{
  "resourceType": "StructureDefinition",
  "id": "sd-mii-icu-monitoring-und-vitaldaten",
  "url": "https://gematik.de/fhir/isik/StructureDefinition/sd-mii-icu-monitoring-und-vitaldaten",
  "version": "5.1.3",
  "name": "SD_MII_ICU_Monitoring_Und_Vitaldaten",
  "title": "SD MII ICU Monitoring und Vitaldaten",
  "status": "active",
  "experimental": false,
  "date": "2026-07-17",
  "publisher": "gematik GmbH",
  "description": "Dieses Profil dient als Abstraktionsprofil für verschiedene spezialisierte Beobachtungen in der Akutmedizin zur Abbildung von Monitoring- und Vitaldaten.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "constraint": [
          {
            "key": "vs-de-2",
            "human": "If there is no component or hasMember element then either a value[x] or a data absent reason must be present",
            "source": "https://gematik.de/fhir/isik/StructureDefinition/sd-mii-icu-monitoring-und-vitaldaten",
            "severity": "error",
            "expression": "(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())"
          }
        ]
      },
      {
        "id": "Observation.id",
        "path": "Observation.id",
        "short": "serverseitige, interne ID des Datensatzes",
        "comment": "**bedingtes Pflichtfeld/bedingtes MS:** Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine `id` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `id`verfügen. ",
        "mustSupport": true
      },
      {
        "id": "Observation.meta.versionId",
        "path": "Observation.meta.versionId",
        "short": "Eindeutiger Name der serverseitigen Version des Datensatzes",
        "comment": "Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine `versionID` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `versionID`verfügen. "
      },
      {
        "id": "Observation.meta.lastUpdated",
        "path": "Observation.meta.lastUpdated",
        "short": "Zeitpunkt der letzten Änderung",
        "comment": "Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein `lastUpdate` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein `lastUpdate`verfügen. "
      },
      {
        "id": "Observation.identifier",
        "path": "Observation.identifier",
        "mustSupport": true
      },
      {
        "id": "Observation.basedOn",
        "path": "Observation.basedOn",
        "short": "maximal Kardinalität bei Übernahme aus MII-Kerndatensatz-ICU entfernt",
        "mustSupport": true
      },
      {
        "id": "Observation.partOf",
        "path": "Observation.partOf",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Procedure"
            ]
          }
        ]
      },
      {
        "id": "Observation.status",
        "path": "Observation.status",
        "comment": "Motivation MS: Observation.status ist bereits durch die Kardinalität der Basisklasse Observation erzwungen. Dieses Feld dient der Präzisierung des Status der Untersuchung",
        "mustSupport": true
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.category:vs-cat",
        "path": "Observation.category",
        "sliceName": "vs-cat",
        "min": 1,
        "max": "1",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "vital-signs",
              "system": "http://terminology.hl7.org/CodeSystem/observation-category"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Observation.category:vs-cat.coding",
        "path": "Observation.category.coding",
        "mustSupport": true
      },
      {
        "id": "Observation.category:vs-cat.coding.system",
        "path": "Observation.category.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.category:vs-cat.coding.code",
        "path": "Observation.category.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "constraint": [
          {
            "key": "code-coding-icu",
            "human": "Es muss mindestens ein snomed oder loinc code vorhanden sein",
            "source": "https://gematik.de/fhir/isik/StructureDefinition/sd-mii-icu-monitoring-und-vitaldaten",
            "severity": "error",
            "expression": "coding.exists() implies coding.where(system = 'http://snomed.info/sct').exists() or coding.where(system = 'http://loinc.org').exists()"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:sct",
        "path": "Observation.code.coding",
        "sliceName": "sct",
        "min": 0,
        "max": "*",
        "patternCoding": {
          "system": "http://snomed.info/sct"
        },
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://gematik.de/fhir/isik/ValueSet/vs-mii-icu-code-monitoring-und-vitaldaten-snomed"
        }
      },
      {
        "id": "Observation.code.coding:sct.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding:sct.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding:loinc",
        "path": "Observation.code.coding",
        "sliceName": "loinc",
        "min": 0,
        "max": "*",
        "patternCoding": {
          "system": "http://loinc.org"
        },
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://gematik.de/fhir/isik/ValueSet/vs-mii-icu-code-monitoring-und-vitaldaten-loinc"
        }
      },
      {
        "id": "Observation.code.coding:loinc.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding:loinc.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding:IEEE-11073",
        "path": "Observation.code.coding",
        "sliceName": "IEEE-11073",
        "min": 0,
        "max": "*",
        "patternCoding": {
          "system": "urn:iso:std:iso:11073:10101"
        },
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://gematik.de/fhir/isik/ValueSet/vs-mii-icu-code-monitoring-und-vitaldaten-iso11073"
        }
      },
      {
        "id": "Observation.code.coding:IEEE-11073.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding:IEEE-11073.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.encounter",
        "path": "Observation.encounter",
        "mustSupport": true
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          },
          {
            "code": "Period"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "comment": "Motivation MS: Dieses Feld stellt eine präzisierende Angaben zum Zweck der Qualitätsbewertung bereit",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].value",
        "path": "Observation.value[x].value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].unit",
        "path": "Observation.value[x].unit",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].system",
        "path": "Observation.value[x].system",
        "min": 1,
        "patternUri": "http://unitsofmeasure.org",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].code",
        "path": "Observation.value[x].code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "constraint": [
          {
            "key": "mii-icu-1",
            "human": "If there is no Observation.value, a dataAbsentReason must be given.",
            "source": "https://gematik.de/fhir/isik/StructureDefinition/sd-mii-icu-monitoring-und-vitaldaten",
            "severity": "error",
            "expression": "value.exists().not() implies dataAbsentReason.exists()"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.interpretation",
        "path": "Observation.interpretation",
        "mustSupport": true
      },
      {
        "id": "Observation.bodySite",
        "path": "Observation.bodySite",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "https://gematik.de/fhir/isik/ValueSet/vs-mii-icu-bodysite-observation-monitoring-und-vitaldaten"
        }
      },
      {
        "id": "Observation.method",
        "path": "Observation.method",
        "comment": "Motivation MS: Dieses Feld stellt eine präzisierende Angaben zum Zweck der Qualitätsbewertung bereit",
        "mustSupport": true
      },
      {
        "id": "Observation.device",
        "path": "Observation.device",
        "mustSupport": true
      },
      {
        "id": "Observation.referenceRange",
        "path": "Observation.referenceRange",
        "mustSupport": true
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "mustSupport": true
      },
      {
        "id": "Observation.component.code",
        "path": "Observation.component.code",
        "mustSupport": true
      },
      {
        "id": "Observation.component.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.component.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "mustSupport": true
      },
      {
        "id": "Observation.component.interpretation",
        "path": "Observation.component.interpretation",
        "mustSupport": true
      },
      {
        "id": "Observation.component.referenceRange",
        "path": "Observation.component.referenceRange",
        "mustSupport": true
      }
    ]
  }
}