{
  "resourceType": "StructureDefinition",
  "id": "profile-vitals",
  "meta": {
    "lastUpdated": "2021-10-27T01:28:30.44+00:00"
  },
  "url": "https://simplifier.net/omd-cdss/vitalsobservationprofile",
  "version": "0.2.0",
  "name": "VitalsObservationProfile",
  "title": "Observation Profile (Vitals)",
  "status": "draft",
  "date": "2021-05-17T20:35:14.5079805+00:00",
  "publisher": "OMD",
  "description": "Proposed constraints on the Observation Resource for general use",
  "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.basedOn",
        "path": "Observation.basedOn",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/CarePlan",
              "http://hl7.org/fhir/StructureDefinition/DeviceRequest",
              "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
              "http://hl7.org/fhir/StructureDefinition/NutritionOrder",
              "http://hl7.org/fhir/StructureDefinition/ServiceRequest",
              "https://simplifier.net/omd-cdss/medicationrequestprofile"
            ]
          }
        ]
      },
      {
        "id": "Observation.partOf",
        "path": "Observation.partOf",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
              "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
              "http://hl7.org/fhir/StructureDefinition/ImagingStudy",
              "https://simplifier.net/omd-cdss/immunizationprofile",
              "https://simplifier.net/omd-cdss/procedureprofile",
              "https://simplifier.net/omd-cdss/medicationdispenseprofile"
            ]
          }
        ]
      },
      {
        "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/heartratecode",
              "https://simplifier.net/omd-cdss/heightcode",
              "https://simplifier.net/omd-cdss/weightcode",
              "https://simplifier.net/omd-cdss/bmicode",
              "https://simplifier.net/omd-cdss/waistcircumferencecode",
              "https://simplifier.net/omd-cdss/smokingstatuscode",
              "https://simplifier.net/omd-cdss/smokingfrequencycode",
              "https://simplifier.net/omd-cdss/alcoholusecode",
              "https://simplifier.net/omd-cdss/erectilefunctioncode",
              "https://simplifier.net/omd-cdss/bloodpressurepanelcode"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.code.coding.system",
        "path": "Observation.code.coding.system",
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.001",
            "comment": "Blood Pressure"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.003",
            "comment": "Heart Rate"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.005",
            "comment": "Height"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.007",
            "comment": "Weight"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.009",
            "comment": "BMI"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.011",
            "comment": "Waist Circumference"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.013",
            "comment": "Smoking Status"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.015",
            "comment": "Smoking Frequency"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.017",
            "comment": "Alcohol Use"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.019",
            "comment": "Erectile Function"
          }
        ]
      },
      {
        "id": "Observation.code.coding.code",
        "path": "Observation.code.coding.code",
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.001",
            "comment": "Blood Pressure"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.003",
            "comment": "Heart Rate"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.005",
            "comment": "Height"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.007",
            "comment": "Weight"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.009",
            "comment": "BMI"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.011",
            "comment": "Waist Circumference"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.013",
            "comment": "Smoking Status"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.015",
            "comment": "Smoking Frequency"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.017",
            "comment": "Alcohol Use"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.019",
            "comment": "Erectile Function"
          }
        ]
      },
      {
        "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"
        },
        "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": "DE16.002",
            "comment": "Blood Pressure - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.004",
            "comment": "Heart Rate - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.006",
            "comment": "Height - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.008",
            "comment": "Weight - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.010",
            "comment": "BMI - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.012",
            "comment": "Waist Circumference - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.014",
            "comment": "Smoking Status - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.016",
            "comment": "Smoking Frequency - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.018",
            "comment": "Alcohol Use - Date"
          },
          {
            "identity": "CDSS5.1",
            "map": "DE16.020",
            "comment": "Erectile Function - Date"
          }
        ]
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
              "http://hl7.org/fhir/StructureDefinition/Organization",
              "http://hl7.org/fhir/StructureDefinition/CareTeam",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
              "https://simplifier.net/omd-cdss/patientprofile",
              "https://simplifier.net/omd-cdss/practitionerprofile"
            ]
          }
        ]
      },
      {
        "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.value[x]",
        "sliceName": "valueQuantity",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "https://simplifier.net/omd-cdss/heartratevalue",
              "https://simplifier.net/omd-cdss/heightvalue",
              "https://simplifier.net/omd-cdss/weightvalue",
              "https://simplifier.net/omd-cdss/bmivalue",
              "https://simplifier.net/omd-cdss/waistcircumferencevalue",
              "https://simplifier.net/omd-cdss/smokingstatusvalue",
              "https://simplifier.net/omd-cdss/smokingfrequencyvalue",
              "https://simplifier.net/omd-cdss/alcoholusevalue",
              "https://simplifier.net/omd-cdss/erectilefunctionvalue"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "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",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code.coding.code"
            },
            {
              "type": "value",
              "path": "code.coding.system"
            }
          ],
          "rules": "open"
        }
      },
      {
        "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.component:SystolicBP",
        "path": "Observation.component",
        "sliceName": "SystolicBP"
      },
      {
        "id": "Observation.component:SystolicBP.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.001",
            "comment": "Blood Pressure"
          }
        ]
      },
      {
        "id": "Observation.component:SystolicBP.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "8480-6",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.001",
            "comment": "Blood Pressure"
          }
        ]
      },
      {
        "id": "Observation.component:SystolicBP.value[x]",
        "path": "Observation.component.value[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:SystolicBP.value[x]:valueQuantity",
        "path": "Observation.component.value[x]",
        "sliceName": "valueQuantity",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "https://simplifier.net/omd-cdss/systolicbpvalue"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:SystolicBP.value[x]:valueQuantity.value",
        "path": "Observation.component.value[x].value",
        "definition": "BASE RESOURCE DEFINITION:\r\nThe value of the measured amount. The value includes an implicit precision in the presentation of the value.\r\n\r\nCDS-S PROFILE DEFINITION:\r\nThe systolic blood pressure as measured by the provider.",
        "mustSupport": true
      },
      {
        "id": "Observation.component:SystolicBP.value[x]:valueQuantity.unit",
        "path": "Observation.component.value[x].unit",
        "fixedString": "mm[Hg]",
        "mustSupport": true
      },
      {
        "id": "Observation.component:SystolicBP.value[x]:valueQuantity.system",
        "path": "Observation.component.value[x].system",
        "fixedUri": "http://unitsofmeasure.org",
        "mustSupport": true
      },
      {
        "id": "Observation.component:DiastolicBP",
        "path": "Observation.component",
        "sliceName": "DiastolicBP"
      },
      {
        "id": "Observation.component:DiastolicBP.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.001",
            "comment": "Blood Pressure"
          }
        ]
      },
      {
        "id": "Observation.component:DiastolicBP.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "8462-4",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "CDSS5.1",
            "map": "DE16.001",
            "comment": "Blood Pressure"
          }
        ]
      },
      {
        "id": "Observation.component:DiastolicBP.value[x]",
        "path": "Observation.component.value[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:DiastolicBP.value[x]:valueQuantity",
        "path": "Observation.component.value[x]",
        "sliceName": "valueQuantity",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "https://simplifier.net/omd-cdss/diastolicbpvalue"
            ]
          }
        ]
      }
    ]
  }
}