation.referenceRange">
<path value="Observation.referenceRange" />
<short value="Provides guide for interpretation" />
<definition value="Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two `referenceRange` elements would be used." />
<comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." />
<requirements value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.referenceRange" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="obs-3" />
<severity value="error" />
<human value="Must have at least a low or a high or text" />
<expression value="low.exists() or high.exists() or text.exists()" />
<xpath value="(exists(f:low) or exists(f:high)or exists(f:text))" />
<source value="http://hl7.org/fhir/StructureDefinition/bp" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="Observation.referenceRange.id">
<path value="Observation.referenceRange.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.referenceRange.extension">
<path value="Observation.referenceRange.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.referenceRange.modifierExtension">
<path value="Observation.referenceRange.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.referenceRange.low">
<path value="Observation.referenceRange.low" />
<short value="Low Range, if relevant" />
<definition value="The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.referenceRange.low" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1">
<extension url="http://hl7.org/fhir/tools/StructureDefinition/type-profile-constraints">
<valueCode value="full" />
</extension>
</profile>
</type>
<condition value="obs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value:IVL_PQ.low" />
</mapping>
</element>
<element id="Observation.referenceRange.high">
<path value="Observation.referenceRange.high" />
<short value="High Range, if relevant" />
<definition value="The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.referenceRange.high" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1">
<extension url="http://hl7.org/fhir/tools/StructureDefinition/type-profile-constraints">
<valueCode value="full" />
</extension>
</profile>
</type>
<condition value="obs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value:IVL_PQ.high" />
</mapping>
</element>
<element id="Observation.referenceRange.type">
<path value="Observation.referenceRange.type" />
<short value="Reference range qualifier" />
<definition value="Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range." />
<comment value="This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed." />
<requirements value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.referenceRange.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationRangeMeaning" />
</extension>
<strength value="preferred" />
<description value="Code for the meaning of a reference range." />
<valueSet value="http://hl7.org/fhir/ValueSet/referencerange-meaning|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 260245000 |Findings values| OR \n< 365860008 |General clinical state finding| \nOR \n< 250171008 |Clinical history or observation findings| OR \n< 415229000 |Racial group| OR \n< 365400002 |Finding of puberty stage| OR\n< 443938003 |Procedure carried out on subject|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-10" />
</mapping>
<mapping>
<identity value="rim" />
<map value="interpretationCode" />
</mapping>
</element>
<element id="Observation.referenceRange.appliesTo">
<path value="Observation.referenceRange.appliesTo" />
<short value="Reference range population" />
<definition value="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. Multiple `appliesTo` are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used." />
<comment value="This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed." />
<requirements value="Need to be able to identify the target population for proper interpretation." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.referenceRange.appliesTo" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationRangeType" />
</extension>
<strength value="example" />
<description value="Codes identifying the population the reference range applies to." />
<valueSet value="http://hl7.org/fhir/ValueSet/referencerange-appliesto|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 260245000 |Findings values| OR \n< 365860008 |General clinical state finding| \nOR \n< 250171008 |Clinical history or observation findings| OR \n< 415229000 |Racial group| OR \n< 365400002 |Finding of puberty stage| OR\n< 443938003 |Procedure carried out on subject|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-10" />
</mapping>
<mapping>
<identity value="rim" />
<map value="interpretationCode" />
</mapping>
</element>
<element id="Observation.referenceRange.age">
<path value="Observation.referenceRange.age" />
<short value="Applicable age range, if relevant" />
<definition value="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." />
<requirements value="Some analytes vary greatly over age." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.referenceRange.age" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Range" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value" />
</mapping>
</element>
<element id="Observation.referenceRange.text">
<path value="Observation.referenceRange.text" />
<short value="Text based reference range in an observation" />
<definition value="Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals"." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.referenceRange.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value:ST" />
</mapping>
</element>
<element id="Observation.hasMember">
<path value="Observation.hasMember" />
<short value="Used when reporting vital signs panel components" />
<definition value="Used when reporting vital signs panel components." />
<comment value="When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/questionnaireresponse.html) into a final score and represent the score as an Observation." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.hasMember" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="Relationships established by OBX-4 usage" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outBoundRelationship" />
</mapping>
</element>
<element id="Observation.derivedFrom">
<path value="Observation.derivedFrom" />
<short value="Related measurements the observation is made from" />
<definition value="The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image." />
<comment value="All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/observation.html#obsgrouping) below." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.derivedFrom" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Media|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence|4.0.1" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns|4.0.1" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="Relationships established by OBX-4 usage" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".targetObservation" />
</mapping>
</element>
<element id="Observation.component">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component" />
<slicing>
<discriminator>
<type value="value" />
<path value="code.coding.code" />
</discriminator>
<discriminator>
<type value="value" />
<path value="code.coding.system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Used when reporting systolic and diastolic blood pressure." />
<definition value="Used when reporting systolic and diastolic blood pressure." />
<comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." />
<min value="2" />
<max value="*" />
<base>
<path value="Observation.component" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="vs-3" />
<severity value="error" />
<human value="If there is no a value a data absent reason must be present" />
<expression value="value.exists() or dataAbsentReason.exists()" />
<xpath value="f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason" />
<source value="http://hl7.org/fhir/StructureDefinition/vitalsigns" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="containment by OBX-4?" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outBoundRelationship[typeCode=COMP]" />
</mapping>
</element>
<element id="Observation.component.id">
<path value="Observation.component.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component.extension">
<path value="Observation.component.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component.modifierExtension">
<path value="Observation.component.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.component.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.code" />
<short value="Type of component observation (code / type)" />
<definition value="Describes what was observed. Sometimes this is called the observation "code"." />
<comment value="*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation." />
<requirements value="Knowing what kind of observation is being made is essential to understanding the observation." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.component.code" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSigns" />
</extension>
<strength value="extensible" />
<description value="This identifies the vital sign result type." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="sct-concept" />
<map value="< 363787002 |Observable entity| OR \n< 386053000 |Evaluation procedure|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="code" />
</mapping>
</element>
<element id="Observation.component.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x]" />
<short value="Vital Sign Value recorded with UCUM" />
<definition value="Vital Sign Value recorded with UCUM." />
<comment value="Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.component.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
</type>
<type>
<code value="CodeableConcept" />
</type>
<type>
<code value="string" />
</type>
<type>
<code value="boolean" />
</type>
<type>
<code value="integer" />
</type>
<type>
<code value="Range" />
</type>
<type>
<code value="Ratio" />
</type>
<type>
<code value="SampledData" />
</type>
<type>
<code value="time" />
</type>
<type>
<code value="dateTime" />
</type>
<type>
<code value="Period" />
</type>
<condition value="vs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSignsUnits" />
</extension>
<strength value="extensible" />
<description value="Common UCUM units for recording Vital Signs." />
<valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="363714003 |Interprets| < 441742003 |Evaluation finding|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX.2, OBX.5, OBX.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363714003 |Interprets|" />
</mapping>
</element>
<element id="Observation.component.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.dataAbsentReason" />
<short value="Why the component result is missing" />
<definition value="Provides a reason why the expected value in the element Observation.component.value[x] is missing." />
<comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." />
<requirements value="For many results it is necessary to handle exceptional values in measurements." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.component.dataAbsentReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="obs-6" />
<condition value="vs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason" />
</extension>
<strength value="extensible" />
<description value="Codes specifying why the result (`Observation.value[x]`) is missing." />
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value.nullFlavor" />
</mapping>
</element>
<element id="Observation.component.interpretation">
<path value="Observation.component.interpretation" />
<short value="High, low, normal, etc." />
<definition value="A categorical assessment of an observation value. For example, high, low, normal." />
<comment value="Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result." />
<requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." />
<alias value="Abnormal Flag" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.component.interpretation" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation" />
</extension>
<strength value="extensible" />
<description value="Codes identifying interpretations of observations." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 260245000 |Findings values|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="interpretationCode" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363713009 |Has interpretation|" />
</mapping>
</element>
<element id="Observation.component.referenceRange">
<path value="Observation.component.referenceRange" />
<short value="Provides guide for interpretation of component result" />
<definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." />
<comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." />
<requirements value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.component.referenceRange" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="Observation.component:SystolicBP">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component" />
<sliceName value="SystolicBP" />
<short value="Used when reporting systolic and diastolic blood pressure." />
<definition value="Used when reporting systolic and diastolic blood pressure." />
<comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.component" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="vs-3" />
<severity value="error" />
<human value="If there is no a value a data absent reason must be present" />
<expression value="value.exists() or dataAbsentReason.exists()" />
<xpath value="f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason" />
<source value="http://hl7.org/fhir/StructureDefinition/vitalsigns" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="containment by OBX-4?" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outBoundRelationship[typeCode=COMP]" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.id">
<path value="Observation.component.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.extension">
<path value="Observation.component.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.modifierExtension">
<path value="Observation.component.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.code" />
<short value="Type of component observation (code / type)" />
<definition value="Describes what was observed. Sometimes this is called the observation "code"." />
<comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." />
<requirements value="Knowing what kind of observation is being made is essential to understanding the observation." />
<alias value="Component Test" />
<alias value="Component Name" />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.component.code" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSigns" />
</extension>
<strength value="extensible" />
<description value="This identifies the vital sign result type." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="sct-concept" />
<map value="< 363787002 |Observable entity| OR \n< 386053000 |Evaluation procedure|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="code" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.id">
<path value="Observation.component.code.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.extension">
<path value="Observation.component.code.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding">
<path value="Observation.component.code.coding" />
<slicing>
<discriminator>
<type value="value" />
<path value="code" />
</discriminator>
<discriminator>
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Systolic Blood Pressure" />
<definition value="Systolic Blood Pressure." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode">
<path value="Observation.component.code.coding" />
<sliceName value="SBPCode" />
<short value="Systolic Blood Pressure" />
<definition value="Systolic Blood Pressure." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="1" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.id">
<path value="Observation.component.code.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.extension">
<path value="Observation.component.code.coding.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.system">
<path value="Observation.component.code.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="http://loinc.org" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.version">
<path value="Observation.component.code.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.code">
<path value="Observation.component.code.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="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)." />
<requirements value="Need to refer to a particular code in the system." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="8480-6" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.component.code.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.coding:SBPCode.userSelected">
<path value="Observation.component.code.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<mapping>
<identity value="orim" />
<map value="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 ]" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.code.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.component.code.text" />
<short value="Plain text representation of the concept" />
<definition value="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." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x]" />
<short value="Vital Sign Value recorded with UCUM" />
<definition value="Vital Sign Value recorded with UCUM." />
<comment value="Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.component.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
</type>
<condition value="vs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSignsUnits" />
</extension>
<strength value="extensible" />
<description value="Common UCUM units for recording Vital Signs." />
<valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="363714003 |Interprets| < 441742003 |Evaluation finding|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX.2, OBX.5, OBX.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363714003 |Interprets|" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].id">
<path value="Observation.component.value[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].extension">
<path value="Observation.component.value[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].value" />
<short value="Numerical value (with implicit precision)" />
<definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
<comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
<requirements value="Precision is handled implicitly in almost all cases of measurement." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="decimal" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="SN.2 / CQ - N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].comparator">
<path value="Observation.component.value[x].comparator" />
<short value="< | <= | >= | > - how to understand the value" />
<definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." />
<requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." />
<min value="0" />
<max value="1" />
<base>
<path value="Quantity.comparator" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="QuantityComparator" />
</extension>
<strength value="required" />
<description value="How the Quantity should be understood and represented." />
<valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="SN.1 / CQ.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="IVL properties" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].unit">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].unit" />
<short value="Unit representation" />
<definition value="A human-readable form of the unit." />
<requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.unit" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.unit" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].system" />
<short value="System that defines coded unit form" />
<definition value="The identification of the system that provides the coded form of the unit." />
<requirements value="Need to know the system that defines the coded form of the unit." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="http://unitsofmeasure.org" />
<condition value="qty-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CO.codeSystem, PQ.translation.codeSystem" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.value[x].code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].code" />
<short value="Coded responses from the common UCUM units for vital signs value set." />
<definition value="Coded responses from the common UCUM units for vital signs value set." />
<comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." />
<requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="mm[Hg]" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.code, MO.currency, PQ.translation.code" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.dataAbsentReason" />
<short value="Why the component result is missing" />
<definition value="Provides a reason why the expected value in the element Observation.component.value[x] is missing." />
<comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." />
<requirements value="For many results it is necessary to handle exceptional values in measurements." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.component.dataAbsentReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="obs-6" />
<condition value="vs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason" />
</extension>
<strength value="extensible" />
<description value="Codes specifying why the result (`Observation.value[x]`) is missing." />
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value.nullFlavor" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.interpretation">
<path value="Observation.component.interpretation" />
<short value="High, low, normal, etc." />
<definition value="A categorical assessment of an observation value. For example, high, low, normal." />
<comment value="Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result." />
<requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." />
<alias value="Abnormal Flag" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.component.interpretation" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation" />
</extension>
<strength value="extensible" />
<description value="Codes identifying interpretations of observations." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 260245000 |Findings values|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="interpretationCode" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363713009 |Has interpretation|" />
</mapping>
</element>
<element id="Observation.component:SystolicBP.referenceRange">
<path value="Observation.component.referenceRange" />
<short value="Provides guide for interpretation of component result" />
<definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." />
<comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." />
<requirements value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.component.referenceRange" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component" />
<sliceName value="DiastolicBP" />
<short value="Used when reporting systolic and diastolic blood pressure." />
<definition value="Used when reporting systolic and diastolic blood pressure." />
<comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.component" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="vs-3" />
<severity value="error" />
<human value="If there is no a value a data absent reason must be present" />
<expression value="value.exists() or dataAbsentReason.exists()" />
<xpath value="f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason" />
<source value="http://hl7.org/fhir/StructureDefinition/vitalsigns" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="containment by OBX-4?" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outBoundRelationship[typeCode=COMP]" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.id">
<path value="Observation.component.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.extension">
<path value="Observation.component.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.modifierExtension">
<path value="Observation.component.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.code" />
<short value="Type of component observation (code / type)" />
<definition value="Describes what was observed. Sometimes this is called the observation "code"." />
<comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." />
<requirements value="Knowing what kind of observation is being made is essential to understanding the observation." />
<min value="1" />
<max value="1" />
<base>
<path value="Observation.component.code" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSigns" />
</extension>
<strength value="extensible" />
<description value="This identifies the vital sign result type." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1" />
</binding>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="sct-concept" />
<map value="< 363787002 |Observable entity| OR \n< 386053000 |Evaluation procedure|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="code" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.id">
<path value="Observation.component.code.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.extension">
<path value="Observation.component.code.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding">
<path value="Observation.component.code.coding" />
<slicing>
<discriminator>
<type value="value" />
<path value="code" />
</discriminator>
<discriminator>
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Diastolic Blood Pressure" />
<definition value="Diastolic Blood Pressure." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode">
<path value="Observation.component.code.coding" />
<sliceName value="DBPCode" />
<short value="Diastolic Blood Pressure" />
<definition value="Diastolic Blood Pressure." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="1" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.id">
<path value="Observation.component.code.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.extension">
<path value="Observation.component.code.coding.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.system">
<path value="Observation.component.code.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="http://loinc.org" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.version">
<path value="Observation.component.code.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.code">
<path value="Observation.component.code.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="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)." />
<requirements value="Need to refer to a particular code in the system." />
<min value="1" />
<max value="1" />
<base>
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="8462-4" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.component.code.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.coding:DBPCode.userSelected">
<path value="Observation.component.code.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<mapping>
<identity value="orim" />
<map value="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 ]" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.code.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Observation.component.code.text" />
<short value="Plain text representation of the concept" />
<definition value="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." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x]" />
<short value="Vital Sign Value recorded with UCUM" />
<definition value="Vital Sign Value recorded with UCUM." />
<comment value="Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below." />
<requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.component.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
</type>
<condition value="vs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="VitalSignsUnits" />
</extension>
<strength value="extensible" />
<description value="Common UCUM units for recording Vital Signs." />
<valueSet value="http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="363714003 |Interprets| < 441742003 |Evaluation finding|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX.2, OBX.5, OBX.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363714003 |Interprets|" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].id">
<path value="Observation.component.value[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].extension">
<path value="Observation.component.value[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].value" />
<short value="Numerical value (with implicit precision)" />
<definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
<comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
<requirements value="Precision is handled implicitly in almost all cases of measurement." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="decimal" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="SN.2 / CQ - N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].comparator">
<path value="Observation.component.value[x].comparator" />
<short value="< | <= | >= | > - how to understand the value" />
<definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." />
<requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." />
<min value="0" />
<max value="1" />
<base>
<path value="Quantity.comparator" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="QuantityComparator" />
</extension>
<strength value="required" />
<description value="How the Quantity should be understood and represented." />
<valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="SN.1 / CQ.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="IVL properties" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].unit">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].unit" />
<short value="Unit representation" />
<definition value="A human-readable form of the unit." />
<requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.unit" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.unit" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].system" />
<short value="System that defines coded unit form" />
<definition value="The identification of the system that provides the coded form of the unit." />
<requirements value="Need to know the system that defines the coded form of the unit." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="http://unitsofmeasure.org" />
<condition value="qty-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CO.codeSystem, PQ.translation.codeSystem" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.value[x].code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.value[x].code" />
<short value="Coded responses from the common UCUM units for vital signs value set." />
<definition value="Coded responses from the common UCUM units for vital signs value set." />
<comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." />
<requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
<min value="1" />
<max value="1" />
<base>
<path value="Quantity.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="mm[Hg]" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.code, MO.currency, PQ.translation.code" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-source">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0" />
</extension>
</extension>
<path value="Observation.component.dataAbsentReason" />
<short value="Why the component result is missing" />
<definition value="Provides a reason why the expected value in the element Observation.component.value[x] is missing." />
<comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." />
<requirements value="For many results it is necessary to handle exceptional values in measurements." />
<min value="0" />
<max value="1" />
<base>
<path value="Observation.component.dataAbsentReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="obs-6" />
<condition value="vs-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationValueAbsentReason" />
</extension>
<strength value="extensible" />
<description value="Codes specifying why the result (`Observation.value[x]`) is missing." />
<valueSet value="http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="value.nullFlavor" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.interpretation">
<path value="Observation.component.interpretation" />
<short value="High, low, normal, etc." />
<definition value="A categorical assessment of an observation value. For example, high, low, normal." />
<comment value="Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result." />
<requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." />
<alias value="Abnormal Flag" />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.component.interpretation" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ObservationInterpretation" />
</extension>
<strength value="extensible" />
<description value="Codes identifying interpretations of observations." />
<valueSet value="http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1" />
</binding>
<mapping>
<identity value="sct-concept" />
<map value="< 260245000 |Findings values|" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="interpretationCode" />
</mapping>
<mapping>
<identity value="sct-attr" />
<map value="363713009 |Has interpretation|" />
</mapping>
</element>
<element id="Observation.component:DiastolicBP.referenceRange">
<path value="Observation.component.referenceRange" />
<short value="Provides guide for interpretation of component result" />
<definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." />
<comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." />
<requirements value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Observation.component.referenceRange" />
<min value="0" />
<max value="*" />
</base>
<contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
</snapshot>
<differential>
<element id="Observation.status">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
<valueString value="default: final" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.status" />
</element>
<element id="Observation.category">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.category" />
</element>
<element id="Observation.category:VSCat">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.category" />
<sliceName value="VSCat" />
</element>
<element id="Observation.category:VSCat.coding">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.category.coding" />
</element>
<element id="Observation.category:VSCat.coding.system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.category.coding.system" />
</element>
<element id="Observation.category:VSCat.coding.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.category.coding.code" />
</element>
<element id="Observation.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.code" />
</element>
<element id="Observation.code.coding">
<path value="Observation.code.coding" />
<min value="1" />
</element>
<element id="Observation.subject">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.subject" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/patient" />
</type>
</element>
<element id="Observation.effective[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.effective[x]" />
</element>
<element id="Observation.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.value[x]" />
</element>
<element id="Observation.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.dataAbsentReason" />
</element>
<element id="Observation.component">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component" />
</element>
<element id="Observation.component.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.code" />
</element>
<element id="Observation.component.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x]" />
</element>
<element id="Observation.component.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.dataAbsentReason" />
</element>
<element id="Observation.component:SystolicBP">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component" />
<sliceName value="SystolicBP" />
</element>
<element id="Observation.component:SystolicBP.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.code" />
</element>
<element id="Observation.component:SystolicBP.code.coding">
<path value="Observation.component.code.coding" />
<min value="1" />
</element>
<element id="Observation.component:SystolicBP.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x]" />
</element>
<element id="Observation.component:SystolicBP.value[x].value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].value" />
</element>
<element id="Observation.component:SystolicBP.value[x].unit">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].unit" />
</element>
<element id="Observation.component:SystolicBP.value[x].system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].system" />
</element>
<element id="Observation.component:SystolicBP.value[x].code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].code" />
</element>
<element id="Observation.component:SystolicBP.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.dataAbsentReason" />
</element>
<element id="Observation.component:DiastolicBP">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component" />
<sliceName value="DiastolicBP" />
</element>
<element id="Observation.component:DiastolicBP.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.code" />
</element>
<element id="Observation.component:DiastolicBP.code.coding">
<path value="Observation.component.code.coding" />
<min value="1" />
</element>
<element id="Observation.component:DiastolicBP.value[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x]" />
</element>
<element id="Observation.component:DiastolicBP.value[x].value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].value" />
</element>
<element id="Observation.component:DiastolicBP.value[x].unit">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].unit" />
</element>
<element id="Observation.component:DiastolicBP.value[x].system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].system" />
</element>
<element id="Observation.component:DiastolicBP.value[x].code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.value[x].code" />
</element>
<element id="Observation.component:DiastolicBP.dataAbsentReason">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="name">
<valueString value="pcare" />
</extension>
<extension url="code">
<valueCode value="SHALL:populate" />
</extension>
<extension url="code">
<valueCode value="SHOULD:persist" />
</extension>
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="documentation">
<valueMarkdown value="P-Care server population, persistence, and acceptance requirements for this element." />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server" />
</extension>
</extension>
<path value="Observation.component.dataAbsentReason" />
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"id": "observation-blood-pressure",
"text": {
"status": "extensions",
--- We have skipped the narrative for better readability of the resource ---
},
"url": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure",
"version": "0.1.0",
"name": "PCareObservationBloodPressure",
"title": "P-Care Observation Blood Pressure",
"status": "draft",
"date": "2026-10-19T22:14:59+00:00",
"publisher": "Infoway",
"description": "This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure.",
"fhirVersion": "4.0.1",
"mapping": [
{
"identity": "workflow",
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern"
},
{
"identity": "sct-concept",
"uri": "http://snomed.info/conceptdomain",
"name": "SNOMED CT Concept Domain Binding"
},
{
"identity": "v2",
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping"
},
{
"identity": "sct-attr",
"uri": "http://snomed.org/attributebinding",
"name": "SNOMED CT Attribute Binding"
}
],
"kind": "resource",
"abstract": false,
"type": "Observation",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/bp",
"derivation": "constraint",
"snapshot": {
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "4.0.1"
}
],
"element": [
{
"id": "Observation",
"path": "Observation",
"short": "FHIR Blood Pressure Profile",
"definition": "This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure. This is a grouping structure. It has no value in Observation.valueQuantity but contains at least one component (systolic and/or diastolic).",
"comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.",
"alias": [
"Vital Signs",
"Measurement",
"Results",
"Tests"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "obs-6",
"severity": "error",
"human": "dataAbsentReason SHALL only be present if Observation.value[x] is not present",
"expression": "dataAbsentReason.empty() or value.empty()",
"xpath": "not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))",
"source": "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"key": "obs-7",
"severity": "error",
"human": "If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present",
"expression": "value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()",
"xpath": "not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@value]))",
"source": "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"key": "vs-2",
"severity": "error",
"human": "If there is no component or hasMember element then either a value[x] or a data absent reason must be present.",
"expression": "(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())",
"xpath": "f:component or f:memberOF or f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason",
"source": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "sct-concept",
"map": "< 363787002 |Observable entity|"
},
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": "Observation[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "Observation.id",
"path": "Observation.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "Observation.meta",
"path": "Observation.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "Observation.implicitRules",
"path": "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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
},
{
"id": "Observation.language",
"path": "Observation.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1"
}
},
{
"id": "Observation.text",
"path": "Observation.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Observation.contained",
"path": "Observation.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.extension",
"path": "Observation.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.modifierExtension",
"path": "Observation.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.identifier",
"path": "Observation.identifier",
"short": "Business Identifier for observation",
"definition": "A unique identifier assigned to this observation.",
"requirements": "Allows observations to be distinguished and referenced.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "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."
},
{
"identity": "rim",
"map": "id"
}
]
},
{
"id": "Observation.basedOn",
"path": "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. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.",
"requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
"alias": [
"Fulfills"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation.basedOn",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/CarePlan|4.0.1",
"http://hl7.org/fhir/StructureDefinition/DeviceRequest|4.0.1",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation|4.0.1",
"http://hl7.org/fhir/StructureDefinition/MedicationRequest|4.0.1",
"http://hl7.org/fhir/StructureDefinition/NutritionOrder|4.0.1",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.basedOn"
},
{
"identity": "v2",
"map": "ORC"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"
}
]
},
{
"id": "Observation.partOf",
"path": "Observation.partOf",
"short": "Part of referenced event",
"definition": "A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.",
"comment": "To link an Observation to an Encounter use `encounter`. See the [Notes](http://hl7.org/fhir/observation.html#obsgrouping) below for guidance on referencing another Observation.",
"alias": [
"Container"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation.partOf",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationAdministration|4.0.1",
"http://hl7.org/fhir/StructureDefinition/MedicationDispense|4.0.1",
"http://hl7.org/fhir/StructureDefinition/MedicationStatement|4.0.1",
"http://hl7.org/fhir/StructureDefinition/Procedure|4.0.1",
"http://hl7.org/fhir/StructureDefinition/Immunization|4.0.1",
"http://hl7.org/fhir/StructureDefinition/ImagingStudy|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.partOf"
},
{
"identity": "v2",
"map": "Varies by domain"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=FLFS].target"
}
]
},
{
"id": "Observation.status",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
"valueString": "default: final"
},
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.status",
"short": "registered | preliminary | final | amended +",
"definition": "The status of the result value.",
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Status"
}
],
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-status|4.0.1"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "sct-concept",
"map": "< 445584004 |Report by finality status|"
},
{
"identity": "v2",
"map": "OBX-11"
},
{
"identity": "rim",
"map": "status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of \"revise\""
}
]
},
{
"id": "Observation.category",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "coding.code"
},
{
"type": "value",
"path": "coding.system"
}
],
"ordered": false,
"rules": "open"
},
"short": "Classification of type of observation",
"definition": "A code that classifies the general type of observation being made.",
"comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.",
"requirements": "Used for filtering what observations are retrieved and displayed.",
"min": 1,
"max": "*",
"base": {
"path": "Observation.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationCategory"
}
],
"strength": "preferred",
"description": "Codes for high level observation categories.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-category|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
}
]
},
{
"id": "Observation.category:VSCat",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category",
"sliceName": "VSCat",
"short": "Classification of type of observation",
"definition": "A code that classifies the general type of observation being made.",
"comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.",
"requirements": "Used for filtering what observations are retrieved and displayed.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationCategory"
}
],
"strength": "preferred",
"description": "Codes for high level observation categories.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-category|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
}
]
},
{
"id": "Observation.category:VSCat.id",
"path": "Observation.category.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.category:VSCat.extension",
"path": "Observation.category.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.category:VSCat.coding",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category.coding",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.category:VSCat.coding.id",
"path": "Observation.category.coding.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.category:VSCat.coding.extension",
"path": "Observation.category.coding.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.category:VSCat.coding.system",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://terminology.hl7.org/CodeSystem/observation-category",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "Observation.category:VSCat.coding.version",
"path": "Observation.category.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "Observation.category:VSCat.coding.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category.coding.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).",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "vital-signs",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "Observation.category:VSCat.coding.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Observation.category.coding.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.",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "Observation.category:VSCat.coding.userSelected",
"path": "Observation.category.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "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 ]"
}
]
},
{
"id": "Observation.category:VSCat.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "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.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "Observation.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.code",
"short": "Blood Pressure",
"definition": "Blood Pressure.",
"comment": "additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.",
"requirements": "5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).",
"alias": [
"Name",
"Test"
],
"min": 1,
"max": "1",
"base": {
"path": "Observation.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSigns"
}
],
"strength": "extensible",
"description": "This identifies the vital sign result type.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1"
},
"mapping": [
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "sct-concept",
"map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
},
{
"identity": "v2",
"map": "OBX-3"
},
{
"identity": "rim",
"map": "code"
},
{
"identity": "sct-attr",
"map": "116680003 |Is a|"
}
]
},
{
"id": "Observation.code.id",
"path": "Observation.code.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.code.extension",
"path": "Observation.code.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.code.coding",
"path": "Observation.code.coding",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "code"
},
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
},
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.code.coding:BPCode",
"path": "Observation.code.coding",
"sliceName": "BPCode",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "1",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.code.coding:BPCode.id",
"path": "Observation.code.coding.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.code.coding:BPCode.extension",
"path": "Observation.code.coding.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.code.coding:BPCode.system",
"path": "Observation.code.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://loinc.org",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "Observation.code.coding:BPCode.version",
"path": "Observation.code.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "Observation.code.coding:BPCode.code",
"path": "Observation.code.coding.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).",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "85354-9",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "Observation.code.coding:BPCode.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Observation.code.coding.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.",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "Observation.code.coding:BPCode.userSelected",
"path": "Observation.code.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "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 ]"
}
]
},
{
"id": "Observation.code.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "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.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "Observation.subject",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.subject",
"short": "Who and/or what the observation is about",
"definition": "The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.",
"comment": "One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.",
"requirements": "Observations have no value if you don't know who or what they're about.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.subject",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/patient"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": "participation[typeCode=RTGT]"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "Observation.focus",
"path": "Observation.focus",
"short": "What the observation is about, when it is not about the subject of record",
"definition": "The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.",
"comment": "Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., \"Blood Glucose\") and does not need to be represented separately using this element. Use `specimen` if a reference to a specimen is required. If a code is required instead of a resource use either `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/extension-observation-focuscode.html).",
"min": 0,
"max": "*",
"base": {
"path": "Observation.focus",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "OBX-3"
},
{
"identity": "rim",
"map": "participation[typeCode=SBJ]"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "Observation.encounter",
"path": "Observation.encounter",
"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.",
"comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).",
"requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
"alias": [
"Context"
],
"min": 0,
"max": "1",
"base": {
"path": "Observation.encounter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.context"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "v2",
"map": "PV1"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
}
]
},
{
"id": "Observation.effective[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.effective[x]",
"short": "Often just a dateTime for Vital Signs",
"definition": "Often just a dateTime for Vital Signs.",
"comment": "At least a date should be present unless this observation is a historical report. For recording imprecise or \"fuzzy\" times (For example, a blood glucose measurement taken \"after breakfast\") use the [Timing](http://hl7.org/fhir/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.",
"requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
"alias": [
"Occurrence"
],
"min": 1,
"max": "1",
"base": {
"path": "Observation.effective[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"condition": [
"vs-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "vs-1",
"severity": "error",
"human": "if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day",
"expression": "$this is dateTime implies $this.toString().length() >= 10",
"xpath": "f:effectiveDateTime[matches(@value, '^\\d{4}-\\d{2}-\\d{2}')]",
"source": "http://hl7.org/fhir/StructureDefinition/bp"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "v2",
"map": "OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)"
},
{
"identity": "rim",
"map": "effectiveTime"
}
]
},
{
"id": "Observation.issued",
"path": "Observation.issued",
"short": "Date/Time this version was made available",
"definition": "The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.",
"comment": "For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/resource-definitions.html#Meta.lastUpdated) time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.issued",
"min": 0,
"max": "1"
},
"type": [
{
"code": "instant"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.recorded"
},
{
"identity": "v2",
"map": "OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)"
},
{
"identity": "rim",
"map": "participation[typeCode=AUT].time"
}
]
},
{
"id": "Observation.performer",
"path": "Observation.performer",
"short": "Who is responsible for the observation",
"definition": "Who was responsible for asserting the observed value as \"true\".",
"requirements": "May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.performer",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1",
"http://hl7.org/fhir/StructureDefinition/Organization|4.0.1",
"http://hl7.org/fhir/StructureDefinition/CareTeam|4.0.1",
"http://hl7.org/fhir/StructureDefinition/Patient|4.0.1",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "workflow",
"map": "Event.performer.actor"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "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'"
},
{
"identity": "rim",
"map": "participation[typeCode=PRF]"
}
]
},
{
"id": "Observation.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.value[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "closed"
},
"short": "Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.",
"definition": "Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.",
"comment": "An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
}
],
"condition": [
"obs-7",
"vs-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "sct-concept",
"map": "< 441742003 |Evaluation finding|"
},
{
"identity": "v2",
"map": "OBX.2, OBX.5, OBX.6"
},
{
"identity": "rim",
"map": "value"
},
{
"identity": "sct-attr",
"map": "363714003 |Interprets|"
}
]
},
{
"id": "Observation.value[x]:valueQuantity",
"path": "Observation.value[x]",
"sliceName": "valueQuantity",
"short": "Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.",
"definition": "Vital Signs value are recorded using the Quantity data type. For supporting observations such as Cuff size could use other datatypes such as CodeableConcept.",
"comment": "An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "0",
"base": {
"path": "Observation.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
}
],
"condition": [
"obs-7",
"vs-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "sct-concept",
"map": "< 441742003 |Evaluation finding|"
},
{
"identity": "v2",
"map": "OBX.2, OBX.5, OBX.6"
},
{
"identity": "rim",
"map": "value"
},
{
"identity": "sct-attr",
"map": "363714003 |Interprets|"
}
]
},
{
"id": "Observation.dataAbsentReason",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.dataAbsentReason",
"short": "Why the result is missing",
"definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
"comment": "Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be \"detected\", \"not detected\", \"inconclusive\", or \"specimen unsatisfactory\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
"requirements": "For many results it is necessary to handle exceptional values in measurements.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.dataAbsentReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"obs-6",
"vs-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationValueAbsentReason"
}
],
"strength": "extensible",
"description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
"valueSet": "http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "value.nullFlavor"
}
]
},
{
"id": "Observation.interpretation",
"path": "Observation.interpretation",
"short": "High, low, normal, etc.",
"definition": "A categorical assessment of an observation value. For example, high, low, normal.",
"comment": "Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.",
"requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
"alias": [
"Abnormal Flag"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation.interpretation",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationInterpretation"
}
],
"strength": "extensible",
"description": "Codes identifying interpretations of observations.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 260245000 |Findings values|"
},
{
"identity": "v2",
"map": "OBX-8"
},
{
"identity": "rim",
"map": "interpretationCode"
},
{
"identity": "sct-attr",
"map": "363713009 |Has interpretation|"
}
]
},
{
"id": "Observation.note",
"path": "Observation.note",
"short": "Comments about the observation",
"definition": "Comments about the observation or the results.",
"comment": "May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.",
"requirements": "Need to be able to provide free text additional information.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.note",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Annotation"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
},
{
"identity": "rim",
"map": "subjectOf.observationEvent[code=\"annotation\"].value"
}
]
},
{
"id": "Observation.bodySite",
"path": "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).",
"comment": "Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. \n\nIf the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/extension-bodysite.html).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.bodySite",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
}
],
"strength": "example",
"description": "Codes describing anatomical locations. May include laterality.",
"valueSet": "http://hl7.org/fhir/ValueSet/body-site|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 123037004 |Body structure|"
},
{
"identity": "v2",
"map": "OBX-20"
},
{
"identity": "rim",
"map": "targetSiteCode"
},
{
"identity": "sct-attr",
"map": "718497002 |Inherent location|"
}
]
},
{
"id": "Observation.method",
"path": "Observation.method",
"short": "How it was done",
"definition": "Indicates the mechanism used to perform the observation.",
"comment": "Only used if not implicit in code for Observation.code.",
"requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.method",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationMethod"
}
],
"strength": "example",
"description": "Methods for simple observations.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-methods|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "OBX-17"
},
{
"identity": "rim",
"map": "methodCode"
}
]
},
{
"id": "Observation.specimen",
"path": "Observation.specimen",
"short": "Specimen used for this observation",
"definition": "The specimen that was used when this observation was made.",
"comment": "Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.specimen",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Specimen|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "sct-concept",
"map": "< 123038009 |Specimen|"
},
{
"identity": "v2",
"map": "SPM segment"
},
{
"identity": "rim",
"map": "participation[typeCode=SPC].specimen"
},
{
"identity": "sct-attr",
"map": "704319004 |Inherent in|"
}
]
},
{
"id": "Observation.device",
"path": "Observation.device",
"short": "(Measurement) Device",
"definition": "The device used to generate the observation data.",
"comment": "Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.device",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Device|4.0.1",
"http://hl7.org/fhir/StructureDefinition/DeviceMetric|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "sct-concept",
"map": "< 49062001 |Device|"
},
{
"identity": "v2",
"map": "OBX-17 / PRT -10"
},
{
"identity": "rim",
"map": "participation[typeCode=DEV]"
},
{
"identity": "sct-attr",
"map": "424226004 |Using device|"
}
]
},
{
"id": "Observation.referenceRange",
"path": "Observation.referenceRange",
"short": "Provides guide for interpretation",
"definition": "Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an \"OR\". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.",
"comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.referenceRange",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "obs-3",
"severity": "error",
"human": "Must have at least a low or a high or text",
"expression": "low.exists() or high.exists() or text.exists()",
"xpath": "(exists(f:low) or exists(f:high)or exists(f:text))",
"source": "http://hl7.org/fhir/StructureDefinition/bp"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX.7"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "Observation.referenceRange.id",
"path": "Observation.referenceRange.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.referenceRange.extension",
"path": "Observation.referenceRange.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.referenceRange.modifierExtension",
"path": "Observation.referenceRange.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.referenceRange.low",
"path": "Observation.referenceRange.low",
"short": "Low Range, if relevant",
"definition": "The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.referenceRange.low",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"
],
"_profile": [
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/type-profile-constraints",
"valueCode": "full"
}
]
}
]
}
],
"condition": [
"obs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX-7"
},
{
"identity": "rim",
"map": "value:IVL_PQ.low"
}
]
},
{
"id": "Observation.referenceRange.high",
"path": "Observation.referenceRange.high",
"short": "High Range, if relevant",
"definition": "The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.referenceRange.high",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"
],
"_profile": [
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/type-profile-constraints",
"valueCode": "full"
}
]
}
]
}
],
"condition": [
"obs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX-7"
},
{
"identity": "rim",
"map": "value:IVL_PQ.high"
}
]
},
{
"id": "Observation.referenceRange.type",
"path": "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.",
"comment": "This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.",
"requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.referenceRange.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationRangeMeaning"
}
],
"strength": "preferred",
"description": "Code for the meaning of a reference range.",
"valueSet": "http://hl7.org/fhir/ValueSet/referencerange-meaning|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 260245000 |Findings values| OR \n< 365860008 |General clinical state finding| \nOR \n< 250171008 |Clinical history or observation findings| OR \n< 415229000 |Racial group| OR \n< 365400002 |Finding of puberty stage| OR\n< 443938003 |Procedure carried out on subject|"
},
{
"identity": "v2",
"map": "OBX-10"
},
{
"identity": "rim",
"map": "interpretationCode"
}
]
},
{
"id": "Observation.referenceRange.appliesTo",
"path": "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. Multiple `appliesTo` are interpreted as an \"AND\" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.",
"comment": "This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.",
"requirements": "Need to be able to identify the target population for proper interpretation.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.referenceRange.appliesTo",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationRangeType"
}
],
"strength": "example",
"description": "Codes identifying the population the reference range applies to.",
"valueSet": "http://hl7.org/fhir/ValueSet/referencerange-appliesto|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 260245000 |Findings values| OR \n< 365860008 |General clinical state finding| \nOR \n< 250171008 |Clinical history or observation findings| OR \n< 415229000 |Racial group| OR \n< 365400002 |Finding of puberty stage| OR\n< 443938003 |Procedure carried out on subject|"
},
{
"identity": "v2",
"map": "OBX-10"
},
{
"identity": "rim",
"map": "interpretationCode"
}
]
},
{
"id": "Observation.referenceRange.age",
"path": "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.",
"requirements": "Some analytes vary greatly over age.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.referenceRange.age",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Range"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=\"age\"].value"
}
]
},
{
"id": "Observation.referenceRange.text",
"path": "Observation.referenceRange.text",
"short": "Text based reference range in an observation",
"definition": "Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of \"Negative\" or a list or table of \"normals\".",
"min": 0,
"max": "1",
"base": {
"path": "Observation.referenceRange.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX-7"
},
{
"identity": "rim",
"map": "value:ST"
}
]
},
{
"id": "Observation.hasMember",
"path": "Observation.hasMember",
"short": "Used when reporting vital signs panel components",
"definition": "Used when reporting vital signs panel components.",
"comment": "When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/questionnaireresponse.html) into a final score and represent the score as an Observation.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.hasMember",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|4.0.1",
"http://hl7.org/fhir/StructureDefinition/MolecularSequence|4.0.1",
"http://hl7.org/fhir/StructureDefinition/vitalsigns|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "Relationships established by OBX-4 usage"
},
{
"identity": "rim",
"map": "outBoundRelationship"
}
]
},
{
"id": "Observation.derivedFrom",
"path": "Observation.derivedFrom",
"short": "Related measurements the observation is made from",
"definition": "The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.",
"comment": "All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/observation.html#obsgrouping) below.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.derivedFrom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/DocumentReference|4.0.1",
"http://hl7.org/fhir/StructureDefinition/ImagingStudy|4.0.1",
"http://hl7.org/fhir/StructureDefinition/Media|4.0.1",
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|4.0.1",
"http://hl7.org/fhir/StructureDefinition/MolecularSequence|4.0.1",
"http://hl7.org/fhir/StructureDefinition/vitalsigns|4.0.1"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "Relationships established by OBX-4 usage"
},
{
"identity": "rim",
"map": ".targetObservation"
}
]
},
{
"id": "Observation.component",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "code.coding.code"
},
{
"type": "value",
"path": "code.coding.system"
}
],
"ordered": false,
"rules": "open"
},
"short": "Used when reporting systolic and diastolic blood pressure.",
"definition": "Used when reporting systolic and diastolic blood pressure.",
"comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
"min": 2,
"max": "*",
"base": {
"path": "Observation.component",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "vs-3",
"severity": "error",
"human": "If there is no a value a data absent reason must be present",
"expression": "value.exists() or dataAbsentReason.exists()",
"xpath": "f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason",
"source": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "containment by OBX-4?"
},
{
"identity": "rim",
"map": "outBoundRelationship[typeCode=COMP]"
}
]
},
{
"id": "Observation.component.id",
"path": "Observation.component.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component.extension",
"path": "Observation.component.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component.modifierExtension",
"path": "Observation.component.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.component.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.code",
"short": "Type of component observation (code / type)",
"definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
"comment": "*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
"requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.component.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSigns"
}
],
"strength": "extensible",
"description": "This identifies the vital sign result type.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "sct-concept",
"map": "< 363787002 |Observable entity| OR \n< 386053000 |Evaluation procedure|"
},
{
"identity": "v2",
"map": "OBX-3"
},
{
"identity": "rim",
"map": "code"
}
]
},
{
"id": "Observation.component.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x]",
"short": "Vital Sign Value recorded with UCUM",
"definition": "Vital Sign Value recorded with UCUM.",
"comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.component.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
},
{
"code": "CodeableConcept"
},
{
"code": "string"
},
{
"code": "boolean"
},
{
"code": "integer"
},
{
"code": "Range"
},
{
"code": "Ratio"
},
{
"code": "SampledData"
},
{
"code": "time"
},
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"condition": [
"vs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSignsUnits"
}
],
"strength": "extensible",
"description": "Common UCUM units for recording Vital Signs.",
"valueSet": "http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
},
{
"identity": "v2",
"map": "OBX.2, OBX.5, OBX.6"
},
{
"identity": "rim",
"map": "value"
},
{
"identity": "sct-attr",
"map": "363714003 |Interprets|"
}
]
},
{
"id": "Observation.component.dataAbsentReason",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.dataAbsentReason",
"short": "Why the component result is missing",
"definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
"comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be \"detected\", \"not detected\", \"inconclusive\", or \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
"requirements": "For many results it is necessary to handle exceptional values in measurements.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.component.dataAbsentReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"obs-6",
"vs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationValueAbsentReason"
}
],
"strength": "extensible",
"description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
"valueSet": "http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "value.nullFlavor"
}
]
},
{
"id": "Observation.component.interpretation",
"path": "Observation.component.interpretation",
"short": "High, low, normal, etc.",
"definition": "A categorical assessment of an observation value. For example, high, low, normal.",
"comment": "Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.",
"requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
"alias": [
"Abnormal Flag"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation.component.interpretation",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationInterpretation"
}
],
"strength": "extensible",
"description": "Codes identifying interpretations of observations.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 260245000 |Findings values|"
},
{
"identity": "v2",
"map": "OBX-8"
},
{
"identity": "rim",
"map": "interpretationCode"
},
{
"identity": "sct-attr",
"map": "363713009 |Has interpretation|"
}
]
},
{
"id": "Observation.component.referenceRange",
"path": "Observation.component.referenceRange",
"short": "Provides guide for interpretation of component result",
"definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
"comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.component.referenceRange",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX.7"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "Observation.component:SystolicBP",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component",
"sliceName": "SystolicBP",
"short": "Used when reporting systolic and diastolic blood pressure.",
"definition": "Used when reporting systolic and diastolic blood pressure.",
"comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.component",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "vs-3",
"severity": "error",
"human": "If there is no a value a data absent reason must be present",
"expression": "value.exists() or dataAbsentReason.exists()",
"xpath": "f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason",
"source": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "containment by OBX-4?"
},
{
"identity": "rim",
"map": "outBoundRelationship[typeCode=COMP]"
}
]
},
{
"id": "Observation.component:SystolicBP.id",
"path": "Observation.component.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.extension",
"path": "Observation.component.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.modifierExtension",
"path": "Observation.component.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.component:SystolicBP.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.code",
"short": "Type of component observation (code / type)",
"definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
"comment": "additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.",
"requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
"alias": [
"Component Test",
"Component Name"
],
"min": 1,
"max": "1",
"base": {
"path": "Observation.component.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSigns"
}
],
"strength": "extensible",
"description": "This identifies the vital sign result type.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "sct-concept",
"map": "< 363787002 |Observable entity| OR \n< 386053000 |Evaluation procedure|"
},
{
"identity": "v2",
"map": "OBX-3"
},
{
"identity": "rim",
"map": "code"
}
]
},
{
"id": "Observation.component:SystolicBP.code.id",
"path": "Observation.component.code.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.code.extension",
"path": "Observation.component.code.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding",
"path": "Observation.component.code.coding",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "code"
},
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
},
"short": "Systolic Blood Pressure",
"definition": "Systolic Blood Pressure.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode",
"path": "Observation.component.code.coding",
"sliceName": "SBPCode",
"short": "Systolic Blood Pressure",
"definition": "Systolic Blood Pressure.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "1",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.id",
"path": "Observation.component.code.coding.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.extension",
"path": "Observation.component.code.coding.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.system",
"path": "Observation.component.code.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://loinc.org",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.version",
"path": "Observation.component.code.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.code",
"path": "Observation.component.code.coding.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).",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "8480-6",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Observation.component.code.coding.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.",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "Observation.component:SystolicBP.code.coding:SBPCode.userSelected",
"path": "Observation.component.code.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "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 ]"
}
]
},
{
"id": "Observation.component:SystolicBP.code.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "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.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x]",
"short": "Vital Sign Value recorded with UCUM",
"definition": "Vital Sign Value recorded with UCUM.",
"comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.component.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
}
],
"condition": [
"vs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSignsUnits"
}
],
"strength": "extensible",
"description": "Common UCUM units for recording Vital Signs.",
"valueSet": "http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
},
{
"identity": "v2",
"map": "OBX.2, OBX.5, OBX.6"
},
{
"identity": "rim",
"map": "value"
},
{
"identity": "sct-attr",
"map": "363714003 |Interprets|"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].id",
"path": "Observation.component.value[x].id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].extension",
"path": "Observation.component.value[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].value",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].value",
"short": "Numerical value (with implicit precision)",
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "decimal"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "SN.2 / CQ - N/A"
},
{
"identity": "rim",
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].comparator",
"path": "Observation.component.value[x].comparator",
"short": "< | <= | >= | > - how to understand the value",
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"max": "1",
"base": {
"path": "Quantity.comparator",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
}
],
"strength": "required",
"description": "How the Quantity should be understood and represented.",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "SN.1 / CQ.1"
},
{
"identity": "rim",
"map": "IVL properties"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].unit",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
},
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].unit",
"short": "Unit representation",
"definition": "A human-readable form of the unit.",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.unit",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "PQ.unit"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].system",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].system",
"short": "System that defines coded unit form",
"definition": "The identification of the system that provides the coded form of the unit.",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://unitsofmeasure.org",
"condition": [
"qty-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "CO.codeSystem, PQ.translation.codeSystem"
}
]
},
{
"id": "Observation.component:SystolicBP.value[x].code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].code",
"short": "Coded responses from the common UCUM units for vital signs value set.",
"definition": "Coded responses from the common UCUM units for vital signs value set.",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "mm[Hg]",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "PQ.code, MO.currency, PQ.translation.code"
}
]
},
{
"id": "Observation.component:SystolicBP.dataAbsentReason",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.dataAbsentReason",
"short": "Why the component result is missing",
"definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
"comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be \"detected\", \"not detected\", \"inconclusive\", or \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
"requirements": "For many results it is necessary to handle exceptional values in measurements.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.component.dataAbsentReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"obs-6",
"vs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationValueAbsentReason"
}
],
"strength": "extensible",
"description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
"valueSet": "http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "value.nullFlavor"
}
]
},
{
"id": "Observation.component:SystolicBP.interpretation",
"path": "Observation.component.interpretation",
"short": "High, low, normal, etc.",
"definition": "A categorical assessment of an observation value. For example, high, low, normal.",
"comment": "Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.",
"requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
"alias": [
"Abnormal Flag"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation.component.interpretation",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationInterpretation"
}
],
"strength": "extensible",
"description": "Codes identifying interpretations of observations.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 260245000 |Findings values|"
},
{
"identity": "v2",
"map": "OBX-8"
},
{
"identity": "rim",
"map": "interpretationCode"
},
{
"identity": "sct-attr",
"map": "363713009 |Has interpretation|"
}
]
},
{
"id": "Observation.component:SystolicBP.referenceRange",
"path": "Observation.component.referenceRange",
"short": "Provides guide for interpretation of component result",
"definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
"comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.component.referenceRange",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX.7"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "Observation.component:DiastolicBP",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component",
"sliceName": "DiastolicBP",
"short": "Used when reporting systolic and diastolic blood pressure.",
"definition": "Used when reporting systolic and diastolic blood pressure.",
"comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.component",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "vs-3",
"severity": "error",
"human": "If there is no a value a data absent reason must be present",
"expression": "value.exists() or dataAbsentReason.exists()",
"xpath": "f:*[starts-with(local-name(.), 'value')] or f:dataAbsentReason",
"source": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "containment by OBX-4?"
},
{
"identity": "rim",
"map": "outBoundRelationship[typeCode=COMP]"
}
]
},
{
"id": "Observation.component:DiastolicBP.id",
"path": "Observation.component.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.extension",
"path": "Observation.component.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.modifierExtension",
"path": "Observation.component.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Observation.component:DiastolicBP.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.code",
"short": "Type of component observation (code / type)",
"definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
"comment": "additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system.",
"requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
"min": 1,
"max": "1",
"base": {
"path": "Observation.component.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSigns"
}
],
"strength": "extensible",
"description": "This identifies the vital sign result type.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "sct-concept",
"map": "< 363787002 |Observable entity| OR \n< 386053000 |Evaluation procedure|"
},
{
"identity": "v2",
"map": "OBX-3"
},
{
"identity": "rim",
"map": "code"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.id",
"path": "Observation.component.code.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.extension",
"path": "Observation.component.code.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding",
"path": "Observation.component.code.coding",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "code"
},
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
},
"short": "Diastolic Blood Pressure",
"definition": "Diastolic Blood Pressure.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode",
"path": "Observation.component.code.coding",
"sliceName": "DBPCode",
"short": "Diastolic Blood Pressure",
"definition": "Diastolic Blood Pressure.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "1",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.id",
"path": "Observation.component.code.coding.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.extension",
"path": "Observation.component.code.coding.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.system",
"path": "Observation.component.code.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://loinc.org",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.version",
"path": "Observation.component.code.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.code",
"path": "Observation.component.code.coding.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).",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "8462-4",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Observation.component.code.coding.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.",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.coding:DBPCode.userSelected",
"path": "Observation.component.code.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "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 ]"
}
]
},
{
"id": "Observation.component:DiastolicBP.code.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "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.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x]",
"short": "Vital Sign Value recorded with UCUM",
"definition": "Vital Sign Value recorded with UCUM.",
"comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](http://hl7.org/fhir/observation.html#notes) below.",
"requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
"min": 0,
"max": "1",
"base": {
"path": "Observation.component.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
}
],
"condition": [
"vs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "VitalSignsUnits"
}
],
"strength": "extensible",
"description": "Common UCUM units for recording Vital Signs.",
"valueSet": "http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
},
{
"identity": "v2",
"map": "OBX.2, OBX.5, OBX.6"
},
{
"identity": "rim",
"map": "value"
},
{
"identity": "sct-attr",
"map": "363714003 |Interprets|"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].id",
"path": "Observation.component.value[x].id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].extension",
"path": "Observation.component.value[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].value",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].value",
"short": "Numerical value (with implicit precision)",
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "decimal"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "SN.2 / CQ - N/A"
},
{
"identity": "rim",
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].comparator",
"path": "Observation.component.value[x].comparator",
"short": "< | <= | >= | > - how to understand the value",
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"max": "1",
"base": {
"path": "Quantity.comparator",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
}
],
"strength": "required",
"description": "How the Quantity should be understood and represented.",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "SN.1 / CQ.1"
},
{
"identity": "rim",
"map": "IVL properties"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].unit",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
},
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].unit",
"short": "Unit representation",
"definition": "A human-readable form of the unit.",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.unit",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "PQ.unit"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].system",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].system",
"short": "System that defines coded unit form",
"definition": "The identification of the system that provides the coded form of the unit.",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://unitsofmeasure.org",
"condition": [
"qty-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "CO.codeSystem, PQ.translation.codeSystem"
}
]
},
{
"id": "Observation.component:DiastolicBP.value[x].code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].code",
"short": "Coded responses from the common UCUM units for vital signs value set.",
"definition": "Coded responses from the common UCUM units for vital signs value set.",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 1,
"max": "1",
"base": {
"path": "Quantity.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "mm[Hg]",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "PQ.code, MO.currency, PQ.translation.code"
}
]
},
{
"id": "Observation.component:DiastolicBP.dataAbsentReason",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
},
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-source",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-blood-pressure|0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.dataAbsentReason",
"short": "Why the component result is missing",
"definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
"comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be \"detected\", \"not detected\", \"inconclusive\", or \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
"requirements": "For many results it is necessary to handle exceptional values in measurements.",
"min": 0,
"max": "1",
"base": {
"path": "Observation.component.dataAbsentReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"obs-6",
"vs-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationValueAbsentReason"
}
],
"strength": "extensible",
"description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
"valueSet": "http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "value.nullFlavor"
}
]
},
{
"id": "Observation.component:DiastolicBP.interpretation",
"path": "Observation.component.interpretation",
"short": "High, low, normal, etc.",
"definition": "A categorical assessment of an observation value. For example, high, low, normal.",
"comment": "Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.",
"requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
"alias": [
"Abnormal Flag"
],
"min": 0,
"max": "*",
"base": {
"path": "Observation.component.interpretation",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationInterpretation"
}
],
"strength": "extensible",
"description": "Codes identifying interpretations of observations.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1"
},
"mapping": [
{
"identity": "sct-concept",
"map": "< 260245000 |Findings values|"
},
{
"identity": "v2",
"map": "OBX-8"
},
{
"identity": "rim",
"map": "interpretationCode"
},
{
"identity": "sct-attr",
"map": "363713009 |Has interpretation|"
}
]
},
{
"id": "Observation.component:DiastolicBP.referenceRange",
"path": "Observation.component.referenceRange",
"short": "Provides guide for interpretation of component result",
"definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
"comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Observation.component.referenceRange",
"min": 0,
"max": "*"
},
"contentReference": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX.7"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Observation.status",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
"valueString": "default: final"
},
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.status"
},
{
"id": "Observation.category",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category"
},
{
"id": "Observation.category:VSCat",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category",
"sliceName": "VSCat"
},
{
"id": "Observation.category:VSCat.coding",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category.coding"
},
{
"id": "Observation.category:VSCat.coding.system",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category.coding.system"
},
{
"id": "Observation.category:VSCat.coding.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.category.coding.code"
},
{
"id": "Observation.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.code"
},
{
"id": "Observation.code.coding",
"path": "Observation.code.coding",
"min": 1
},
{
"id": "Observation.subject",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.subject",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/patient"
]
}
]
},
{
"id": "Observation.effective[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.effective[x]"
},
{
"id": "Observation.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
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},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.value[x]"
},
{
"id": "Observation.dataAbsentReason",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
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},
{
"url": "code",
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},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.dataAbsentReason"
},
{
"id": "Observation.component",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component"
},
{
"id": "Observation.component.code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
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},
{
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},
{
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},
{
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},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.code"
},
{
"id": "Observation.component.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
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},
{
"url": "code",
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},
{
"url": "documentation",
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},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x]"
},
{
"id": "Observation.component.dataAbsentReason",
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{
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},
{
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{
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},
{
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},
{
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},
{
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.dataAbsentReason"
},
{
"id": "Observation.component:SystolicBP",
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{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
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{
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{
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{
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},
{
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],
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}
],
"path": "Observation.component",
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},
{
"id": "Observation.component:SystolicBP.code",
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},
{
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.code"
},
{
"id": "Observation.component:SystolicBP.code.coding",
"path": "Observation.component.code.coding",
"min": 1
},
{
"id": "Observation.component:SystolicBP.value[x]",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
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},
{
"url": "code",
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},
{
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},
{
"url": "documentation",
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},
{
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}
],
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}
],
"path": "Observation.component.value[x]"
},
{
"id": "Observation.component:SystolicBP.value[x].value",
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{
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},
{
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},
{
"url": "actor",
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].value"
},
{
"id": "Observation.component:SystolicBP.value[x].unit",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
},
{
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},
{
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{
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{
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},
{
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},
{
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}
],
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}
],
"path": "Observation.component.value[x].unit"
},
{
"id": "Observation.component:SystolicBP.value[x].system",
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{
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{
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{
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].system"
},
{
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{
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{
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],
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],
"path": "Observation.component.value[x].code"
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{
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{
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{
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},
{
"url": "actor",
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.dataAbsentReason"
},
{
"id": "Observation.component:DiastolicBP",
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{
"extension": [
{
"url": "name",
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{
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{
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{
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}
],
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}
],
"path": "Observation.component",
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},
{
"id": "Observation.component:DiastolicBP.code",
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{
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},
{
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.code"
},
{
"id": "Observation.component:DiastolicBP.code.coding",
"path": "Observation.component.code.coding",
"min": 1
},
{
"id": "Observation.component:DiastolicBP.value[x]",
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{
"extension": [
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},
{
"url": "code",
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{
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},
{
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},
{
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},
{
"url": "actor",
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}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x]"
},
{
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{
"extension": [
{
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{
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},
{
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},
{
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},
{
"url": "documentation",
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},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].value"
},
{
"id": "Observation.component:DiastolicBP.value[x].unit",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
},
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].unit"
},
{
"id": "Observation.component:DiastolicBP.value[x].system",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].system"
},
{
"id": "Observation.component:DiastolicBP.value[x].code",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.value[x].code"
},
{
"id": "Observation.component:DiastolicBP.dataAbsentReason",
"extension": [
{
"extension": [
{
"url": "name",
"valueString": "pcare"
},
{
"url": "code",
"valueCode": "SHALL:populate"
},
{
"url": "code",
"valueCode": "SHOULD:persist"
},
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "documentation",
"valueMarkdown": "P-Care server population, persistence, and acceptance requirements for this element."
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-server"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Observation.component.dataAbsentReason"
}
]
}
}

Constraints

Obligations

ElementActorCode
categoryhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
category:VSCathttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
category:VSCat.codinghttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
category:VSCat.coding.codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
category:VSCat.coding.systemhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
componenthttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBPhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.dataAbsentReasonhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.value[x]http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.value[x].codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.value[x].systemhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.value[x].unithttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:DiastolicBP.value[x].valuehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBPhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.dataAbsentReasonhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.value[x]http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.value[x].codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.value[x].systemhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.value[x].unithttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component:SystolicBP.value[x].valuehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component.codehttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component.dataAbsentReasonhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
component.value[x]http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
dataAbsentReasonhttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
effective[x]http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
statushttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
subjecthttp://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error
value[x]http://fhir.infoway-inforoute.ca/p-care/ActorDefinition/pcare-serverSHALL:populate, SHOULD:persist, SHALL:no-error

Terminology bindings (Differential)

Terminology bindings (Snapshot)

PathConformanceValueSet
Observation.languagepreferredhttp://hl7.org/fhir/ValueSet/languages|4.0.1
Observation.statusrequiredhttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
Observation.categorypreferredhttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
Observation.category:VSCatpreferredhttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
Observation.codeextensiblehttp://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1
Observation.dataAbsentReasonextensiblehttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
Observation.interpretationextensiblehttp://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1
Observation.bodySiteexamplehttp://hl7.org/fhir/ValueSet/body-site|4.0.1
Observation.methodexamplehttp://hl7.org/fhir/ValueSet/observation-methods|4.0.1
Observation.referenceRange.typepreferredhttp://hl7.org/fhir/ValueSet/referencerange-meaning|4.0.1
Observation.referenceRange.appliesToexamplehttp://hl7.org/fhir/ValueSet/referencerange-appliesto|4.0.1
Observation.component.codeextensiblehttp://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1
Observation.component.value[x]extensiblehttp://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
Observation.component.dataAbsentReasonextensiblehttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
Observation.component.interpretationextensiblehttp://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1
Observation.component:SystolicBP.codeextensiblehttp://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1
Observation.component:SystolicBP.value[x]extensiblehttp://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
Observation.component:SystolicBP.value[x].comparatorrequiredhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
Observation.component:SystolicBP.dataAbsentReasonextensiblehttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
Observation.component:SystolicBP.interpretationextensiblehttp://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1
Observation.component:DiastolicBP.codeextensiblehttp://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1
Observation.component:DiastolicBP.value[x]extensiblehttp://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1
Observation.component:DiastolicBP.value[x].comparatorrequiredhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
Observation.component:DiastolicBP.dataAbsentReasonextensiblehttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
Observation.component:DiastolicBP.interpretationextensiblehttp://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1

Additional Terminology Bindings Only

IG © based on FHIR R4 | template version 2.5.1 | Package package:ca.infoway.io.pcare@0.1.0-dft-preballot
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