{
  "resourceType": "StructureDefinition",
  "id": "SocialHistoryTobaccoUseMERT",
  "url": "https://intrahealth.com/fhir/mert/StructureDefinition/SocialHistoryTobaccoUseMERT",
  "name": "SocialHistoryTobaccoUseMERT",
  "title": "Social History - Tobacco Use (MERT)",
  "status": "draft",
  "description": "Social history tobacco use observation for MERT exchange.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation.status",
        "path": "Observation.status",
        "short": "'final' only",
        "comment": "For MERT, only Observation.status = 'final' is processed.",
        "patternCode": "final",
        "mustSupport": true
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "short": "social-history",
        "comment": "Exactly one category is used in Social History - Tobacco Use for MERT, and it SHALL be social-history.",
        "min": 1,
        "max": "1",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "social-history",
              "system": "http://terminology.hl7.org/CodeSystem/observation-category"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "short": "Tobacco smoking status (LOINC 72166-2)",
        "comment": "MERT Tobacco Use uses LOINC 72166-2.",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "72166-2",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://intrahealth.com/fhir/mert/StructureDefinition/PatientMERT"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "comment": "Use effective[x] when available to indicate clinically relevant timing (e.g., when smoking started).",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/ValueSet/observation-smokingstatus"
        }
      },
      {
        "id": "Observation.value[x].text",
        "path": "Observation.value[x].text",
        "mustSupport": true
      },
      {
        "id": "Observation.note",
        "path": "Observation.note",
        "comment": "Use note for tobacco-use related comments.",
        "mustSupport": true
      }
    ]
  }
}