{
  "resourceType": "StructureDefinition",
  "id": "il-core-vital-signs",
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "draft"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0
    }
  ],
  "url": "http://fhir.health.gov.il/StructureDefinition/il-core-vital-signs",
  "version": "0.21.0",
  "name": "ILCoreVitalSigns",
  "title": "ILCore Vital Signs Profile",
  "status": "active",
  "date": "2026-03-23",
  "publisher": "Israel Core Team",
  "contact": [
    {
      "telecom": [
        {
          "system": "email",
          "value": "tal.primak@moh.gov.il"
        }
      ]
    }
  ],
  "description": "Israel Core proposed constraints and extensions on the Observation Resource for use in querying and retrieving Vital Signs information.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "ILCore Vital Signs Profile",
        "constraint": [
          {
            "key": "il-vs2",
            "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())",
            "source": "http://fhir.health.gov.il/StructureDefinition/il-core-vital-signs"
          }
        ]
      },
      {
        "id": "Observation.extension",
        "path": "Observation.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.extension:body-position",
        "path": "Observation.extension",
        "sliceName": "body-position",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
            ]
          }
        ]
      },
      {
        "id": "Observation.extension:body-position.value[x]",
        "path": "Observation.extension.value[x]",
        "binding": {
          "strength": "example",
          "valueSet": "http://fhir.health.gov.il/ValueSet/il-core-body-position"
        }
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "coding.code"
            },
            {
              "type": "value",
              "path": "coding.system"
            }
          ],
          "rules": "open",
          "ordered": false
        },
        "min": 1
      },
      {
        "id": "Observation.category:VSCat",
        "path": "Observation.category",
        "sliceName": "VSCat",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.category:VSCat.coding",
        "path": "Observation.category.coding",
        "min": 1
      },
      {
        "id": "Observation.category:VSCat.coding.system",
        "path": "Observation.category.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/observation-category",
        "mustSupport": true
      },
      {
        "id": "Observation.category:VSCat.coding.code",
        "path": "Observation.category.coding.code",
        "min": 1,
        "fixedCode": "vital-signs",
        "mustSupport": true
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "definition": "Code specifying Vital Sign measurement type",
        "binding": {
          "strength": "extensible",
          "valueSet": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
        }
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-patient"
            ]
          }
        ]
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "short": "Often just a dateTime for Vital Signs",
        "min": 1,
        "constraint": [
          {
            "key": "il-vs1",
            "severity": "error",
            "human": "if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day",
            "expression": "($this as dateTime).exists() implies (($this as dateTime).toString().length() >= 10)",
            "source": "http://fhir.health.gov.il/StructureDefinition/il-core-vital-signs"
          }
        ]
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "short": "Vital Signs value are recorded using the Quantity data type.",
        "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, as well as String.",
        "type": [
          {
            "code": "Quantity"
          },
          {
            "code": "CodeableConcept"
          },
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueQuantity",
        "path": "Observation.value[x]",
        "sliceName": "valueQuantity",
        "short": "Vital Signs values are recorded with UCUM",
        "definition": "Vital Signs values are recorded with UCUM",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
        }
      },
      {
        "id": "Observation.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "mustSupport": true
      },
      {
        "id": "Observation.hasMember",
        "path": "Observation.hasMember",
        "definition": "Used when reporting vital signs panel components",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-vital-signs"
            ]
          }
        ]
      },
      {
        "id": "Observation.derivedFrom",
        "path": "Observation.derivedFrom",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-document-reference",
              "http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study",
              "http://fhir.health.gov.il/StructureDefinition/il-core-media",
              "http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response",
              "http://fhir.health.gov.il/StructureDefinition/il-core-vital-signs",
              "http://fhir.health.gov.il/StructureDefinition/il-core-molecular-sequence"
            ]
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "constraint": [
          {
            "key": "il-vs3",
            "severity": "error",
            "human": "If there is no a value a data absent reason must be present",
            "expression": "value.exists() or dataAbsentReason.exists()",
            "source": "http://fhir.health.gov.il/StructureDefinition/il-core-vital-signs"
          }
        ],
        "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"
          },
          {
            "code": "CodeableConcept"
          },
          {
            "code": "string"
          }
        ],
        "condition": [
          "il-vs3"
        ]
      },
      {
        "id": "Observation.component.value[x]:valueQuantity",
        "path": "Observation.component.value[x]",
        "sliceName": "valueQuantity",
        "short": "BP values are recorded with UCUM",
        "definition": "Blood pressuer values are recorded with UCUM",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "binding": {
          "strength": "extensible",
          "valueSet": "http://fhir.health.gov.il/ValueSet/bp-unit"
        }
      },
      {
        "id": "Observation.component.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "condition": [
          "il-vs3"
        ],
        "mustSupport": true
      }
    ]
  }
}