<status value="active" /> <date value="2026-03-23" /> <publisher value="Israel Core Team" /> <contact> <telecom> <system value="email" /> <value value="tal.primak@moh.gov.il" /> </telecom> </contact> <description value="Israel Core proposed constraints and extensions on the Observation Resource" /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation" /> <derivation value="constraint" /> <differential> <element id="Observation"> <path value="Observation" /> <short value="ILCore Observation Profile" /> <definition value="Israel Core proposed constraints and extensions on the Observation resource profile." /> </element> <element id="Observation.identifier"> <path value="Observation.identifier" /> <type> <code value="Identifier" /> <profile value="http://fhir.health.gov.il/StructureDefinition/il-core-identifier" /> </type> </element> <element id="Observation.basedOn"> <path value="Observation.basedOn" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-care-plan" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-device-request" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-immunization-recommendation" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-medication-request" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-nutrition-order" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-service-request" /> </type> </element> <element id="Observation.partOf"> <path value="Observation.partOf" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-medication-administration" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-medication-dispense" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-procedure" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-immunization" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-medication-statement" /> </type> </element> <element id="Observation.status"> <path value="Observation.status" /> <mustSupport value="true" /> </element> <element id="Observation.category"> <path value="Observation.category" /> <mustSupport value="true" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <mustSupport value="true" /> <binding> <strength value="preferred" /> <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-observation-code" /> </binding> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-patient" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-group" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-device" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-location" /> </type> <mustSupport value="true" /> </element> <element id="Observation.encounter"> <path value="Observation.encounter" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-encounter" /> </type> </element> <element id="Observation.performer"> <path value="Observation.performer" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-practitioner" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-organization" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-care-team" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-patient" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-related-person" /> </type> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Observation.value[x]:valueQuantity"> <path value="Observation.value[x]" /> <sliceName value="valueQuantity" /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <constraint> <key value="il-obs-ucum" /> <severity value="warning" /> <human value="SHOULD use UCUM for coded quantity units" /> <expression value="system.empty() or system = 'http://unitsofmeasure.org'" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.value[x]:valueCodeableConcept"> <path value="Observation.value[x]" /> <sliceName value="valueCodeableConcept" /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="il-obs-value-cc" /> <severity value="warning" /> <human value="SHOULD use SNOMED-CT or LOINC Answers for coded results" /> <expression value="coding.where(system='http://snomed.info/sct' and code.exists()).exists() or coding.where(system='http://loinc.org' and code.startsWith('LA')).exists()" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> <binding> <strength value="preferred" /> <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-observation-value" /> </binding> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason" /> <constraint> <key value="il-obs-not-performed" /> <severity value="error" /> <human value="dataAbsentReason - if an IL-Core 'not-performed-reason' code is supplied, the HL7 code (http://terminology.hl7.org/CodeSystem/data-absent-reason) 'not performed' MUST be supplied as well" /> <expression value="coding.where(system='http://fhir.health.gov.il/cs/il-core-not-performed-reason').exists() implies coding.where(system='http://terminology.hl7.org/CodeSystem/data-absent-reason' and code='not-performed').exists()" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.dataAbsentReason.coding"> <path value="Observation.dataAbsentReason.coding" /> <slicing> <discriminator> <type value="value" /> <path value="system" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Observation.dataAbsentReason.coding:not-performed-reason"> <path value="Observation.dataAbsentReason.coding" /> <sliceName value="not-performed-reason" /> <min value="0" /> <max value="1" /> </element> <element id="Observation.dataAbsentReason.coding:not-performed-reason.system"> <path value="Observation.dataAbsentReason.coding.system" /> <min value="1" /> <fixedUri value="http://fhir.health.gov.il/cs/il-core-not-performed-reason" /> </element> <element id="Observation.dataAbsentReason.coding:not-performed-reason.code"> <path value="Observation.dataAbsentReason.coding.code" /> <min value="1" /> </element> <element id="Observation.bodySite"> <path value="Observation.bodySite" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodySite" /> </extension> <strength value="preferred" /> <description value="Codes describing anatomical locations. May include laterality." /> <valueSet value="http://hl7.org/fhir/ValueSet/body-site" /> </binding> </element> <element id="Observation.method"> <path value="Observation.method" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationMethod" /> </extension> <strength value="preferred" /> <description value="Methods for simple observations." /> <valueSet value="http://hl7.org/fhir/ValueSet/observation-methods" /> </binding> </element> <element id="Observation.specimen"> <path value="Observation.specimen" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-specimen" /> </type> </element> <element id="Observation.device"> <path value="Observation.device" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-device" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric" /> </type> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <constraint> <key value="il-obs-ucum" /> <severity value="warning" /> <human value="SHOULD use UCUM for coded quantity units" /> <expression value="system.empty() or system = 'http://unitsofmeasure.org'" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <constraint> <key value="il-obs-ucum" /> <severity value="warning" /> <human value="SHOULD use UCUM for coded quantity units" /> <expression value="system.empty() or system = 'http://unitsofmeasure.org'" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.referenceRange.age.low.system"> <path value="Observation.referenceRange.age.low.system" /> <fixedUri value="http://unitsofmeasure.org" /> </element> <element id="Observation.referenceRange.age.low.code"> <path value="Observation.referenceRange.age.low.code" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/ValueSet/age-units" /> </binding> </element> <element id="Observation.referenceRange.age.high.system"> <path value="Observation.referenceRange.age.high.system" /> <fixedUri value="http://unitsofmeasure.org" /> </element> <element id="Observation.referenceRange.age.high.code"> <path value="Observation.referenceRange.age.high.code" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/ValueSet/age-units" /> </binding> </element> <element id="Observation.hasMember"> <path value="Observation.hasMember" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MolecularSequence" /> </type> </element> <element id="Observation.derivedFrom"> <path value="Observation.derivedFrom" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-document-reference" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-media" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> <targetProfile value="http://fhir.health.gov.il/StructureDefinition/il-core-molecular-sequence" /> </type> </element> <element id="Observation.component.code"> <path value="Observation.component.code" /> <binding> <strength value="preferred" /> <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-observation-code" /> </binding> </element> <element id="Observation.component.value[x]"> <path value="Observation.component.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.component.value[x]:valueQuantity"> <path value="Observation.component.value[x]" /> <sliceName value="valueQuantity" /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <constraint> <key value="il-obs-ucum" /> <severity value="warning" /> <human value="SHOULD use UCUM for coded quantity units" /> <expression value="system.empty() or system = 'http://unitsofmeasure.org'" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.component.value[x]:valueCodeableConcept"> <path value="Observation.component.value[x]" /> <sliceName value="valueCodeableConcept" /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="il-obs-value-cc" /> <severity value="warning" /> <human value="SHOULD use SNOMED-CT or LOINC Answers for coded results" /> <expression value="coding.where(system='http://snomed.info/sct' and code.exists()).exists() or coding.where(system='http://loinc.org' and code.startsWith('LA')).exists()" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> <binding> <strength value="preferred" /> <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-observation-value" /> </binding> </element> <element id="Observation.component.referenceRange"> <path value="Observation.component.referenceRange" /> <type> <code value="BackboneElement" /> </type> </element> <element id="Observation.component.referenceRange.low"> <path value="Observation.component.referenceRange.low" /> <constraint> <key value="il-obs-ucum" /> <severity value="warning" /> <human value="SHOULD use UCUM for coded quantity units" /> <expression value="system.empty() or system = 'http://unitsofmeasure.org'" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.component.referenceRange.high"> <path value="Observation.component.referenceRange.high" /> <constraint> <key value="il-obs-ucum" /> <severity value="warning" /> <human value="SHOULD use UCUM for coded quantity units" /> <expression value="system.empty() or system = 'http://unitsofmeasure.org'" /> <source value="http://fhir.health.gov.il/StructureDefinition/il-core-observation" /> </constraint> </element> <element id="Observation.component.referenceRange.age.low"> <path value="Observation.component.referenceRange.age.low" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/ValueSet/age-units" /> </binding> </element> <element id="Observation.component.referenceRange.age.high"> <path value="Observation.component.referenceRange.age.high" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/ValueSet/age-units" /> </binding> </element> </differential> </StructureDefinition>