{
  "resourceType": "StructureDefinition",
  "meta": {
    "lastUpdated": "2023-08-04T11:36:16.5160024+00:00"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "oo"
    }
  ],
  "url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ACVPU-Observation-1",
  "version": "1.1.0",
  "name": "CareConnect-ACVPU-Observation-1",
  "status": "draft",
  "date": "2019-06-17",
  "publisher": "HL7 UK",
  "contact": [
    {
      "name": "INTEROPen",
      "telecom": [
        {
          "system": "email",
          "value": "admin@interopen.org",
          "use": "work"
        }
      ]
    }
  ],
  "description": "This profile is used to carry alert, new-onset or worsening confusion, voice, pain, and unresponsiveness observations for a patient.",
  "copyright": "Copyright © 2018 HL7 UK\r\nLicensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\r\n\r\nhttp://www.apache.org/licenses/LICENSE-2.0\r\n\r\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\r\n\r\nHL7® FHIR® standard Copyright © 2011+ HL7\r\n\r\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\r\n\r\nhttps://www.hl7.org/fhir/license.html",
  "fhirVersion": "3.0.2",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation.identifier.system",
        "path": "Observation.identifier.system",
        "min": 1
      },
      {
        "id": "Observation.identifier.value",
        "path": "Observation.identifier.value",
        "min": 1
      },
      {
        "id": "Observation.identifier.assigner",
        "path": "Observation.identifier.assigner",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
          }
        ]
      },
      {
        "id": "Observation.basedOn",
        "path": "Observation.basedOn",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-CarePlan-1"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ReferralRequest-1"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-MedicationRequest-1"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ProcedureRequest-1"
          }
        ]
      },
      {
        "id": "Observation.status",
        "path": "Observation.status",
        "fixedCode": "final"
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "short": "Classification of  type of observation."
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "binding": {
          "strength": "required",
          "description": "A code from SNOMED Clinical Terminology UK",
          "valueSetUri": "http://snomed.info/sct"
        }
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding.version",
        "path": "Observation.code.coding.version",
        "max": "0"
      },
      {
        "id": "Observation.code.coding.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "1104441000000107"
      },
      {
        "id": "Observation.code.coding.display",
        "path": "Observation.code.coding.display",
        "min": 1,
        "fixedString": "ACVPU (Alert Confusion Voice Pain Unresponsive) scale score"
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
          }
        ]
      },
      {
        "id": "Observation.context",
        "path": "Observation.context",
        "short": "Healthcare event during which this observation is made.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-EpisodeOfCare-1"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1"
          }
        ]
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-RelatedPerson-1"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept",
        "path": "Observation.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.",
          "valueSetReference": {
            "reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-ACVPU-1"
          }
        }
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding",
        "path": "Observation.valueCodeableConcept.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding.system",
        "path": "Observation.valueCodeableConcept.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding.version",
        "path": "Observation.valueCodeableConcept.coding.version",
        "max": "0"
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding.code",
        "path": "Observation.valueCodeableConcept.coding.code",
        "min": 1
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding.display",
        "path": "Observation.valueCodeableConcept.coding.display",
        "min": 1
      },
      {
        "id": "Observation.bodySite.coding",
        "path": "Observation.bodySite.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "system"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.bodySite.coding:snomedCT",
        "path": "Observation.bodySite.coding",
        "sliceName": "snomedCT",
        "max": "1",
        "binding": {
          "strength": "preferred",
          "description": "A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|).",
          "valueSetReference": {
            "reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-BodySite-1"
          }
        }
      },
      {
        "id": "Observation.bodySite.coding:snomedCT.extension",
        "path": "Observation.bodySite.coding.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Observation.bodySite.coding:snomedCT.extension:snomedCTDescriptionID",
        "path": "Observation.bodySite.coding.extension",
        "sliceName": "snomedCTDescriptionID",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
          }
        ]
      },
      {
        "id": "Observation.bodySite.coding:snomedCT.system",
        "path": "Observation.bodySite.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.bodySite.coding:snomedCT.version",
        "path": "Observation.bodySite.coding.version",
        "max": "0"
      },
      {
        "id": "Observation.bodySite.coding:snomedCT.code",
        "path": "Observation.bodySite.coding.code",
        "min": 1
      },
      {
        "id": "Observation.bodySite.coding:snomedCT.display",
        "path": "Observation.bodySite.coding.display",
        "min": 1
      },
      {
        "id": "Observation.method.coding",
        "path": "Observation.method.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "system"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.method.coding:snomedCT",
        "path": "Observation.method.coding",
        "sliceName": "snomedCT",
        "max": "1",
        "binding": {
          "strength": "preferred",
          "description": "A code from SNOMED Clinical Terminology UK",
          "valueSetReference": {
            "reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-ObservationMethod-1"
          }
        }
      },
      {
        "id": "Observation.method.coding:snomedCT.extension",
        "path": "Observation.method.coding.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Observation.method.coding:snomedCT.extension:snomedCTDescriptionID",
        "path": "Observation.method.coding.extension",
        "sliceName": "snomedCTDescriptionID",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
          }
        ]
      },
      {
        "id": "Observation.method.coding:snomedCT.system",
        "path": "Observation.method.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.method.coding:snomedCT.version",
        "path": "Observation.method.coding.version",
        "max": "0"
      },
      {
        "id": "Observation.method.coding:snomedCT.code",
        "path": "Observation.method.coding.code",
        "min": 1
      },
      {
        "id": "Observation.method.coding:snomedCT.display",
        "path": "Observation.method.coding.display",
        "min": 1
      },
      {
        "id": "Observation.specimen",
        "path": "Observation.specimen",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Specimen-1"
          }
        ]
      },
      {
        "id": "Observation.related.target",
        "path": "Observation.related.target",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Sequence"
          },
          {
            "code": "Reference",
            "targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1"
          }
        ]
      },
      {
        "id": "Observation.component.code.coding",
        "path": "Observation.component.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.component.code.coding:snomedCT",
        "path": "Observation.component.code.coding",
        "sliceName": "snomedCT",
        "max": "1",
        "binding": {
          "strength": "extensible",
          "description": "A code from the SNOMED Clinical Terminology UK coding system describing a type of observation",
          "valueSetReference": {
            "reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-ObservationType-1"
          }
        }
      },
      {
        "id": "Observation.component.code.coding:snomedCT.extension",
        "path": "Observation.component.code.coding.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Observation.component.code.coding:snomedCT.extension:snomedCTDescriptionID",
        "path": "Observation.component.code.coding.extension",
        "sliceName": "snomedCTDescriptionID",
        "min": 0,
        "type": [
          {
            "code": "Extension",
            "profile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
          }
        ]
      },
      {
        "id": "Observation.component.code.coding:snomedCT.system",
        "path": "Observation.component.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.component.code.coding:snomedCT.version",
        "path": "Observation.component.code.coding.version",
        "max": "0"
      },
      {
        "id": "Observation.component.code.coding:snomedCT.code",
        "path": "Observation.component.code.coding.code",
        "min": 1
      },
      {
        "id": "Observation.component.code.coding:snomedCT.display",
        "path": "Observation.component.code.coding.display",
        "min": 1
      }
    ]
  }
}