{
  "resourceType": "StructureDefinition",
  "id": "profile-spirometry",
  "meta": {
    "lastUpdated": "2021-05-18T14:31:59.806+00:00"
  },
  "url": "https://simplifier.net/omd-cdss/spirometyobservationprofile",
  "version": "0.2.0",
  "name": "SpirometyObservationProfile",
  "title": "Observation Profile (Spirometry)",
  "status": "draft",
  "date": "2021-05-18T14:21:00.4921281+00:00",
  "publisher": "OMD",
  "description": "Proposed constraints on the Observation Resource for general use on spirometry care elements.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "CA",
          "display": "Canada"
        }
      ]
    }
  ],
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "CDSS5.1",
      "uri": "www.ontariomd.com",
      "name": "CDS-S 5.1"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "Observation Profile",
        "definition": "The Observation Profile is based upon the core FHIR Observation Resource"
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "mustSupport": true
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "comment": "The binding strength of this element is [Preferred](https://www.hl7.org/fhir/terminologies.html#strength), meaning that codes are encouraged to draw from the LOINC code system for interoperability purposes but are not required to do so to be considered conformant. *All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
        "mustSupport": true,
        "binding": {
          "strength": "preferred",
          "description": "LOINC codes identifying names of simple observations."
        }
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "type": [
          {
            "code": "Coding",
            "profile": [
              "https://simplifier.net/omd-cdss/fev1prebroncode",
              "https://simplifier.net/omd-cdss/fvcprebroncode",
              "https://simplifier.net/omd-cdss/fev1perprebroncode",
              "https://simplifier.net/omd-cdss/fev1predictedcode",
              "https://simplifier.net/omd-cdss/fvcpredictedcode",
              "https://simplifier.net/omd-cdss/fev1perpredictedcode",
              "https://simplifier.net/omd-cdss/fev1perofpredictedprebroncode",
              "https://simplifier.net/omd-cdss/fvcratioprebroncode",
              "https://simplifier.net/omd-cdss/fev1fvcratioprebroncode",
              "https://simplifier.net/omd-cdss/pefpersonalprebroncode",
              "https://simplifier.net/omd-cdss/fev1postbroncode",
              "https://simplifier.net/omd-cdss/fvcpostbroncode",
              "https://simplifier.net/omd-cdss/fev1perpostbroncode",
              "https://simplifier.net/omd-cdss/fev1perofpredictedpostbroncode",
              "https://simplifier.net/omd-cdss/fvcratiopostbroncode",
              "https://simplifier.net/omd-cdss/fev1fvcratiopostbroncode",
              "https://simplifier.net/omd-cdss/pefpersonalpostbroncode",
              "https://simplifier.net/omd-cdss/o2saturationcode"
            ]
          }
        ]
      },
      {
        "id": "Observation.code.coding.system",
        "path": "Observation.code.coding.system",
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.021",
            "comment": "FEV1 (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.023",
            "comment": "FVC (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.025",
            "comment": "FEV1% (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.027",
            "comment": "FEV1 Predicted"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.029",
            "comment": "FVC Predicted"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.031",
            "comment": "FEV1% Prediced"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.033",
            "comment": "FEV1% of Predicted (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.035",
            "comment": "FVC Ratio (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.037",
            "comment": "FEV1/FVC Ratio (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.039",
            "comment": "PEF Personal (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.041",
            "comment": "FEV1 (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.043",
            "comment": "FVC (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.045",
            "comment": "FEV1% (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.047",
            "comment": "FEV1% of Predicted (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.049",
            "comment": "FVC Ratio (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.051",
            "comment": "FEV1/FVC Ratio (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.053",
            "comment": "PEF Personal (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.056",
            "comment": "O2 Saturation"
          }
        ]
      },
      {
        "id": "Observation.code.coding.code",
        "path": "Observation.code.coding.code",
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.021",
            "comment": "FEV1 (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.023",
            "comment": "FVC (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.025",
            "comment": "FEV1% (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.027",
            "comment": "FEV1 Predicted"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.029",
            "comment": "FVC Predicted"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.031",
            "comment": "FEV1% Predicted"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.033",
            "comment": "FEV1% of Predicted (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.035",
            "comment": "FVC Ratio (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.037",
            "comment": "FEV1/FVC Ratio (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.039",
            "comment": "PEF Personal (Before-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.041",
            "comment": "FEV1 (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.043",
            "comment": "FVC (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.045",
            "comment": "FEV1% (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.047",
            "comment": "FEV1% of Predicted (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.049",
            "comment": "FVC Ratio (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.051",
            "comment": "FEV1/FVC Ratio (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.053",
            "comment": "PEF Personal (After-Puff)"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.055",
            "comment": "O2 Saturation"
          }
        ]
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://simplifier.net/omd-cdss/patientprofile"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "definition": "BASE RESOURCE DEFINITION: \r\nThe 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.",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.effective[x]:effectiveDateTime",
        "path": "Observation.effective[x]",
        "sliceName": "effectiveDateTime",
        "definition": "BASE RESOURCE DEFINITION: \r\nThe 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.\r\n\r\nCDS-S PROFILE DEFINITION: \r\nThe date the observation was measured.",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.022",
            "comment": "FEV1 (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.024",
            "comment": "FVC (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.026",
            "comment": "FEV1% (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.028",
            "comment": "FEV1 Predicted - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.030",
            "comment": "FVC Predicted (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.032",
            "comment": "FEV1% Predicted - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.034",
            "comment": "FEV1% of Predicted (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.036",
            "comment": "FVC Ratio (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.038",
            "comment": "FEV1/FVC Ratio (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.040",
            "comment": "PEF Personal (Before Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.042",
            "comment": "FEV1 (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.044",
            "comment": "FVC (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.046",
            "comment": "FEV1% (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.048",
            "comment": "FEV1% of Predicted (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.050",
            "comment": "FVC Ratio (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.052",
            "comment": "FEV1/FVC Ratio (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.054",
            "comment": "PEF Personal (After Puff) - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.056",
            "comment": "O2 Saturation - Date"
          }
        ]
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "profile",
              "path": "resolve()"
            }
          ],
          "rules": "open"
        },
        "constraint": [
          {
            "key": "ca-baseline-value-1",
            "severity": "error",
            "human": "Observation.value[x] or Observation.dataAbsentReason or Observation.component SHOULD be present",
            "expression": "value[x].exists() or dataAbsentReason.exists() or component.exists()",
            "xpath": "Observation.value[x] or Observation.dataAbsentReason or Observation.component",
            "source": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.value[x]:valueQuantity",
        "path": "Observation.valueQuantity",
        "sliceName": "valueQuantity",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "https://simplifier.net/omd-cdss/fev1prebronvalue",
              "https://simplifier.net/omd-cdss/fev1perofpredictedprebronvalue",
              "https://simplifier.net/omd-cdss/fev1predictedvalue",
              "https://simplifier.net/omd-cdss/fev1perofpredictedprebronvalue",
              "https://simplifier.net/omd-cdss/fev1perofpredictedpostbronvalue",
              "https://simplifier.net/omd-cdss/fev1fvcratioprebronvalue",
              "https://simplifier.net/omd-cdss/fvcprebronvalue",
              "https://simplifier.net/omd-cdss/fev1perprebronvalue",
              "https://simplifier.net/omd-cdss/fev1perpredictedvalue",
              "https://simplifier.net/omd-cdss/fvcratioprebronvalue",
              "https://simplifier.net/omd-cdss/fvcpredictedvalue",
              "https://simplifier.net/omd-cdss/pefpersonalprebronvalue",
              "https://simplifier.net/omd-cdss/fev1perpostbronvalue",
              "https://simplifier.net/omd-cdss/fvcpostbronvalue",
              "https://simplifier.net/omd-cdss/fev1fvcratiopostbronvalue",
              "https://simplifier.net/omd-cdss/fvcratiopostbronvalue",
              "https://simplifier.net/omd-cdss/pefpersonalpostbronvalue",
              "https://simplifier.net/omd-cdss/o2saturationvalue"
            ]
          }
        ]
      },
      {
        "id": "Observation.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "constraint": [
          {
            "key": "ca-baseline-value-1",
            "severity": "error",
            "human": "Observation.value[x] or Observation.dataAbsentReason or Observation.component SHOULD be present",
            "expression": "value[x].exists() or dataAbsentReason.exists() or component.exists()",
            "xpath": "Observation.value[x] or Observation.dataAbsentReason or Observation.component",
            "source": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.component.code",
        "path": "Observation.component.code",
        "comment": "The binding strength of this element is [Preferred](https://www.hl7.org/fhir/terminologies.html#strength), meaning that codes are encouraged to draw from the LOINC code system for interoperability purposes but are not required to do so to be considered conformant. *All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
        "mustSupport": true,
        "binding": {
          "strength": "preferred",
          "description": "LOINC codes identifying names of simple observations."
        }
      },
      {
        "id": "Observation.component.value[x]",
        "path": "Observation.component.value[x]",
        "constraint": [
          {
            "key": "ca-baseline-value-2",
            "severity": "error",
            "human": "Observation.component.value[x] or Observation.component.dataAbsentReason SHALL be present",
            "expression": "component.value[x].exists() or component.dataAbsentReason.exists()",
            "xpath": "Observation.component.value[x] or Observation.component.dataAbsentReason",
            "source": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.component.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "constraint": [
          {
            "key": "ca-baseline-value-2",
            "severity": "error",
            "human": "Observation.component.value[x] or Observation.component.dataAbsentReason SHALL be present",
            "expression": "component.value[x].exists() or component.dataAbsentReason.exists()",
            "xpath": "Observation.component.value[x] or Observation.component.dataAbsentReason",
            "source": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.value",
        "path": "Observation.value",
        "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value."
      }
    ]
  }
}