Professional Record Standards Body (PRSB) - About me standard v1.2

About Me

The expectation is that this information would be written or recorded by an individual (or someone supporting them) in an electronic record for that individual. How the information is recorded and added to the electronic record is for local determination.

The information in the About Me section should be prominent and one of the first sections viewed in a health and care record as it includes important information about the person relevant to all care and support providers. Ideally this information is also available in a multimedia format e.g., video, particularly when a person has difficulties expressing themselves.

The information in the About Me section should sit alongside other information entered by health and social care professionals such as medications and allergies to enable the information to be cross-checked.

Local implementations will need to define how and where the information is displayed.

It should be possible for the individual to update the information as it changes or when they need to record new information. A record of the changes that were made and when they were made should be captured.

It is recommended that About Me information is reviewed and updated at key transition points for example for children and young people with Education, Health and Care (EHC) plans when transitioning from primary to secondary school, moving onto college and whenever their home circumstances change (for example moving into supported living or residential care). The transition process from children’s social care to adult’s social care is also a recommended time for reviewing and updating About Me information. For adults, it should be reviewed and updated at planned reviews or when requested by the individual

It is the intention that everyone should be able to record About Me information however local implementers may want to identify population groups for which the ability to record and share this type of information would deliver most benefit and start with those groups for example children and young people accessing children and adolescent mental health services (CAMHS), children and young people with an EHC plan, older people in care homes, people living with long term conditions and individuals receiving support from children’s and adult’s social care.

The information in the About Me section is intended to be used to support direct care and not to assess an individual’s right to receive care or support.

What it is

  • a section within the Core Information Standard and transfer of care standards which is designed for sharing information that the person (or somebody acting on their behalf) considers important to share about themselves with others caring for or supporting them for the purposes of direct care, to enable the best, personalised care and support to be provided
  • aimed at capturing an individual’s needs, preferences and wishes for how they receive care and support in a person-centred approach. It could also include information on the individual’s strengths to provide a basis for building upon personal and community assets to enable self-care where possible
  • aimed at capturing holistic information about the individual, not just what people caring for and supporting the individual need to know when someone is unwell (or in an emergency) but what they are able to do and enjoy on a typical day
  • divided into sub-categories of information to help individuals to determine what information to share and to help those providing care and support to the individual to easily locate the information they need
  • designed to be generic and apply to everyone, from those who have complex care and support needs to those who rarely require care and/or support. This could include, for example, older people, people with mental health conditions, people with learning disabilities, people with physical impairments and people with long-term conditions etc.

What it is not:

  • intended to be used for determining an individual’s right to access social care or health services
  • a person-held record, therefore, does not include any information recorded by professionals in an electronic patient record such as medications, problems, examination findings and investigation results. In a shared care record the About Me (information from the person themselves) would sit alongside clinical and social care information recorded by professionals about the person
  • a care or support plan. Individuals may have an end-of-life care plan, plans for management of specific conditions or situations (e.g., an asthma management plan or a behaviour support plan) and these would sit alongside the About Me information in a shared care record
  • a go-to section for legal information such as Deprivation of Liberty Safeguards, Lasting Power of Attorney, Nearest relative or Next of Kin
  • a prescriptive definition of what must be included. The About Me section enables an individual to reflect their unique position. They can include whatever information they choose in an About Me section and they can choose not to share any information at all
  • a definition of who should be able to see the information in the About Me section for an individual (local implementers will need to determine this based on the legal framework and NHS England’s Information Governance Framework and Role-Based Access Control framework)
  • a definition of how the information in the About Me section should be presented to professionals. What is presented and how much information (history) and how it is viewed and accessed should be defined locally
  • a definition of a form or system for capturing information in the About Me section from an individual
  • a definition of how and where individuals can record information in the About Me section, how it is captured and displayed in clinical systems and shared records, how it is kept up-to-date and how multiple versions of information in the About Me section are managed (e.g., About Me records originating in different settings)
 <status value="draft" /> <description value="Observation with coded components to be used to capture a Patients PRSB About Me information" /> <purpose value="Observation with coded components to be used to capture a Patients PRSB About Me information" /> <fhirVersion value="3.0.2" /> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="PRSB About Me" /> <definition value="This profile defines how to represent the PRSB About Me as an observations in FHIR. This is a grouping structure, it has no value in Observation.valueQuantity but contains multiple components" /> <comment value="Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as lab reports, etc." /> <alias value="Vital Signs" /> <alias value="Measurement" /> <alias value="Results" /> <alias value="Tests" /> <min value="0" /> <max value="*" /> <base> <path value="Resource" /> <min value="0" /> <max value="*" /> </base> <constraint> <key value="dom-2" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" /> <expression value="contained.contained.empty()" /> <xpath value="not(parent::f:contained and f:contained)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-1" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" /> <expression value="contained.text.empty()" /> <xpath value="not(parent::f:contained and f:text)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-4" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" /> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-3" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource" /> <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()" /> <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="obs-7" /> <severity value="error" /> <human value="If code is the same as a component code then the value element associated with the code SHALL NOT be present" /> <expression value="value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()" /> <xpath value="not(exists(f:*[starts-with(local-name(.), 'value')])) or not(count(for $coding in f:code/f:coding return parent::*/f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0)" /> <source value="http://hl7.org/fhir/StructureDefinition/Observation" /> </constraint> <constraint> <key value="obs-6" /> <severity value="error" /> <human value="dataAbsentReason SHALL only be present if Observation.value[x] is not present" /> <expression value="dataAbsentReason.empty() or value.empty()" /> <xpath value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))" /> <source value="http://hl7.org/fhir/StructureDefinition/Observation" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="Observation[classCode=OBS, moodCode=EVN]" /> </mapping> <mapping> <identity value="w5" /> <map value="clinical.diagnostics" /> </mapping> </element> <element id="Observation.id"> <path value="Observation.id" /> <short value="Logical id of this artifact" /> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." /> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="id" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.meta"> <path value="Observation.meta" /> <short value="Metadata about the resource" /> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.meta" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Meta" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.implicitRules"> <path value="Observation.implicitRules" /> <short value="A set of rules under which this content was created" /> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." /> <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.implicitRules" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.language"> <path value="Observation.language" /> <short value="Language of the resource content" /> <definition value="The base language in which the resource is written." /> <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.language" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueReference> <reference value="http://hl7.org/fhir/ValueSet/all-languages" /> </valueReference> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.text"> <path value="Observation.text" /> <short value="Text summary of the resource, for human interpretation" /> <definition value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." /> <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later." /> <alias value="narrative" /> <alias value="html" /> <alias value="xhtml" /> <alias value="display" /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Narrative" /> </type> <condition value="ele-1" /> <condition value="dom-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="Observation.contained"> <path value="Observation.contained" /> <short value="Contained, inline Resources" /> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." /> <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again." /> <alias value="inline resources" /> <alias value="anonymous resources" /> <alias value="contained resources" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.contained" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Resource" /> </type> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.modifierExtension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.identifier"> <path value="Observation.identifier" /> <short value="Business Identifier for observation" /> <definition value="A unique identifier assigned to this observation." /> <requirements value="Allows observations to be distinguished and referenced." /> <min value="0" /> <max value="*" /> <base> <path value="Observation.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" /> </mapping> <mapping> <identity value="rim" /> <map value="II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" /> </mapping> <mapping> <identity value="servd" /> <map value="Identifier" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4." /> </mapping> <mapping> <identity value="rim" /> <map value="id" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="Observation.basedOn"> <path value="Observation.basedOn" /> <short value="Fulfills plan, proposal or order" /> <definition value="A plan, proposal or order that is fulfilled in whole or in part by this event." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon." /> <alias value="Fulfills" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.basedOn" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.basedOn" /> </mapping> <mapping> <identity value="v2" /> <map value="ORC" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=FLFS].target" /> </mapping> </element> <element id="Observation.status"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint"> <valueString value="default: final" /> </extension> <path value="Observation.status" /> <short value="registered | preliminary | final | amended +" /> <definition value="The status of the result value." /> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." /> <requirements value="Need to track the status of individual results. Some results are finalized before the whole report is finalized." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="final" /> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationStatus" /> </extension> <strength value="required" /> <description value="Codes providing the status of an observation." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 445584004 |Report by finality status|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-11" /> </mapping> <mapping> <identity value="rim" /> <map value="status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"" /> </mapping> <mapping> <identity value="w5" /> <map value="status" /> </mapping> </element> <element id="Observation.category"> <path value="Observation.category" /> <short value="Classification of type of observation" /> <definition value="A code that classifies the general type of observation being made." /> <comment value="In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set." /> <requirements value="Used for filtering what observations are retrieved and displayed." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://hl7.org/fhir/observation-category" /> <code value="social-history" /> <display value="Social History" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCategory" /> </extension> <strength value="preferred" /> <description value="Codes for high level observation categories." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-category" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Type of observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "name"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <alias value="Name" /> <min value="1" /> <max value="1" /> <base> <path value="Observation.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="822761000000108" /> <display value="Patient preferences record (record artifact)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.code" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="116680003 |Is a|" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Patient the About Me if for" /> <definition value="The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, donor, other observer (for example a relative or EMT), or any observation made about the subject." /> <comment value="One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. If the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html). may be used. However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code." /> <requirements value="Observations have no value if you don't know who or what they're about." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.subject" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.subject" /> </mapping> <mapping> <identity value="v2" /> <map value="PID-3" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.focus" /> </mapping> </element> <element id="Observation.context"> <path value="Observation.context" /> <short value="Healthcare event during which this observation is made" /> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made." /> <comment value="This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests)." /> <requirements value="For some observations it may be important to know the link between an observation and a particular encounter." /> <alias value="Encounter" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.context" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.context" /> </mapping> <mapping> <identity value="v2" /> <map value="PV1" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]" /> <short value="Clinically relevant time/time-period for observation" /> <definition value="The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself." /> <comment value="At least a date should be present unless this observation is a historical report." /> <requirements value="Knowing when an observation was deemed true is important to its relevance as well as determining trends." /> <alias value="Occurrence" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.occurrence[x]" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)" /> </mapping> <mapping> <identity value="rim" /> <map value="effectiveTime" /> </mapping> <mapping> <identity value="w5" /> <map value="when.done" /> </mapping> </element> <element id="Observation.issued"> <path value="Observation.issued" /> <short value="Date and Time Created" /> <definition value="This is a record of the date and time that this About Me was created" /> <comment value="Updated when the result is updated." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=AUT].time" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="Observation.performer"> <path value="Observation.performer" /> <short value="Supported to write this by" /> <definition value="Where relevant, this is a record of name, relationship/role and contact details of the individual who supported the person to write this section e.g. carer, family member, advocate, professional." /> <comment value="Where the About Me is updated my a Practitioner on behalf of the Patient, the appropriate reference / identifier should be used. Where only text description of the supporting individual available use Observation.performer.display." /> <requirements value="May give a degree of confidence in the observation and also indicates where follow-up questions should be directed." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.performer" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.performer" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=PRF]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.actor" /> </mapping> </element> <element id="Observation.performer.id"> <path value="Observation.performer.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.performer.extension"> <path value="Observation.performer.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.performer.reference"> <path value="Observation.performer.reference" /> <short value="Literal reference, Relative, internal or absolute URL" /> <definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." /> <comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." /> <min value="0" /> <max value="1" /> <base> <path value="Reference.reference" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <condition value="ref-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.performer.identifier"> <path value="Observation.performer.identifier" /> <short value="Logical reference, when literal reference is not known" /> <definition value="An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." /> <comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it." /> <min value="0" /> <max value="1" /> <base> <path value="Reference.identifier" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" /> </mapping> <mapping> <identity value="rim" /> <map value="II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" /> </mapping> <mapping> <identity value="servd" /> <map value="Identifier" /> </mapping> <mapping> <identity value="rim" /> <map value=".identifier" /> </mapping> </element> <element id="Observation.performer.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.performer.display" /> <short value="Text alternative for the resource" /> <definition value="Plain text narrative that identifies the resource in addition to the resource reference." /> <comment value="This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it." /> <min value="1" /> <max value="1" /> <base> <path value="Reference.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mustSupport value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]" /> <short value="Actual result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is "'value' + the type name" with a capital on the first letter of the type). If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text. A value set is bound to the ValueCodeableConcept element. For further discussion and examples see the [notes section](observation.html#notes) below." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="string" /> </type> <type> <code value="boolean" /> </type> <type> <code value="Range" /> </type> <type> <code value="Ratio" /> </type> <type> <code value="SampledData" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="time" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <condition value="ele-1" /> <condition value="obs-7" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason" /> <short value="Why the result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value="Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.notDone, Event.notDoneReason (maps to valeu[x] or dataAbsentReason)" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.comment"> <path value="Observation.comment" /> <short value="Comments about result" /> <definition value="May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event.note" /> </mapping> <mapping> <identity value="v2" /> <map value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)" /> </mapping> <mapping> <identity value="rim" /> <map value="subjectOf.observationEvent[code="annotation"].value" /> </mapping> </element> <element id="Observation.bodySite"> <path value="Observation.bodySite" /> <short value="Observed body part" /> <definition value="Indicates the site on the subject's body where the observation was made (i.e. the target site)." /> <comment value="Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html)." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodySite" /> </extension> <strength value="example" /> <description value="Codes describing anatomical locations. May include laterality." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/body-site" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 123037004 |Body structure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-20" /> </mapping> <mapping> <identity value="rim" /> <map value="targetSiteCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="718497002 |Inherent location|" /> </mapping> </element> <element id="Observation.method"> <path value="Observation.method" /> <short value="How it was done" /> <definition value="Indicates the mechanism used to perform the observation." /> <comment value="Only used if not implicit in code for Observation.code." /> <requirements value="In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationMethod" /> </extension> <strength value="example" /> <description value="Methods for simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-methods" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-17" /> </mapping> <mapping> <identity value="rim" /> <map value="methodCode" /> </mapping> </element> <element id="Observation.specimen"> <path value="Observation.specimen" /> <short value="Specimen used for this observation" /> <definition value="The specimen that was used when this observation was made." /> <comment value="Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report)." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.specimen" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 123038009 |Specimen|" /> </mapping> <mapping> <identity value="v2" /> <map value="SPM segment" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SPC].specimen" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="704319004 |Inherent in|" /> </mapping> </element> <element id="Observation.device"> <path value="Observation.device" /> <short value="(Measurement) Device" /> <definition value="The device used to generate the observation data." /> <comment value="An extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.device" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceMetric" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 49062001 |Device|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-17 / PRT -10" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=DEV]" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="424226004 |Using device|" /> </mapping> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange" /> <short value="Provides guide for interpretation" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Observation" /> </constraint> <constraint> <key value="obs-3" /> <severity value="error" /> <human value="Must have at least a low or a high or text" /> <expression value="low.exists() or high.exists() or text.exists()" /> <xpath value="(exists(f:low) or exists(f:high)or exists(f:text))" /> <source value="http://hl7.org/fhir/StructureDefinition/Observation" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.referenceRange.id"> <path value="Observation.referenceRange.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.referenceRange.modifierExtension"> <path value="Observation.referenceRange.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <short value="Low Range, if relevant" /> <definition value="The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3)." /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.low" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <condition value="obs-3" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <isModifier value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-7" /> </mapping> <mapping> <identity value="rim" /> <map value="value:IVL_PQ.low" /> </mapping> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <short value="High Range, if relevant" /> <definition value="The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3)." /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.high" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <condition value="obs-3" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <isModifier value="false" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-7" /> </mapping> <mapping> <identity value="rim" /> <map value="value:IVL_PQ.high" /> </mapping> </element> <element id="Observation.referenceRange.type"> <path value="Observation.referenceRange.type" /> <short value="Reference range qualifier" /> <definition value="Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range." /> <comment value="This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed." /> <requirements value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc, - for proper interpretation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationRangeMeaning" /> </extension> <strength value="extensible" /> <description value="Code for the meaning of a reference range." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-10" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> </element> <element id="Observation.referenceRange.appliesTo"> <path value="Observation.referenceRange.appliesTo" /> <short value="Reference range population" /> <definition value="Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race." /> <comment value="This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed." /> <requirements value="Need to be able to identify the target population for proper interpretation." /> <min value="0" /> <max value="*" /> <base> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationRangeType" /> </extension> <strength value="example" /> <description value="Codes identifying the population the reference range applies to." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/referencerange-appliesto" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-10" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> </element> <element id="Observation.referenceRange.age"> <path value="Observation.referenceRange.age" /> <short value="Applicable age range, if relevant" /> <definition value="The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so." /> <comment value="The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3." /> <requirements value="Some analytes vary greatly over age." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Range" /> </constraint> <constraint> <key value="rng-2" /> <severity value="error" /> <human value="If present, low SHALL have a lower value than high" /> <expression value="low.empty() or high.empty() or (low <= high)" /> <xpath value="not(exists(f:low/f:value/@value)) or not(exists(f:high/f:value/@value)) or (number(f:low/f:value/@value) <= number(f:high/f:value/@value))" /> <source value="http://hl7.org/fhir/StructureDefinition/Range" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="NR and also possibly SN (but see also quantity)" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL<QTY[not(type="TS")]> [lowClosed="true" and highClosed="true"]or URG<QTY[not(type="TS")]>" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value" /> </mapping> </element> <element id="Observation.referenceRange.text"> <path value="Observation.referenceRange.text" /> <short value="Text based reference range in an observation" /> <definition value="Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of 'normals'." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-7" /> </mapping> <mapping> <identity value="rim" /> <map value="value:ST" /> </mapping> </element> <element id="Observation.related"> <path value="Observation.related" /> <short value="Resource related to this observation" /> <definition value="A reference to another resource (usually another Observation) whose relationship is defined by the relationship type code." /> <comment value="For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4)." /> <requirements value="Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="Relationships established by OBX-4 usage" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship" /> </mapping> </element> <element id="Observation.related.id"> <path value="Observation.related.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.related.modifierExtension"> <path value="Observation.related.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.related.type"> <path value="Observation.related.type" /> <short value="has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by" /> <definition value="A code specifying the kind of relationship that exists with the target resource." /> <comment value="The "derived-from" type is the only logical choice when referencing the QuestionnaireAnswer resource." /> <requirements value="A relationship type SHOULD be provided." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationRelationshipType" /> </extension> <strength value="required" /> <description value="Codes specifying how two observations are related." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-relationshiptypes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value=".typeCode" /> </mapping> </element> <element id="Observation.related.target"> <path value="Observation.related.target" /> <short value="Resource that is related to this one" /> <definition value="A reference to the observation or [QuestionnaireResponse](questionnaireresponse.html#) resource that is related to this observation." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.related.target" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Sequence" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <slicing> <discriminator> <type value="value" /> <path value="code.coding.code" /> </discriminator> <rules value="closed" /> </slicing> <short value="Component results" /> <definition value="Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations." /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="1" /> <max value="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me"> <path value="Observation.component" /> <sliceName value="What_is_most_important_to_me" /> <short value="What is most important to me" /> <definition value="*A description of what is most important to you* ###### Emergency Information Include any essential information that any professional in health and social care should know about you in any situation, including emergencies. ###### Other information This could include: - Values - Spirituality and religion - Ethnicity - Culture - Pets - Goals and aspirations - Meaningful activities including leisure activities, visiting places, sport and exercise, listening to music, employment, education, volunteering" /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="363882003" /> <display value="Motivation (observable entity)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:What_is_most_important_to_me.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me"> <path value="Observation.component" /> <sliceName value="People_who_are_important_to_me" /> <short value="People who are important to me" /> <definition value="*Details of who is important to you and why.* They could be family members, carers, friends, members of staff etc. Include how you want the people important to you to be engaged and involved in your care and support in both emergency and normal situations. Include how you stay connected to the people important to you. Who should not be contacted or consulted about your care and support and why, if you wish to say." /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="302160007" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:People_who_are_important_to_me.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me"> <path value="Observation.component" /> <sliceName value="How_I_communicate_and_how_to_communicate_with_me" /> <short value="How I communicate and how to communicate with me" /> <definition value="*A description of how you communicate normally including any communication aids you use, for example a hearing aid.* Include your preferred language of communication, if your first language is not English. Include how you would communicate when you are in pain or distress. Include how you communicate choices. Include how you give feedback or raise a concern. Include how you like to receive information. Describe how you would like others to engage and communicate with you, including how you would like to be addressed" /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="428330008" /> <display value="Preferred mode of communication (observable entity)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:My_wellness"> <path value="Observation.component" /> <sliceName value="My_wellness" /> <short value="My_wellness" /> <definition value="*A description covering what you are able to do, how you engage with others and how you feel on a typical day through to on a day when you are unwell or really unwell.* - Include any causes that might result in you becoming unwell and strategies for avoiding or addressing the causes. For example, not drinking enough water could cause constipation. - Include any signs that indicate you might be becoming unwell. - On a bad day describe what is different about what you are able to do, how you engage with others and how you feel. - Include how your everyday life is affected by any medical conditions, e.g., dementia, andsymptoms, e.g., itchiness, cough or pain, and how you manage those conditions - Include past health issues or experiences that need to be considered - Include your wellbeing and lifestyle goals and aspirations" /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:My_wellness.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:My_wellness.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:My_wellness.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:My_wellness.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="363800008" /> <display value="General wellbeing (observable entity)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:My_wellness.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:My_wellness.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:My_wellness.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:My_wellness.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me"> <path value="Observation.component" /> <sliceName value="How_and_when_to_support_me" /> <short value="How and when to support me" /> <definition value="*A description of how and when you want someone caring for you to support you.* This could include support needs in an emergency situation (for example taking blood). This could include support you need to maintain important routines or to carry out particular activities, for example: - Personal care routines - Eating and drinking - Bedtime routines - Taking medications - Moving and transitioning This could also include support needed with: - wearing glasses, hearing aids or false teeth etc. - making informed choices or understanding dangers and risks. - managing your emotions, moods and behaviours. - memory or confusion. Include how your support needs change in different environments. Include any triggers that might result in you needing further support and strategies for avoiding or addressing the triggers. Include how you want the support to be provided." /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="1364521000000106" /> <display value="Trigger factor to activate care plan (observable entity)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:How_and_when_to_support_me.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont"> <path value="Observation.component" /> <sliceName value="Please_do_and_please_dont" /> <short value="Please do and please don't" /> <definition value="*A description of things you want someone supporting you to do or not to do.* For example, this might include: - Talk to me not to my carer - Remind me to take my medication - Encourage me to wash my hands regularly - Explain to me what is happening and why - Respond to my communication A description of things you do not want someone supporting for you to do. For example, this might include: - Discussing or asking questions about certain topics - Making assumptions about something - Providing support when it is not wanted - Talking to you in a certain way" /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="414642003" /> <display value="Making considered choices (observable entity)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:Please_do_and_please_dont.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me"> <path value="Observation.component" /> <sliceName value="Also_worth_knowing_about_me" /> <short value="Also worth knowing about me" /> <definition value="*A description of what is also worth knowing about you for people caring or supporting you.* This could include a short history of your life (where you have worked, where you lived, important events in your life important people in your past life). This could include a short profile of your current life: - your work and/or study - your aspirations - your skills - your networks - things you like e.g. particular foods, places, a football team and things you like to talk about. - things you dislike This could also include any care and support preferences that have not been included elsewhere." /> <comment value="For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below." /> <requirements value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="containment by OBX-4?" /> </mapping> <mapping> <identity value="rim" /> <map value="outBoundRelationship[typeCode=COMP]" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.id"> <path value="Observation.component.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.extension"> <path value="Observation.component.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.modifierExtension"> <path value="Observation.component.modifierExtension" /> <short value="Extensions that cannot be ignored" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.code"> <path value="Observation.component.code" /> <short value="Type of component observation (code / type)" /> <definition value="Describes what was observed. Sometimes this is called the observation "code"." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="160476009" /> <display value="Social / personal history observable (observable entity)" /> </coding> </fixedCodeableConcept> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationCode" /> </extension> <strength value="example" /> <description value="Codes identifying names of simple observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-3" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.value[x]"> <path value="Observation.component.value[x]" /> <short value="Actual component result" /> <definition value="The information determined as a result of making the observation, if the information has a simple value." /> <comment value="Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is "'value' + the type name" with a capital on the first letter of the type)." /> <requirements value="An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="363714003 |Interprets| < 441742003 |Evaluation finding|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX.2, OBX.5, OBX.6" /> </mapping> <mapping> <identity value="rim" /> <map value="value" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363714003 |Interprets|" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <short value="Why the component result is missing" /> <definition value="Provides a reason why the expected value in the element Observation.value[x] is missing." /> <comment value=""Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values." /> <requirements value="For many results it is necessary to handle exceptional values in measurements." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <condition value="obs-6" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationValueAbsentReason" /> </extension> <strength value="extensible" /> <description value="Codes specifying why the result (Observation.value[x]) is missing." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.interpretation"> <path value="Observation.component.interpretation" /> <short value="High, low, normal, etc." /> <definition value="The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag." /> <comment value="The component interpretation applies only to the individual component value. For an overall interpretation all components together use thes Observation.interpretation element." /> <requirements value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result." /> <alias value="Abnormal Flag" /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ObservationInterpretation" /> </extension> <strength value="extensible" /> <description value="Codes identifying interpretations of observations." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="sct-concept" /> <map value="< 260245000 |Findings values|" /> </mapping> <mapping> <identity value="v2" /> <map value="OBX-8" /> </mapping> <mapping> <identity value="rim" /> <map value="interpretationCode" /> </mapping> <mapping> <identity value="sct-attr" /> <map value="363713009 |Has interpretation|" /> </mapping> </element> <element id="Observation.component:Also_worth_knowing_about_me.referenceRange"> <path value="Observation.component.referenceRange" /> <short value="Provides guide for interpretation of component result" /> <definition value="Guidance on how to interpret the value by comparison to a normal or recommended range." /> <comment value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties." /> <requirements value="Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange" /> <mapping> <identity value="v2" /> <map value="OBX.7" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]" /> </mapping> </element> </snapshot> <differential> <element id="Observation"> <path value="Observation" /> <short value="PRSB About Me" /> <definition value="This profile defines how to represent the PRSB About Me as an observations in FHIR. This is a grouping structure, it has no value in Observation.valueQuantity but contains multiple components" /> </element> <element id="Observation.basedOn"> <path value="Observation.basedOn" /> <max value="0" /> </element> <element id="Observation.status"> <path value="Observation.status" /> <fixedCode value="final" /> </element> <element id="Observation.category"> <path value="Observation.category" /> <min value="1" /> <max value="1" /> <fixedCodeableConcept> <coding> <system value="http://hl7.org/fhir/observation-category" /> <code value="social-history" /> <display value="Social History" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.code"> <path value="Observation.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="822761000000108" /> <display value="Patient preferences record (record artifact)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Patient the About Me if for" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> </element> <element id="Observation.context"> <path value="Observation.context" /> <max value="0" /> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]" /> <max value="0" /> </element> <element id="Observation.issued"> <path value="Observation.issued" /> <short value="Date and Time Created" /> <definition value="This is a record of the date and time that this About Me was created" /> <min value="1" /> </element> <element id="Observation.performer"> <path value="Observation.performer" /> <short value="Supported to write this by" /> <definition value="Where relevant, this is a record of name, relationship/role and contact details of the individual who supported the person to write this section e.g. carer, family member, advocate, professional." /> <comment value="Where the About Me is updated my a Practitioner on behalf of the Patient, the appropriate reference / identifier should be used. Where only text description of the supporting individual available use Observation.performer.display." /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> </type> <mustSupport value="true" /> </element> <element id="Observation.performer.display"> <path value="Observation.performer.display" /> <min value="1" /> <mustSupport value="false" /> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]" /> <max value="0" /> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation" /> <max value="0" /> </element> <element id="Observation.comment"> <path value="Observation.comment" /> <max value="0" /> </element> <element id="Observation.bodySite"> <path value="Observation.bodySite" /> <max value="0" /> </element> <element id="Observation.method"> <path value="Observation.method" /> <max value="0" /> </element> <element id="Observation.specimen"> <path value="Observation.specimen" /> <max value="0" /> </element> <element id="Observation.device"> <path value="Observation.device" /> <max value="0" /> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange" /> <max value="0" /> </element> <element id="Observation.related"> <path value="Observation.related" /> <max value="0" /> </element> <element id="Observation.component"> <path value="Observation.component" /> <slicing> <discriminator> <type value="value" /> <path value="code.coding.code" /> </discriminator> <rules value="closed" /> </slicing> <min value="1" /> </element> <element id="Observation.component.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:What_is_most_important_to_me"> <path value="Observation.component" /> <sliceName value="What_is_most_important_to_me" /> <short value="What is most important to me" /> <definition value="*A description of what is most important to you* ###### Emergency Information Include any essential information that any professional in health and social care should know about you in any situation, including emergencies. ###### Other information This could include: - Values - Spirituality and religion - Ethnicity - Culture - Pets - Goals and aspirations - Meaningful activities including leisure activities, visiting places, sport and exercise, listening to music, employment, education, volunteering" /> <max value="1" /> </element> <element id="Observation.component:What_is_most_important_to_me.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="363882003" /> <display value="Motivation (observable entity)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:What_is_most_important_to_me.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:What_is_most_important_to_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:What_is_most_important_to_me.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:What_is_most_important_to_me.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:People_who_are_important_to_me"> <path value="Observation.component" /> <sliceName value="People_who_are_important_to_me" /> <short value="People who are important to me" /> <definition value="*Details of who is important to you and why.* They could be family members, carers, friends, members of staff etc. Include how you want the people important to you to be engaged and involved in your care and support in both emergency and normal situations. Include how you stay connected to the people important to you. Who should not be contacted or consulted about your care and support and why, if you wish to say." /> <max value="1" /> </element> <element id="Observation.component:People_who_are_important_to_me.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="302160007" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:People_who_are_important_to_me.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:People_who_are_important_to_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:People_who_are_important_to_me.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:People_who_are_important_to_me.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me"> <path value="Observation.component" /> <sliceName value="How_I_communicate_and_how_to_communicate_with_me" /> <short value="How I communicate and how to communicate with me" /> <definition value="*A description of how you communicate normally including any communication aids you use, for example a hearing aid.* Include your preferred language of communication, if your first language is not English. Include how you would communicate when you are in pain or distress. Include how you communicate choices. Include how you give feedback or raise a concern. Include how you like to receive information. Describe how you would like others to engage and communicate with you, including how you would like to be addressed" /> <max value="1" /> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="428330008" /> <display value="Preferred mode of communication (observable entity)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:How_I_communicate_and_how_to_communicate_with_me.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:My_wellness"> <path value="Observation.component" /> <sliceName value="My_wellness" /> <short value="My_wellness" /> <definition value="*A description covering what you are able to do, how you engage with others and how you feel on a typical day through to on a day when you are unwell or really unwell.* - Include any causes that might result in you becoming unwell and strategies for avoiding or addressing the causes. For example, not drinking enough water could cause constipation. - Include any signs that indicate you might be becoming unwell. - On a bad day describe what is different about what you are able to do, how you engage with others and how you feel. - Include how your everyday life is affected by any medical conditions, e.g., dementia, andsymptoms, e.g., itchiness, cough or pain, and how you manage those conditions - Include past health issues or experiences that need to be considered - Include your wellbeing and lifestyle goals and aspirations" /> <max value="1" /> </element> <element id="Observation.component:My_wellness.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="363800008" /> <display value="General wellbeing (observable entity)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:My_wellness.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:My_wellness.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:My_wellness.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:My_wellness.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:How_and_when_to_support_me"> <path value="Observation.component" /> <sliceName value="How_and_when_to_support_me" /> <short value="How and when to support me" /> <definition value="*A description of how and when you want someone caring for you to support you.* This could include support needs in an emergency situation (for example taking blood). This could include support you need to maintain important routines or to carry out particular activities, for example: - Personal care routines - Eating and drinking - Bedtime routines - Taking medications - Moving and transitioning This could also include support needed with: - wearing glasses, hearing aids or false teeth etc. - making informed choices or understanding dangers and risks. - managing your emotions, moods and behaviours. - memory or confusion. Include how your support needs change in different environments. Include any triggers that might result in you needing further support and strategies for avoiding or addressing the triggers. Include how you want the support to be provided." /> <max value="1" /> </element> <element id="Observation.component:How_and_when_to_support_me.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="1364521000000106" /> <display value="Trigger factor to activate care plan (observable entity)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:How_and_when_to_support_me.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:How_and_when_to_support_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:How_and_when_to_support_me.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:How_and_when_to_support_me.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:Please_do_and_please_dont"> <path value="Observation.component" /> <sliceName value="Please_do_and_please_dont" /> <short value="Please do and please don't" /> <definition value="*A description of things you want someone supporting you to do or not to do.* For example, this might include: - Talk to me not to my carer - Remind me to take my medication - Encourage me to wash my hands regularly - Explain to me what is happening and why - Respond to my communication A description of things you do not want someone supporting for you to do. For example, this might include: - Discussing or asking questions about certain topics - Making assumptions about something - Providing support when it is not wanted - Talking to you in a certain way" /> <max value="1" /> </element> <element id="Observation.component:Please_do_and_please_dont.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="414642003" /> <display value="Making considered choices (observable entity)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:Please_do_and_please_dont.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:Please_do_and_please_dont.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:Please_do_and_please_dont.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:Please_do_and_please_dont.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> <element id="Observation.component:Also_worth_knowing_about_me"> <path value="Observation.component" /> <sliceName value="Also_worth_knowing_about_me" /> <short value="Also worth knowing about me" /> <definition value="*A description of what is also worth knowing about you for people caring or supporting you.* This could include a short history of your life (where you have worked, where you lived, important events in your life important people in your past life). This could include a short profile of your current life: - your work and/or study - your aspirations - your skills - your networks - things you like e.g. particular foods, places, a football team and things you like to talk about. - things you dislike This could also include any care and support preferences that have not been included elsewhere." /> <max value="1" /> </element> <element id="Observation.component:Also_worth_knowing_about_me.code"> <path value="Observation.component.code" /> <fixedCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="160476009" /> <display value="Social / personal history observable (observable entity)" /> </coding> </fixedCodeableConcept> </element> <element id="Observation.component:Also_worth_knowing_about_me.value[x]"> <path value="Observation.component.value[x]" /> <type> <code value="string" /> </type> <type> <code value="Attachment" /> </type> </element> <element id="Observation.component:Also_worth_knowing_about_me.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <max value="0" /> </element> <element id="Observation.component:Also_worth_knowing_about_me.interpretation"> <path value="Observation.component.interpretation" /> <max value="0" /> </element> <element id="Observation.component:Also_worth_knowing_about_me.referenceRange"> <path value="Observation.component.referenceRange" /> <max value="0" /> </element> </differential> </StructureDefinition>