<status value="draft" /> <date value="2021-05-17T20:35:14.5079805+00:00" /> <publisher value="OMD" /> <description value="Proposed constraints on the Observation Resource for general use" /> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166" /> <code value="CA" /> <display value="Canada" /> </coding> </jurisdiction> <fhirVersion value="4.0.1" /> <mapping> <identity value="CDSS5.1" /> <uri value="www.ontariomd.com" /> <name value="CDS-S 5.1" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation" /> <derivation value="constraint" /> <differential> <element id="Observation"> <path value="Observation" /> <short value="Observation Profile" /> <definition value="The Observation Profile is based upon the core FHIR Observation Resource" /> </element> <element id="Observation.basedOn"> <path value="Observation.basedOn" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" /> <targetProfile value="https://simplifier.net/omd-cdss/medicationrequestprofile" /> </type> </element> <element id="Observation.partOf"> <path value="Observation.partOf" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" /> <targetProfile value="https://simplifier.net/omd-cdss/immunizationprofile" /> <targetProfile value="https://simplifier.net/omd-cdss/procedureprofile" /> <targetProfile value="https://simplifier.net/omd-cdss/medicationdispenseprofile" /> </type> </element> <element id="Observation.category"> <path value="Observation.category" /> <mustSupport value="true" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <slicing> <discriminator> <type value="profile" /> <path value="resolve()" /> </discriminator> <rules value="open" /> </slicing> <comment value="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 value="true" /> <binding> <strength value="preferred" /> <description value="LOINC codes identifying names of simple observations." /> </binding> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <type> <code value="Coding" /> <profile value="https://simplifier.net/omd-cdss/heartratecode" /> <profile value="https://simplifier.net/omd-cdss/heightcode" /> <profile value="https://simplifier.net/omd-cdss/weightcode" /> <profile value="https://simplifier.net/omd-cdss/bmicode" /> <profile value="https://simplifier.net/omd-cdss/waistcircumferencecode" /> <profile value="https://simplifier.net/omd-cdss/smokingstatuscode" /> <profile value="https://simplifier.net/omd-cdss/smokingfrequencycode" /> <profile value="https://simplifier.net/omd-cdss/alcoholusecode" /> <profile value="https://simplifier.net/omd-cdss/erectilefunctioncode" /> <profile value="https://simplifier.net/omd-cdss/bloodpressurepanelcode" /> </type> <mustSupport value="true" /> </element> <element id="Observation.code.coding.system"> <path value="Observation.code.coding.system" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.001" /> <comment value="Blood Pressure" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.003" /> <comment value="Heart Rate" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.005" /> <comment value="Height" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.007" /> <comment value="Weight" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.009" /> <comment value="BMI" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.011" /> <comment value="Waist Circumference" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.013" /> <comment value="Smoking Status" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.015" /> <comment value="Smoking Frequency" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.017" /> <comment value="Alcohol Use" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.019" /> <comment value="Erectile Function" /> </mapping> </element> <element id="Observation.code.coding.code"> <path value="Observation.code.coding.code" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.001" /> <comment value="Blood Pressure" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.003" /> <comment value="Heart Rate" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.005" /> <comment value="Height" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.007" /> <comment value="Weight" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.009" /> <comment value="BMI" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.011" /> <comment value="Waist Circumference" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.013" /> <comment value="Smoking Status" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.015" /> <comment value="Smoking Frequency" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.017" /> <comment value="Alcohol Use" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.019" /> <comment value="Erectile Function" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="https://simplifier.net/omd-cdss/patientprofile" /> </type> <mustSupport value="true" /> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <type> <code value="dateTime" /> </type> <mustSupport value="true" /> </element> <element id="Observation.effective[x]:effectiveDateTime"> <path value="Observation.effective[x]" /> <sliceName value="effectiveDateTime" /> <definition value="BASE RESOURCE DEFINITION: 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. CDS-S PROFILE DEFINITION: The date the observation was measured." /> <type> <code value="dateTime" /> </type> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.002" /> <comment value="Blood Pressure - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.004" /> <comment value="Heart Rate - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.006" /> <comment value="Height - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.008" /> <comment value="Weight - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.010" /> <comment value="BMI - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.012" /> <comment value="Waist Circumference - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.014" /> <comment value="Smoking Status - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.016" /> <comment value="Smoking Frequency - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.018" /> <comment value="Alcohol Use - Date" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE16.020" /> <comment value="Erectile Function - Date" /> </mapping> </element> <element id="Observation.performer"> <path value="Observation.performer" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> <targetProfile value="https://simplifier.net/omd-cdss/patientprofile" /> <targetProfile value="https://simplifier.net/omd-cdss/practitionerprofile" /> </type> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]" /> <slicing> <discriminator> <type value="profile" /> <path value="resolve()" /> </discriminator> <rules value="open" /> </slicing> <constraint> <key value="ca-baseline-value-1" /> <severity value="error" /> <human value="Observation.value[x] or Observation.dataAbsentReason or Observation.component SHOULD be present" /> <expression value="value[x].exists() or dataAbsentReason.exists() or component.exists()" /> <xpath value="Observation.value[x] or Observation.dataAbsentReason or Observation.component" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.value[x]:valueQuantity"> <path value="Observation.value[x]" /> <sliceName value="valueQuantity" /> <type> <code value="Quantity" /> <profile value="https://simplifier.net/omd-cdss/heartratevalue" /> <profile value="https://simplifier.net/omd-cdss/heightvalue" /> <profile value="https://simplifier.net/omd-cdss/weightvalue" /> <profile value="https://simplifier.net/omd-cdss/bmivalue" /> <profile value="https://simplifier.net/omd-cdss/waistcircumferencevalue" /> <profile value="https://simplifier.net/omd-cdss/smokingstatusvalue" /> <profile value="https://simplifier.net/omd-cdss/smokingfrequencyvalue" /> <profile value="https://simplifier.net/omd-cdss/alcoholusevalue" /> <profile value="https://simplifier.net/omd-cdss/erectilefunctionvalue" /> </type> <mustSupport value="true" /> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason" /> <constraint> <key value="ca-baseline-value-1" /> <severity value="error" /> <human value="Observation.value[x] or Observation.dataAbsentReason or Observation.component SHOULD be present" /> <expression value="value[x].exists() or dataAbsentReason.exists() or component.exists()" /> <xpath value="Observation.value[x] or Observation.dataAbsentReason or Observation.component" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.component"> <path value="Observation.component" /> <slicing> <discriminator> <type value="value" /> <path value="code.coding.code" /> </discriminator> <discriminator> <type value="value" /> <path value="code.coding.system" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Observation.component.code"> <path value="Observation.component.code" /> <comment value="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 value="true" /> <binding> <strength value="preferred" /> <description value="LOINC codes identifying names of simple observations." /> </binding> </element> <element id="Observation.component.value[x]"> <path value="Observation.component.value[x]" /> <constraint> <key value="ca-baseline-value-2" /> <severity value="error" /> <human value="Observation.component.value[x] or Observation.component.dataAbsentReason SHALL be present" /> <expression value="component.value[x].exists() or component.dataAbsentReason.exists()" /> <xpath value="Observation.component.value[x] or Observation.component.dataAbsentReason" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.component.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <constraint> <key value="ca-baseline-value-2" /> <severity value="error" /> <human value="Observation.component.value[x] or Observation.component.dataAbsentReason SHALL be present" /> <expression value="component.value[x].exists() or component.dataAbsentReason.exists()" /> <xpath value="Observation.component.value[x] or Observation.component.dataAbsentReason" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.component:SystolicBP"> <path value="Observation.component" /> <sliceName value="SystolicBP" /> </element> <element id="Observation.component:SystolicBP.code.coding.system"> <path value="Observation.component.code.coding.system" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.001" /> <comment value="Blood Pressure" /> </mapping> </element> <element id="Observation.component:SystolicBP.code.coding.code"> <path value="Observation.component.code.coding.code" /> <fixedCode value="8480-6" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.001" /> <comment value="Blood Pressure" /> </mapping> </element> <element id="Observation.component:SystolicBP.value[x]"> <path value="Observation.component.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity"> <path value="Observation.component.value[x]" /> <sliceName value="valueQuantity" /> <type> <code value="Quantity" /> <profile value="https://simplifier.net/omd-cdss/systolicbpvalue" /> </type> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity.value"> <path value="Observation.component.value[x].value" /> <definition value="BASE RESOURCE DEFINITION: The value of the measured amount. The value includes an implicit precision in the presentation of the value. CDS-S PROFILE DEFINITION: The systolic blood pressure as measured by the provider." /> <mustSupport value="true" /> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity.unit"> <path value="Observation.component.value[x].unit" /> <fixedString value="mm[Hg]" /> <mustSupport value="true" /> </element> <element id="Observation.component:SystolicBP.value[x]:valueQuantity.system"> <path value="Observation.component.value[x].system" /> <fixedUri value="http://unitsofmeasure.org" /> <mustSupport value="true" /> </element> <element id="Observation.component:DiastolicBP"> <path value="Observation.component" /> <sliceName value="DiastolicBP" /> </element> <element id="Observation.component:DiastolicBP.code.coding.system"> <path value="Observation.component.code.coding.system" /> <fixedUri value="http://loinc.org" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.001" /> <comment value="Blood Pressure" /> </mapping> </element> <element id="Observation.component:DiastolicBP.code.coding.code"> <path value="Observation.component.code.coding.code" /> <fixedCode value="8462-4" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE16.001" /> <comment value="Blood Pressure" /> </mapping> </element> <element id="Observation.component:DiastolicBP.value[x]"> <path value="Observation.component.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Observation.component:DiastolicBP.value[x]:valueQuantity"> <path value="Observation.component.value[x]" /> <sliceName value="valueQuantity" /> <type> <code value="Quantity" /> <profile value="https://simplifier.net/omd-cdss/diastolicbpvalue" /> </type> </element> </differential> </StructureDefinition>