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 <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Vital Signs Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <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="FHIR Vital Signs Profile" /> <definition value="The FHIR Vitals Signs profile sets a minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Coded Responses from C-CDA Vital Sign Results" /> <definition value="Coded Responses from C-CDA Vital Sign Results." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Vital Signs Profile" /> <definition value="The FHIR Vitals Signs profile sets a minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient." /> <alias value="Vital Signs" /> <alias value="Measurement" /> <alias value="Results" /> <alias value="Tests" /> <min value="0" /> <max value="*" /> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> </element> <element id="Observation.status"> <path value="Observation.status" /> <min value="1" /> <max value="1" /> <type> <code value="code" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> </element> <element id="Observation.category"> <path value="Observation.category" /> <min value="1" /> <max value="*" /> <type> <code value="CodeableConcept" /> </type> <condition value="vs-4" /> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Coded Responses from C-CDA Vital Sign Results" /> <definition value="Coded Responses from C-CDA Vital Sign Results." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <mustSupport value="true" /> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]" /> <short value="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <min value="1" /> <max value="1" /> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <condition value="vs-1" /> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <condition value="vs-2" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <min value="1" /> <max value="1" /> <type> <code value="decimal" /> </type> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.unit"> <path value="Observation.valueQuantity.unit" /> <min value="1" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <min value="1" /> <max value="1" /> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <min value="1" /> <max value="1" /> <type> <code value="code" /> </type> <mustSupport value="true" /> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <condition value="vs-2" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> </element> <element id="Observation.related"> <path value="Observation.related" /> <short value="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <mustSupport value="true" /> </element> <element id="Observation.related.type"> <path value="Observation.related.type" /> <min value="1" /> <max value="1" /> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> </element> <element id="Observation.related.target"> <path value="Observation.related.target" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> </type> <mustSupport value="true" /> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.component.code"> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> </element> <element id="Observation.component.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <requirements value="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <condition value="vs-3" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <min value="1" /> <max value="1" /> <type> <code value="decimal" /> </type> <mustSupport value="true" /> </element> <element id="Observation.component.valueQuantity.unit"> <path value="Observation.component.valueQuantity.unit" /> <min value="1" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <min value="1" /> <max value="1" /> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <mustSupport value="true" /> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <min value="1" /> <max value="1" /> <type> <code value="code" /> </type> <mustSupport value="true" /> </element> <element id="Observation.component.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <condition value="vs-3" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/bodyweight" /> <resource> <StructureDefinition> <id value="bodyweight" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'29463-7'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. `Observation.valueQuantity.code` = **'kg', 'g', or '[lb_av]'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/bodyweight" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Body Weight Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Body Weight Profile" /> <definition value="This profile defines how to represent body weight observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Body Weight" /> <definition value="Body Weight." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode"> <path value="Observation.code.coding" /> <sliceName value="BodyWeightCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="29463-7" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyWeightUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Weight" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodyweight" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Body Weight Profile" /> <definition value="This profile defines how to represent body weight observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Body Weight" /> <definition value="Body Weight." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bodyweightcode"> <path value="Observation.code.coding" /> <sliceName value="BodyWeightCode" /> </element> <element id="Observation.code.coding:bodyweightcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bodyweightcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="29463-7" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyWeightUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Weight" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodyweight" /> </valueSetReference> </binding> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/resprate" /> <resource> <StructureDefinition> <id value="resprate" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'9279-1'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'/min'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/resprate" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Respiratory Rate Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Respiratory Rate Profile" /> <definition value="This profile defines how to represent Respiratory Rate observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Respiratory Rate" /> <definition value="Respiratory Rate." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:respratecode"> <path value="Observation.code.coding" /> <sliceName value="RespRateCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:respratecode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:respratecode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:respratecode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:respratecode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:respratecode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="9279-1" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:respratecode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:respratecode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="/min" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Respiratory Rate Profile" /> <definition value="This profile defines how to represent Respiratory Rate observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Respiratory Rate" /> <definition value="Respiratory Rate." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:respratecode"> <path value="Observation.code.coding" /> <sliceName value="RespRateCode" /> </element> <element id="Observation.code.coding:respratecode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:respratecode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="9279-1" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <type> <code value="code" /> </type> <fixedCode value="/min" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/heartrate" /> <resource> <StructureDefinition> <id value="heartrate" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'8867-4'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'/min'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/heartrate" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Heart Rate Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Heart Rate Profile" /> <definition value="This profile defines how to represent heart rate observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Heart Rate" /> <definition value="Heart Rate." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:heartratecode"> <path value="Observation.code.coding" /> <sliceName value="HeartRateCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8867-4" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:heartratecode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="/min" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Heart Rate Profile" /> <definition value="This profile defines how to represent heart rate observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Heart Rate" /> <definition value="Heart Rate." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:heartratecode"> <path value="Observation.code.coding" /> <sliceName value="HeartRateCode" /> </element> <element id="Observation.code.coding:heartratecode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:heartratecode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8867-4" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <type> <code value="code" /> </type> <fixedCode value="/min" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/bodytemp" /> <resource> <StructureDefinition> <id value="bodytemp" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'8310-5'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'Cel', or '[degF]'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/bodytemp" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Body Temperature Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Body Temperature Profile" /> <definition value="This profile defines how to represent Body Temperature observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Body Temperature" /> <definition value="Body Temperature." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode"> <path value="Observation.code.coding" /> <sliceName value="BodyTempCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8310-5" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bodytempcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyTempUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Temperature" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodytemp" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Body Temperature Profile" /> <definition value="This profile defines how to represent Body Temperature observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Body Temperature" /> <definition value="Body Temperature." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bodytempcode"> <path value="Observation.code.coding" /> <sliceName value="BodyTempCode" /> </element> <element id="Observation.code.coding:bodytempcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bodytempcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8310-5" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyTempUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Temperature" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodytemp" /> </valueSetReference> </binding> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/bodyheight" /> <resource> <StructureDefinition> <id value="bodyheight" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'8302-2'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'cm', or '[in_i]'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/bodyheight" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Body Height Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Body Height Profile" /> <definition value="This profile defines how to represent Body Height observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Body Height" /> <definition value="Body Height." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode"> <path value="Observation.code.coding" /> <sliceName value="BodyHeightCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8302-2" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bodyheightcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Length measures such as Body Height and Head Circumference" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodylength" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Body Height Profile" /> <definition value="This profile defines how to represent Body Height observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Body Height" /> <definition value="Body Height." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bodyheightcode"> <path value="Observation.code.coding" /> <sliceName value="BodyHeightCode" /> </element> <element id="Observation.code.coding:bodyheightcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bodyheightcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8302-2" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Length measures such as Body Height and Head Circumference" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodylength" /> </valueSetReference> </binding> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/bodylength" /> <resource> <StructureDefinition> <id value="bodylength" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'8306-3'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'cm', or '[in_i]'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/bodylength" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Body Length Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Body Length Profile" /> <definition value="This profile defines how to represent Body Length observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Body Length" /> <definition value="Body Length." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode"> <path value="Observation.code.coding" /> <sliceName value="BodyLengthCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8306-3" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bodylengthcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Length measures such as Body Height and Head Circumference" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodylength" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Body Length Profile" /> <definition value="This profile defines how to represent Body Length observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Body Length" /> <definition value="Body Length." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bodylengthcode"> <path value="Observation.code.coding" /> <sliceName value="BodyLengthCode" /> </element> <element id="Observation.code.coding:bodylengthcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bodylengthcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8306-3" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Length measures such as Body Height and Head Circumference" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodylength" /> </valueSetReference> </binding> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/headcircum" /> <resource> <StructureDefinition> <id value="headcircum" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'8287-5'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'cm', or '[in_i]'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/headcircum" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Head Circumference Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Head Circumference Profile" /> <definition value="This profile defines how to represent Head Circumference observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Head Circumference" /> <definition value="Head Circumference." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode"> <path value="Observation.code.coding" /> <sliceName value="HeadCircumCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8287-5" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:headcircumcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Length measures such as Body Height and Head Circumference" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodylength" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Head Circumference Profile" /> <definition value="This profile defines how to represent Head Circumference observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Head Circumference" /> <definition value="Head Circumference." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:headcircumcode"> <path value="Observation.code.coding" /> <sliceName value="HeadCircumCode" /> </element> <element id="Observation.code.coding:headcircumcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:headcircumcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8287-5" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodyLengthUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for Body Length measures such as Body Height and Head Circumference" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-bodylength" /> </valueSetReference> </binding> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/oxygensat" /> <resource> <StructureDefinition> <id value="oxygensat" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value=""####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'59408-5'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'%'** "" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/oxygensat" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Oxygen Saturation Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Oxygen Saturation Profile" /> <definition value="This profile defines how to represent Oxygen Saturation observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Oxygen Saturation" /> <definition value="Oxygen Saturation." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode"> <path value="Observation.code.coding" /> <sliceName value="OxygenSatCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="59408-5" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:oxygensatcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="%" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Oxygen Saturation Profile" /> <definition value="This profile defines how to represent Oxygen Saturation observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Oxygen Saturation" /> <definition value="Oxygen Saturation." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:oxygensatcode"> <path value="Observation.code.coding" /> <sliceName value="OxygenSatCode" /> </element> <element id="Observation.code.coding:oxygensatcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:oxygensatcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="59408-5" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <type> <code value="code" /> </type> <fixedCode value="%" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/bmi" /> <resource> <StructureDefinition> <id value="bmi" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'39156-5'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. a fixed`Observation.valueQuantity.code` = **'kg/m2'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/bmi" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Body Mass Index (BMI) Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Body Mass Index (BMI) Profile" /> <definition value="This profile defines how to represent Body Mass Index (BMI) observations in FHIR using a standard LOINC code and UCUM units of measure." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Body Mass Index (BMI)" /> <definition value="Body Mass Index (BMI)." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bmicode"> <path value="Observation.code.coding" /> <sliceName value="BMICode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bmicode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bmicode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bmicode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bmicode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bmicode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="39156-5" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bmicode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bmicode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="kg/m2" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Body Mass Index (BMI) Profile" /> <definition value="This profile defines how to represent Body Mass Index (BMI) observations in FHIR using a standard LOINC code and UCUM units of measure." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Body Mass Index (BMI)" /> <definition value="Body Mass Index (BMI)." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bmicode"> <path value="Observation.code.coding" /> <sliceName value="BMICode" /> </element> <element id="Observation.code.coding:bmicode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bmicode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="39156-5" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <type> <code value="code" /> </type> <fixedCode value="kg/m2" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/bp" /> <resource> <StructureDefinition> <id value="bp" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **85354-9'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 2. One `Observation.component.code` which must have - a fixed `Observation.component.code.coding.system`=**'http://loinc.org'** - fixed `Observation.component.code.coding.code`= **'8480-6'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 3. One `Observation.component.code` which must have - a fixed `Observation.component.code.coding.system`=**'http://loinc.org'** - fixed `Observation.component.code.coding.code`= **'8462-4'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 4. fixed`Observation.component.valueQuantity.code` = **'mm[Hg]'**" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/bp" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Blood Pressure Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Blood Pressure Profile" /> <definition value="This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure. This is a grouping structure. It has no value in Observation.valueQuantity but contains at least one component (systolic and/or diastolic)." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Blood Pressure" /> <definition value="Blood Pressure." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Test" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bpcode"> <path value="Observation.code.coding" /> <sliceName value="BPCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bpcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bpcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bpcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bpcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bpcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="85354-9" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bpcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bpcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <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> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="Observation.component" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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:systolicbp"> <path value="Observation.component" /> <sliceName value="SystolicBP" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="Observation.component" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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:systolicbp.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.extension"> <path value="Observation.component.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:systolicbp.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="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="Knowing what kind of observation is being made is essential to understanding the observation." /> <alias value="Component Test" /> <alias value="Component Name" /> <min value="1" /> <max value="1" /> <base> <path value="Observation.component.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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:systolicbp.code.id"> <path value="Observation.component.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.code.extension"> <path value="Observation.component.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding"> <path value="Observation.component.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode"> <path value="Observation.component.code.coding" /> <sliceName value="SBPCode" /> <short value="Systolic Blood Pressure" /> <definition value="Systolic Blood Pressure." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.id"> <path value="Observation.component.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.extension"> <path value="Observation.component.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.system"> <path value="Observation.component.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.version"> <path value="Observation.component.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.code"> <path value="Observation.component.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8480-6" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.userSelected"> <path value="Observation.component.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.component:systolicbp.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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:systolicbp.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component:systolicbp.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="mm[Hg]" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </mapping> </element> <element id="Observation.component:systolicbp.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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:systolicbp.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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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:systolicbp.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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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:diastolicbp"> <path value="Observation.component" /> <sliceName value="DiastolicBP" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="Observation.component" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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:diastolicbp.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.extension"> <path value="Observation.component.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.component:diastolicbp.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="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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:diastolicbp.code.id"> <path value="Observation.component.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.extension"> <path value="Observation.component.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding"> <path value="Observation.component.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode"> <path value="Observation.component.code.coding" /> <sliceName value="DBPCode" /> <short value="Diastolic Blood Pressure" /> <definition value="Diastolic Blood Pressure." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.id"> <path value="Observation.component.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.extension"> <path value="Observation.component.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.system"> <path value="Observation.component.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.version"> <path value="Observation.component.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.code"> <path value="Observation.component.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="8462-4" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.userSelected"> <path value="Observation.component.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.component:diastolicbp.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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:diastolicbp.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component:diastolicbp.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="mm[Hg]" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </mapping> </element> <element id="Observation.component:diastolicbp.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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="value.nullFlavor" /> </mapping> </element> <element id="Observation.component:diastolicbp.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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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:diastolicbp.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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Blood Pressure Profile" /> <definition value="This profile defines how to represent Blood Pressure observations in FHIR using a standard LOINC code and UCUM units of measure. This is a grouping structure. It has no value in Observation.valueQuantity but contains at least one component (systolic and/or diastolic)." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Blood Pressure" /> <definition value="Blood Pressure." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Test" /> <alias value="Name" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bpcode"> <path value="Observation.code.coding" /> <sliceName value="BPCode" /> </element> <element id="Observation.code.coding:bpcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bpcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="85354-9" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <min value="0" /> <max value="0" /> </element> <element id="Observation.component"> <path value="Observation.component" /> <slicing> <discriminator> <type value="value" /> <path value="code.coding.code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.component:systolicbp"> <path value="Observation.component" /> <sliceName value="SystolicBP" /> </element> <element id="Observation.component:systolicbp.code"> <path value="Observation.component.code" /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Component Test" /> <alias value="Component Name" /> </element> <element id="Observation.component:systolicbp.code.coding"> <path value="Observation.component.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode"> <path value="Observation.component.code.coding" /> <sliceName value="SBPCode" /> <short value="Systolic Blood Pressure" /> <definition value="Systolic Blood Pressure." /> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.system"> <path value="Observation.component.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.component:systolicbp.code.coding:sbpcode.code"> <path value="Observation.component.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8480-6" /> </element> <element id="Observation.component:systolicbp.valueQuantity"> <path value="Observation.component.valueQuantity" /> <type> <code value="Quantity" /> </type> </element> <element id="Observation.component:systolicbp.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <type> <code value="code" /> </type> <fixedCode value="mm[Hg]" /> </element> <element id="Observation.component:diastolicbp"> <path value="Observation.component" /> <sliceName value="DiastolicBP" /> </element> <element id="Observation.component:diastolicbp.code"> <path value="Observation.component.code" /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> </element> <element id="Observation.component:diastolicbp.code.coding"> <path value="Observation.component.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode"> <path value="Observation.component.code.coding" /> <sliceName value="DBPCode" /> <short value="Diastolic Blood Pressure" /> <definition value="Diastolic Blood Pressure." /> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.system"> <path value="Observation.component.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.component:diastolicbp.code.coding:dbpcode.code"> <path value="Observation.component.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="8462-4" /> </element> <element id="Observation.component:diastolicbp.valueQuantity"> <path value="Observation.component.valueQuantity" /> <type> <code value="Quantity" /> </type> </element> <element id="Observation.component:diastolicbp.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <type> <code value="code" /> </type> <fixedCode value="mm[Hg]" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/vitalspanel" /> <resource> <StructureDefinition> <id value="vitalspanel" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="####Complete Summary of the Mandatory Requirements 1. One code in `Observation.code` which must have - a fixed `Observation.code.coding.system`=**'http ://loinc.org'** - a fixed `Observation.code.coding.code`= **'85353-1'** - Other additional codes are allowed - e.g. more specific LOINC Codes, SNOMED CT concepts, system specific codes. All codes SHALL have an system value 1. No value in `Observation.value[x]` 1. At Least one Vitals Sign Observation reference in `Observation.related`" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/vitalspanel" /> <name value="Vital Signs Profile" /> <title value="VitalSigns" /> <status value="draft" /> <experimental value="false" /> <date value="2016-03-25" /> <publisher value="Health Level Seven International (Orders and Observations Workgroup)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations" /> </telecom> </contact> <description value="FHIR Vital Signs Panel Profile" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/vitalsigns" /> <derivation value="constraint" /> <snapshot> <element id="Observation"> <path value="Observation" /> <short value="FHIR Vital Signs Panel Profile" /> <definition value="This profile defines the top-level grouping structure for a set of vital signs. It has no value in Observation.valueQuantity ; instead, it just includes related links (with type=has-member) to the Observations in this set (e.g. respiratory rate, heart rate, BP)." /> <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="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="Observation" /> </constraint> <constraint> <key value="vs-2" /> <severity value="error" /> <human value="If there is no component or related element then either a value[x] or a data absent reason must be present" /> <expression value="(component.empty() and related.empty()) implies (dataAbsentReason or value)" /> <xpath value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> <source value="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <mustSupport value="true" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Status" /> </extension> <strength value="required" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status" /> </valueSetReference> </binding> <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="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <constraint> <key value="vs-4" /> <severity value="error" /> <human value="Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'" /> <expression value="where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()" /> <xpath value="exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])" /> </constraint> <mustSupport value="true" /> <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=".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="Vital Signs Panel" /> <definition value="Vital Signs Panel." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <requirements value="5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301)." /> <alias value="Name" /> <alias value="Panel Name" /> <alias value="Panel Code" /> <min value="1" /> <max value="1" /> <base> <path value="Observation.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.code.id"> <path value="Observation.code.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.extension"> <path value="Observation.code.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode"> <path value="Observation.code.coding" /> <sliceName value="BodyWeightCode" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.id"> <path value="Observation.code.coding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.extension"> <path value="Observation.code.coding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.system"> <path value="Observation.code.coding.system" /> <short value="Identity of the terminology system" /> <definition value="The identification of the code system that defines the meaning of the symbol in the code." /> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." /> <requirements value="Need to be unambiguous about the source of the definition of the symbol." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.3" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystem" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.version"> <path value="Observation.code.coding.version" /> <short value="Version of the system - if relevant" /> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." /> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./codeSystemVersion" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.code"> <path value="Observation.code.coding.code" /> <short value="Symbol in syntax defined by the system" /> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." /> <requirements value="Need to refer to a particular code in the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="85353-1" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.coding.display" /> <short value="Representation defined by the system" /> <definition value="A representation of the meaning of the code in the system, following the rules of the system." /> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.display" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.2 - but note this is not well followed" /> </mapping> <mapping> <identity value="rim" /> <map value="CV.displayName" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" /> </mapping> </element> <element id="Observation.code.coding:bodyweightcode.userSelected"> <path value="Observation.code.coding.userSelected" /> <short value="If this coding was chosen directly by the user" /> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." /> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." /> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." /> <min value="0" /> <max value="1" /> <base> <path value="Coding.userSelected" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="Sometimes implied by being first" /> </mapping> <mapping> <identity value="rim" /> <map value="CD.codingRationale" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" /> </mapping> </element> <element id="Observation.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <short value="Who and/or what this is about" /> <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> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <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> <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="Often just a dateTime for Vital Signs" /> <definition value="Often just a dateTime for Vital Signs." /> <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="1" /> <max value="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <constraint> <key value="vs-1" /> <severity value="error" /> <human value="Datetime must be at least to day." /> <expression value="($this as dateTime).toString().length() >= 8" /> <xpath value="f:matches(effectiveDateTime,/\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="*" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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))" /> </constraint> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <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="obs-3" /> <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)." /> <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="obs-3" /> <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> <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="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> <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="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." /> <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> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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="Used when reporting vital signs panel components" /> <definition value="Used when reporting vital signs panel components." /> <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="1" /> <max value="*" /> <base> <path value="Observation.related" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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="1" /> <max value="1" /> <base> <path value="Observation.related.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="has-member" /> <mustSupport value="true" /> <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="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." /> <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/vitalsigns" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <short value="Used when reporting systolic and diastolic blood pressure." /> <definition value="Used when reporting systolic and diastolic blood pressure." /> <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="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="vs-3" /> <severity value="error" /> <human value="If there is no a value a data absent reason must be present" /> <expression value="value.exists() or dataAbsentReason.exists()" /> <xpath value="exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSigns" /> </extension> <strength value="extensible" /> <description value="This identifies the vital sign result type." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-vitalsignresult" /> </valueSetReference> </binding> <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.valueQuantity"> <path value="Observation.component.valueQuantity" /> <short value="Vital Sign Value recorded with UCUM" /> <definition value="Vital Sign Value recorded with UCUM." /> <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="9. SHALL contain exactly one [1..1] value with @xsi:type="PQ" (CONF:7305)." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.component.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="VitalSignsUnits" /> </extension> <strength value="required" /> <description value="Common UCUM units for recording Vital Signs" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-vitals-common" /> </valueSetReference> </binding> <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.valueQuantity.id"> <path value="Observation.component.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.extension"> <path value="Observation.component.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.valueQuantity.value"> <path value="Observation.component.valueQuantity.value" /> <short value="Numerical value (with implicit precision)" /> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.component.valueQuantity.comparator"> <path value="Observation.component.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.component.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.component.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.component.valueQuantity.system"> <path value="Observation.component.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.component.valueQuantity.code"> <path value="Observation.component.valueQuantity.code" /> <short value="Coded responses from the common UCUM units for vital signs value set." /> <definition value="Coded responses from the common UCUM units for vital signs value set." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DAR" /> </extension> <strength value="extensible" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-valueabsentreason" /> </valueSetReference> </binding> <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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="FHIR Vital Signs Panel Profile" /> <definition value="This profile defines the top-level grouping structure for a set of vital signs. It has no value in Observation.valueQuantity ; instead, it just includes related links (with type=has-member) to the Observations in this set (e.g. respiratory rate, heart rate, BP)." /> <min value="0" /> <max value="*" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Vital Signs Panel" /> <definition value="Vital Signs Panel." /> <comment value="additional codes that translate or map to this code are allowed. For example a more granular LOINC code or code that is used locally in a system." /> <alias value="Panel Name" /> <alias value="Panel Code" /> </element> <element id="Observation.code.coding"> <path value="Observation.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="code" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Observation.code.coding:bodyweightcode"> <path value="Observation.code.coding" /> <sliceName value="BodyWeightCode" /> </element> <element id="Observation.code.coding:bodyweightcode.system"> <path value="Observation.code.coding.system" /> <type> <code value="uri" /> </type> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding:bodyweightcode.code"> <path value="Observation.code.coding.code" /> <type> <code value="code" /> </type> <fixedCode value="85353-1" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <min value="0" /> <max value="0" /> </element> <element id="Observation.related"> <path value="Observation.related" /> <min value="1" /> <max value="*" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/lipidprofile" /> <resource> <StructureDefinition> <id value="lipidprofile" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-summary"> <valueMarkdown value="This is a test summary [lipids](observation.html)" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="1" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/lipidprofile" /> <name value="Example Lipid Profile" /> <status value="draft" /> <experimental value="true" /> <date value="2012-05-12" /> <publisher value="Grahame Grieve" /> <contact> <telecom> <system value="url" /> <value value="grahame@healthintersections.com.au" /> </telecom> </contact> <description value="Lipid Lab Report" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="DiagnosticReport" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> <derivation value="constraint" /> <snapshot> <element id="DiagnosticReport"> <path value="DiagnosticReport" /> <short value="Lipid Lab Report" /> <definition value="The findings and interpretation of a general lipd lab profile." /> <comment value="In this profile, mustSupport means that authoring systems must include the ability to report these elements, and processing systems must cater for them by either displaying them to the user or considering them appropriately in decision support systems." /> <alias value="Report" /> <alias value="Test" /> <alias value="Result" /> <alias value="Results" /> <alias value="Labs" /> <alias value="Laboratory" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport" /> <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="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="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="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="DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="v2" /> <map value="ORU -> OBR" /> </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="DiagnosticReport.id"> <path value="DiagnosticReport.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> <isSummary value="true" /> </element> <element id="DiagnosticReport.meta"> <path value="DiagnosticReport.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> <isSummary value="true" /> </element> <element id="DiagnosticReport.implicitRules"> <path value="DiagnosticReport.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="DiagnosticReport.language"> <path value="DiagnosticReport.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="DiagnosticReport.text"> <path value="DiagnosticReport.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="DiagnosticReport.contained"> <path value="DiagnosticReport.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="N/A" /> </mapping> </element> <element id="DiagnosticReport.extension"> <path value="DiagnosticReport.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.modifierExtension"> <path value="DiagnosticReport.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.identifier"> <path value="DiagnosticReport.identifier" /> <short value="Business identifier for report" /> <definition value="Identifiers assigned to this report by the performer or other systems." /> <comment value="Usually assigned by the Information System of the diagnostic service provider (filler id)." /> <requirements value="Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context." /> <alias value="ReportID" /> <alias value="Filler ID" /> <alias value="Placer ID" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-51" /> </mapping> <mapping> <identity value="rim" /> <map value="id" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="DiagnosticReport.basedOn"> <path value="DiagnosticReport.basedOn" /> <short value="What was requested" /> <definition value="Details concerning a test or procedure requested." /> <comment value="Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports." /> <requirements value="This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon." /> <alias value="Request" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.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/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> <mapping> <identity value="workflow" /> <map value="Event.basedOn" /> </mapping> <mapping> <identity value="v2" /> <map value="ORC? OBR-2/3?" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=FLFS].target" /> </mapping> </element> <element id="DiagnosticReport.status"> <path value="DiagnosticReport.status" /> <short value="registered | partial | preliminary | final +" /> <definition value="The status of the diagnostic report as a whole." /> <comment value="This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn." /> <requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportStatus" /> </extension> <strength value="required" /> <description value="The status of the diagnostic report as a whole." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/diagnostic-report-status" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-25 (not 1:1 mapping)" /> </mapping> <mapping> <identity value="rim" /> <map value="statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"" /> </mapping> <mapping> <identity value="w5" /> <map value="status" /> </mapping> </element> <element id="DiagnosticReport.category"> <path value="DiagnosticReport.category" /> <short value="Service category" /> <definition value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes." /> <comment value="The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code." /> <alias value="Department" /> <alias value="Sub-department" /> <alias value="Service" /> <alias value="Discipline" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.category" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticServiceSection" /> </extension> <strength value="example" /> <description value="Codes for diagnostic service sections." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OBR-24" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code" /> <short value="LOINC Code for Lipid Panel with LDL" /> <definition value="LOINC Code for Lipid Panel with LDL." /> <comment value="LOINC code includes "direct" LDL - does this mean LDL derived by measuring VLDL by ultracentrifugation? This panel includes both measured and calculated LDL." /> <alias value="Type" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="57698-3" /> <display value="Lipid panel with direct LDL - Serum or Plasma" /> </coding> </fixedCodeableConcept> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportCodes" /> </extension> <strength value="preferred" /> <description value="Codes that describe Diagnostic Reports." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/report-codes" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.code" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="DiagnosticReport.subject"> <path value="DiagnosticReport.subject" /> <short value="The subject of the report - usually, but not always, the patient" /> <definition value="The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources." /> <requirements value="SHALL know the subject context." /> <alias value="Patient" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.subject" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.subject" /> </mapping> <mapping> <identity value="v2" /> <map value="PID-3 (no HL7 v2 mapping for Group or Device)" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.focus" /> </mapping> </element> <element id="DiagnosticReport.context"> <path value="DiagnosticReport.context" /> <short value="Health care event when test ordered" /> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about." /> <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="Links the request to the Encounter context." /> <alias value="Encounter" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.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> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.context" /> </mapping> <mapping> <identity value="v2" /> <map value="PV1-19" /> </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="DiagnosticReport.effective[x]"> <path value="DiagnosticReport.effective[x]" /> <short value="Clinically relevant time/time-period for report" /> <definition value="The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself." /> <comment value="If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic." /> <requirements value="Need to know where in the patient history to file/present this report." /> <alias value="Observation time" /> <alias value="Effective Time" /> <alias value="Occurrence" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.occurrence[x]" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-7" /> </mapping> <mapping> <identity value="rim" /> <map value="effectiveTime" /> </mapping> <mapping> <identity value="w5" /> <map value="when.done" /> </mapping> </element> <element id="DiagnosticReport.issued"> <path value="DiagnosticReport.issued" /> <short value="DateTime this version was released" /> <definition value="The date and time that this version of the report was released from the source diagnostic service." /> <comment value="May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report." /> <requirements value="Clinicians need to be able to check the date that the report was released." /> <alias value="Date Created" /> <alias value="Date published" /> <alias value="Date Issued" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OBR-22" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=VRF or AUT].time" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="DiagnosticReport.performer"> <path value="DiagnosticReport.performer" /> <short value="Participants in producing the report" /> <definition value="Indicates who or what participated in producing the report." /> <alias value="Laboratory" /> <alias value="Service" /> <alias value="Practitioner" /> <alias value="Department" /> <alias value="Company" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.performer" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.performer" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".participation[typeCode=PRF]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="DiagnosticReport.performer.id"> <path value="DiagnosticReport.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.performer.extension"> <path value="DiagnosticReport.performer.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.performer.modifierExtension"> <path value="DiagnosticReport.performer.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.performer.role"> <path value="DiagnosticReport.performer.role" /> <short value="Type of performer" /> <definition value="Describes the type of participation (e.g. a responsible party, author, or verifier)." /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.performer.role" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Role" /> </extension> <strength value="example" /> <description value="Indicate a role of diagnostic report performer" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/performer-role" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.performer.role" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".functionCode" /> </mapping> </element> <element id="DiagnosticReport.performer.actor"> <path value="DiagnosticReport.performer.actor" /> <short value="Practitioner or Organization participant" /> <definition value="The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report." /> <comment value="This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report." /> <requirements value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.performer.actor" /> <min value="1" /> <max value="1" /> </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/Organization" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.performer.actor" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".role" /> </mapping> </element> <element id="DiagnosticReport.specimen"> <path value="DiagnosticReport.specimen" /> <short value="Specimens this report is based on" /> <definition value="Details about the specimens on which this diagnostic report is based." /> <comment value="If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group." /> <requirements value="Need to be able to report information about the collected specimens on which the report is based." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.specimen" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" /> </type> <mapping> <identity value="v2" /> <map value="SPM" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result" /> <slicing> <discriminator> <type value="value" /> <path value="reference.code" /> </discriminator> <ordered value="true" /> <rules value="closed" /> </slicing> <short value="Observations - simple, or complex nested groups" /> <definition value="Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. "atomic" results), or they can be grouping observations that include references to other members of the group (e.g. "panels")." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> </type> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.result:cholesterol"> <path value="DiagnosticReport.result" /> <sliceName value="Cholesterol" /> <short value="Cholesterol Result" /> <definition value="Reference to Cholesterol Result." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/cholesterol" /> </type> <mustSupport value="true" /> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.result:triglyceride"> <path value="DiagnosticReport.result" /> <sliceName value="Triglyceride" /> <short value="Triglyceride Result" /> <definition value="Group of elements for Triglyceride result." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/triglyceride" /> </type> <mustSupport value="true" /> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.result:hdlcholesterol"> <path value="DiagnosticReport.result" /> <sliceName value="HDLCholesterol" /> <short value="HDL Cholesterol Result" /> <definition value="Group of elements for HDL Cholesterol result." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/hdlcholesterol" /> </type> <mustSupport value="true" /> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.result:ldlcholesterol"> <path value="DiagnosticReport.result" /> <sliceName value="LDLCholesterol" /> <short value="LDL Cholesterol result, if reported" /> <definition value="LDL Cholesterol result, if reported." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ldlcholesterol" /> </type> <mustSupport value="true" /> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.imagingStudy"> <path value="DiagnosticReport.imagingStudy" /> <short value="Reference to full details of imaging associated with the diagnostic report" /> <definition value="One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images." /> <comment value="ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.imagingStudy" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingManifest" /> </type> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]" /> </mapping> </element> <element id="DiagnosticReport.image"> <path value="DiagnosticReport.image" /> <short value="Key images associated with this report" /> <definition value="A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest)." /> <requirements value="Many diagnostic services include images in the report as part of their service." /> <alias value="DICOM" /> <alias value="Slides" /> <alias value="Scans" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.image" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OBX?" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.image.id"> <path value="DiagnosticReport.image.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.image.extension"> <path value="DiagnosticReport.image.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.image.modifierExtension"> <path value="DiagnosticReport.image.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.image.comment"> <path value="DiagnosticReport.image.comment" /> <short value="Comment about the image (e.g. explanation)" /> <definition value="A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features." /> <comment value="The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion." /> <requirements value="The provider of the report should make a comment about each image included in the report." /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.image.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value" /> </mapping> </element> <element id="DiagnosticReport.image.link"> <path value="DiagnosticReport.image.link" /> <short value="Reference to the image source" /> <definition value="Reference to the image source." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.image.link" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".value.reference" /> </mapping> </element> <element id="DiagnosticReport.conclusion"> <path value="DiagnosticReport.conclusion" /> <short value="Clinical Interpretation of Lipid Panel" /> <definition value="May include diagnosis or suggestions for follow up testing." /> <comment value="It's not unusual for the lab to make some kind of interpretative comment on the set of results." /> <requirements value="Need to be able to provide a conclusion that is not lost among the basic result data." /> <alias value="Report" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.conclusion" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)" /> </mapping> </element> <element id="DiagnosticReport.codedDiagnosis"> <path value="DiagnosticReport.codedDiagnosis" /> <short value="No codes for a lipid panel" /> <definition value="No codes for a lipid panel." /> <comment value="Not used in this context." /> <min value="0" /> <max value="0" /> <base> <path value="DiagnosticReport.codedDiagnosis" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjunctDiagnosis" /> </extension> <strength value="example" /> <description value="Diagnosis codes provided as adjuncts to the report." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/clinical-findings" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)" /> </mapping> </element> <element id="DiagnosticReport.presentedForm"> <path value="DiagnosticReport.presentedForm" /> <short value="Entire report as issued" /> <definition value="Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent." /> <comment value=""application/pdf" is recommended as the most reliable and interoperable in this context." /> <requirements value="Gives laboratory the ability to provide its own fully formatted report for clinical fidelity." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.presentedForm" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Attachment" /> </type> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="text (type=ED)" /> </mapping> </element> </snapshot> <differential> <element id="DiagnosticReport"> <path value="DiagnosticReport" /> <short value="Lipid Lab Report" /> <definition value="The findings and interpretation of a general lipd lab profile." /> <comment value="In this profile, mustSupport means that authoring systems must include the ability to report these elements, and processing systems must cater for them by either displaying them to the user or considering them appropriately in decision support systems." /> <min value="1" /> <max value="1" /> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code" /> <short value="LOINC Code for Lipid Panel with LDL" /> <definition value="LOINC Code for Lipid Panel with LDL." /> <comment value="LOINC code includes "direct" LDL - does this mean LDL derived by measuring VLDL by ultracentrifugation? This panel includes both measured and calculated LDL." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="57698-3" /> <display value="Lipid panel with direct LDL - Serum or Plasma" /> </coding> </fixedCodeableConcept> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result" /> <slicing> <discriminator> <type value="value" /> <path value="reference.code" /> </discriminator> <ordered value="true" /> <rules value="closed" /> </slicing> <max value="1" /> </element> <element id="DiagnosticReport.result:cholesterol"> <path value="DiagnosticReport.result" /> <sliceName value="Cholesterol" /> <short value="Cholesterol Result" /> <definition value="Reference to Cholesterol Result." /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/cholesterol" /> </type> <mustSupport value="true" /> </element> <element id="DiagnosticReport.result:triglyceride"> <path value="DiagnosticReport.result" /> <sliceName value="Triglyceride" /> <short value="Triglyceride Result" /> <definition value="Group of elements for Triglyceride result." /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/triglyceride" /> </type> <mustSupport value="true" /> </element> <element id="DiagnosticReport.result:hdlcholesterol"> <path value="DiagnosticReport.result" /> <sliceName value="HDLCholesterol" /> <short value="HDL Cholesterol Result" /> <definition value="Group of elements for HDL Cholesterol result." /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/hdlcholesterol" /> </type> <mustSupport value="true" /> </element> <element id="DiagnosticReport.result:ldlcholesterol"> <path value="DiagnosticReport.result" /> <sliceName value="LDLCholesterol" /> <short value="LDL Cholesterol result, if reported" /> <definition value="LDL Cholesterol result, if reported." /> <min value="0" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ldlcholesterol" /> </type> <mustSupport value="true" /> </element> <element id="DiagnosticReport.conclusion"> <path value="DiagnosticReport.conclusion" /> <short value="Clinical Interpretation of Lipid Panel" /> <definition value="May include diagnosis or suggestions for follow up testing." /> <comment value="It's not unusual for the lab to make some kind of interpretative comment on the set of results." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="DiagnosticReport.codedDiagnosis"> <path value="DiagnosticReport.codedDiagnosis" /> <short value="No codes for a lipid panel" /> <definition value="No codes for a lipid panel." /> <comment value="Not used in this context." /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/cholesterol" /> <resource> <StructureDefinition> <id value="cholesterol" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="1" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/cholesterol" /> <name value="Example Lipid Profile" /> <status value="draft" /> <experimental value="true" /> <date value="2012-05-12" /> <publisher value="Grahame Grieve" /> <contact> <telecom> <system value="url" /> <value value="grahame@healthintersections.com.au" /> </telecom> </contact> <description value="Describes how the lab report is used for a standard Lipid Profile - Cholesterol, Triglyceride and Cholesterol fractions. Uses LOINC codes" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <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="Measurements and simple assertions" /> <definition value="Measurements and simple assertions made about a patient, device or other subject." /> <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="1" /> <max value="1" /> <base> <path value="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <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="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="0" /> <max value="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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=".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="Cholesterol" /> <definition value="Cholesterol." /> <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://loinc.org" /> <code value="35200-5" /> <display value="Cholesterol" /> </coding> </fixedCodeableConcept> <mustSupport value="true" /> <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="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="Who and/or what this is about" /> <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="0" /> <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> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <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="1" /> <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> <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="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Cholesterol value" /> <definition value="Cholesterol value. If a result is not available, use the comments field." /> <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="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <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.valueQuantity.id"> <path value="Observation.valueQuantity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.extension"> <path value="Observation.valueQuantity.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Actual numerical value" /> <definition value="Actual numerical value." /> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." /> <requirements value="Precision is handled implicitly in almost all cases of measurement." /> <min value="0" /> <max value="1" /> <base> <path value="Quantity.value" /> <min value="0" /> <max value="1" /> </base> <type> <code value="decimal" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="SN.2 / CQ - N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" /> </mapping> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <short value="< | <= | >= | > - how to understand the value" /> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value." /> <comment value="No need for this on cholesterol." /> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." /> <min value="0" /> <max value="0" /> <base> <path value="Quantity.comparator" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" /> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator" /> </extension> <strength value="required" /> <description value="How the Quantity should be understood and represented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="SN.1 / CQ.1" /> </mapping> <mapping> <identity value="rim" /> <map value="IVL properties" /> </mapping> </element> <element id="Observation.valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Observation.valueQuantity.unit" /> <short value="Unit representation" /> <definition value="A human-readable form of the unit." /> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.unit" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <fixedString value="mmol/L" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.unit" /> </mapping> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <short value="System that defines coded unit form" /> <definition value="The identification of the system that provides the coded form of the unit." /> <requirements value="Need to know the system that defines the coded form of the unit." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.system" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <condition value="qty-3" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="CO.codeSystem, PQ.translation.codeSystem" /> </mapping> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <short value="Coded form of the unit" /> <definition value="A computer processable form of the unit in some unit representation system." /> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." /> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." /> <min value="1" /> <max value="1" /> <base> <path value="Quantity.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <fixedCode value="mmol/L" /> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="(see OBX.6 etc.) / CQ.2" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ.code, MO.currency, PQ.translation.code" /> </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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <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="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." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="1" /> <max value="1" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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="Observation.referenceRange" /> </constraint> <mustSupport value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <min value="0" /> <max value="0" /> <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="obs-3" /> <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="A fixed quantity (no comparator)" /> <definition value="<4.5 mmol/L." /> <comment value="Per Australian NHF Recommendations." /> <min value="1" /> <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> <fixedQuantity> <value value="4.5" /> </fixedQuantity> <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="Element" /> </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="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="Quantity:simplequantity" /> </constraint> <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> </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="0" /> <base> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="0" /> <base> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Some analytes vary greatly over age." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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> <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="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." /> <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> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <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="0" /> <max value="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <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="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="Quantity" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="string" /> </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> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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" /> <min value="1" /> <max value="1" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Cholesterol" /> <definition value="Cholesterol." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="35200-5" /> <display value="Cholesterol" /> </coding> </fixedCodeableConcept> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Cholesterol value" /> <definition value="Cholesterol value. If a result is not available, use the comments field." /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.value"> <path value="Observation.valueQuantity.value" /> <short value="Actual numerical value" /> <definition value="Actual numerical value." /> <min value="0" /> <max value="1" /> <type> <code value="decimal" /> </type> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.comparator"> <path value="Observation.valueQuantity.comparator" /> <comment value="No need for this on cholesterol." /> <min value="0" /> <max value="0" /> <type> <code value="code" /> </type> </element> <element id="Observation.valueQuantity.unit"> <path value="Observation.valueQuantity.unit" /> <min value="1" /> <max value="1" /> <type> <code value="string" /> </type> <fixedString value="mmol/L" /> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.system"> <path value="Observation.valueQuantity.system" /> <min value="1" /> <max value="1" /> <type> <code value="uri" /> </type> <fixedUri value="http://unitsofmeasure.org" /> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity.code"> <path value="Observation.valueQuantity.code" /> <min value="1" /> <max value="1" /> <type> <code value="code" /> </type> <fixedCode value="mmol/L" /> <mustSupport value="true" /> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation" /> <short value="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> </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." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <min value="0" /> <max value="0" /> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <definition value="<4.5 mmol/L." /> <comment value="Per Australian NHF Recommendations." /> <min value="1" /> <max value="1" /> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <fixedQuantity> <value value="4.5" /> </fixedQuantity> </element> <element id="Observation.referenceRange.type"> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.appliesTo"> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.age"> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="0" /> <type> <code value="Range" /> </type> </element> <element id="Observation.related"> <path value="Observation.related" /> <min value="0" /> <max value="0" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/triglyceride" /> <resource> <StructureDefinition> <id value="triglyceride" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="1" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/triglyceride" /> <name value="Example Lipid Profile" /> <status value="draft" /> <experimental value="true" /> <date value="2012-05-12" /> <publisher value="Grahame Grieve" /> <contact> <telecom> <system value="url" /> <value value="grahame@healthintersections.com.au" /> </telecom> </contact> <description value="Triglyceride Result" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <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="Triglyceride Result" /> <definition value="Group of elements for Triglyceride result." /> <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="1" /> <max value="1" /> <base> <path value="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <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="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="0" /> <max value="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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=".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="Triglyceride" /> <definition value="Triglyceride." /> <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> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="35217-9" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> <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="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="Who and/or what this is about" /> <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="0" /> <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> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <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="1" /> <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> <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="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Triglyceride value" /> <definition value="Triglyceride value. If a result is not available, use the comments field." /> <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="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <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="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="Comments about result." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="1" /> <max value="1" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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="Observation.referenceRange" /> </constraint> <mustSupport value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <min value="0" /> <max value="0" /> <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="obs-3" /> <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="Per Australian NHF Recommendations." /> <requirements value="<2.0 mmol/L." /> <min value="1" /> <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="obs-3" /> <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="0" /> <base> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="0" /> <base> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Some analytes vary greatly over age." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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> <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="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." /> <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> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <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="0" /> <max value="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <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="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="Quantity" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="string" /> </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> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="Triglyceride Result" /> <definition value="Group of elements for Triglyceride result." /> <min value="1" /> <max value="1" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="Triglyceride" /> <definition value="Triglyceride." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <patternCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="35217-9" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="Triglyceride value" /> <definition value="Triglyceride value. If a result is not available, use the comments field." /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation" /> <short value="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> </element> <element id="Observation.comment"> <path value="Observation.comment" /> <short value="Comments about result" /> <definition value="Comments about result." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <min value="0" /> <max value="0" /> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <comment value="Per Australian NHF Recommendations." /> <requirements value="<2.0 mmol/L." /> <min value="1" /> <max value="1" /> </element> <element id="Observation.referenceRange.type"> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.appliesTo"> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.age"> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="0" /> <type> <code value="Range" /> </type> </element> <element id="Observation.related"> <path value="Observation.related" /> <min value="0" /> <max value="0" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/hdlcholesterol" /> <resource> <StructureDefinition> <id value="hdlcholesterol" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="1" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/hdlcholesterol" /> <name value="Example Lipid Profile" /> <status value="draft" /> <experimental value="true" /> <date value="2012-05-12" /> <publisher value="Grahame Grieve" /> <contact> <telecom> <system value="url" /> <value value="grahame@healthintersections.com.au" /> </telecom> </contact> <description value="HDL Cholesterol Result" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <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="HDL Cholesterol Result" /> <definition value="Group of elements for HDL Cholesterol result." /> <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="1" /> <max value="1" /> <base> <path value="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <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="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="0" /> <max value="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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=".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="HDL Cholesterol" /> <definition value="HDL Cholesterol." /> <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://loinc.org" /> <code value="2085-9" /> <display value="HDL Cholesterol" /> </coding> </fixedCodeableConcept> <mustSupport value="true" /> <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="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="Who and/or what this is about" /> <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="0" /> <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> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <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="1" /> <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> <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="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="HDL Cholesterol value" /> <definition value="HDL Cholesterol value. If a result is not available, use the comments field." /> <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="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <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="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="Comments about result." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="1" /> <max value="1" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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="Observation.referenceRange" /> </constraint> <mustSupport value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <short value="A fixed quantity (no comparator)" /> <definition value=">1.5 mmol/L." /> <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="1" /> <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> <fixedQuantity> <value value="1.5" /> </fixedQuantity> <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="Element" /> </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="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="Quantity:simplequantity" /> </constraint> <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> </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="Per Australian NHF Recommendations." /> <min value="0" /> <max value="0" /> <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="obs-3" /> <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="0" /> <base> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="0" /> <base> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Some analytes vary greatly over age." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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> <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="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." /> <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> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <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="0" /> <max value="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <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="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="Quantity" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="string" /> </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> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="HDL Cholesterol Result" /> <definition value="Group of elements for HDL Cholesterol result." /> <min value="1" /> <max value="1" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="HDL Cholesterol" /> <definition value="HDL Cholesterol." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <fixedCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="2085-9" /> <display value="HDL Cholesterol" /> </coding> </fixedCodeableConcept> <mustSupport value="true" /> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="HDL Cholesterol value" /> <definition value="HDL Cholesterol value. If a result is not available, use the comments field." /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation" /> <short value="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> </element> <element id="Observation.comment"> <path value="Observation.comment" /> <short value="Comments about result" /> <definition value="Comments about result." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <definition value=">1.5 mmol/L." /> <min value="1" /> <max value="1" /> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <fixedQuantity> <value value="1.5" /> </fixedQuantity> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <comment value="Per Australian NHF Recommendations." /> <min value="0" /> <max value="0" /> </element> <element id="Observation.referenceRange.type"> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.appliesTo"> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.age"> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="0" /> <type> <code value="Range" /> </type> </element> <element id="Observation.related"> <path value="Observation.related" /> <min value="0" /> <max value="0" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/ldlcholesterol" /> <resource> <StructureDefinition> <id value="ldlcholesterol" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="1" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="oo" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/ldlcholesterol" /> <name value="Example Lipid Profile" /> <status value="draft" /> <experimental value="true" /> <date value="2012-05-12" /> <publisher value="Grahame Grieve" /> <contact> <telecom> <system value="url" /> <value value="grahame@healthintersections.com.au" /> </telecom> </contact> <description value="LDL Cholesterol Result" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="sct-concept" /> <uri value="http://snomed.info/conceptdomain" /> <name value="SNOMED CT Concept Domain Binding" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="sct-attr" /> <uri value="http://snomed.info/sct" /> <name value="SNOMED CT Attribute Binding" /> </mapping> <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="LDL Cholesterol Result" /> <definition value="Group of elements for LDL Cholesterol result." /> <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="1" /> <max value="1" /> <base> <path value="Observation" /> <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="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="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="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="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 code!=component.code" /> <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="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="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> <isSummary value="true" /> </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> <isSummary value="true" /> </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> <isModifier value="true" /> <isSummary value="true" /> </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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </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="dom-1" /> <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="N/A" /> </mapping> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Observation.modifierExtension"> <path value="Observation.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 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> <isModifier value="true" /> <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> <isSummary value="true" /> <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." /> <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="*" /> <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> <isSummary value="true" /> <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> <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="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="0" /> <max value="*" /> <base> <path value="Observation.category" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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=".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="LDL Cholesterol -measured or calculated per code" /> <definition value="LDL Cholesterol -measured or calculated per code." /> <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> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="LDLCodes" /> </extension> <strength value="required" /> <description value="LDL Cholesterol codes - measured or calculated" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ldlcholesterol-codes" /> </valueSetReference> </binding> <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="Who and/or what this is about" /> <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="0" /> <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> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <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="1" /> <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> <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="1" /> <base> <path value="Observation.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <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/Time this was made available" /> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified." /> <comment value="Updated when the result is updated." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <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="Who is responsible for the observation" /> <definition value="Who was responsible for asserting the observed value as "true"." /> <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="*" /> <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/Organization" /> </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> <isSummary value="true" /> <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.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="LDL Cholesterol value" /> <definition value="LDL Cholesterol value. If a result is not available, use the comments field." /> <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="1" /> <base> <path value="Observation.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> </type> <condition value="obs-7" /> <mustSupport value="true" /> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <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="1" /> <base> <path value="Observation.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <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="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="Comments about result." /> <requirements value="Need to be able to provide free text additional information." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <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="1" /> <base> <path value="Observation.bodySite" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <base> <path value="Observation.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="1" /> <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> <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="1" /> <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> <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="1" /> <max value="1" /> <base> <path value="Observation.referenceRange" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </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="Observation.referenceRange" /> </constraint> <mustSupport value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.referenceRange.extension"> <path value="Observation.referenceRange.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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)." /> <min value="0" /> <max value="0" /> <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="obs-3" /> <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="A fixed quantity (no comparator)" /> <definition value="<3.0 mmol/L." /> <comment value="Per Australian NHF Recommendations." /> <min value="1" /> <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> <fixedQuantity> <value value="3.0" /> </fixedQuantity> <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="Element" /> </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="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="Quantity:simplequantity" /> </constraint> <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> </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="0" /> <base> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="0" /> <base> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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." /> <requirements value="Some analytes vary greatly over age." /> <min value="0" /> <max value="0" /> <base> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <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'." /> <min value="0" /> <max value="1" /> <base> <path value="Observation.referenceRange.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <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> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.related.extension"> <path value="Observation.related.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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> <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="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." /> <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> <mapping> <identity value="rim" /> <map value=".targetObservation" /> </mapping> </element> <element id="Observation.component"> <path value="Observation.component" /> <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="0" /> <max value="*" /> <base> <path value="Observation.component" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Observation.component.extension"> <path value="Observation.component.extension" /> <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> <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> <isModifier value="true" /> <isSummary value="true" /> <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"." /> <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> <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="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="Quantity" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="string" /> </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> <isSummary value="true" /> <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="1" /> <base> <path value="Observation.component.dataAbsentReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="obs-6" /> <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="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="1" /> <base> <path value="Observation.component.interpretation" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <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="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="*" /> <base> <path value="Observation.component.referenceRange" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#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="LDL Cholesterol Result" /> <definition value="Group of elements for LDL Cholesterol result." /> <min value="1" /> <max value="1" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <short value="LDL Cholesterol -measured or calculated per code" /> <definition value="LDL Cholesterol -measured or calculated per code." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="LDLCodes" /> </extension> <strength value="required" /> <description value="LDL Cholesterol codes - measured or calculated" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ldlcholesterol-codes" /> </valueSetReference> </binding> </element> <element id="Observation.valueQuantity"> <path value="Observation.valueQuantity" /> <short value="LDL Cholesterol value" /> <definition value="LDL Cholesterol value. If a result is not available, use the comments field." /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> </type> <mustSupport value="true" /> </element> <element id="Observation.interpretation"> <path value="Observation.interpretation" /> <short value="+ | ++ | +++ | - | -- | ---" /> <definition value="+ | ++ | +++ | - | -- | ---." /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> </element> <element id="Observation.comment"> <path value="Observation.comment" /> <short value="Comments about result" /> <definition value="Comments about result." /> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> <mustSupport value="true" /> </element> <element id="Observation.referenceRange"> <path value="Observation.referenceRange" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <min value="0" /> <max value="0" /> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <definition value="<3.0 mmol/L." /> <comment value="Per Australian NHF Recommendations." /> <min value="1" /> <max value="1" /> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <fixedQuantity> <value value="3.0" /> </fixedQuantity> </element> <element id="Observation.referenceRange.type"> <path value="Observation.referenceRange.type" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.appliesTo"> <path value="Observation.referenceRange.appliesTo" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> <element id="Observation.referenceRange.age"> <path value="Observation.referenceRange.age" /> <min value="0" /> <max value="0" /> <type> <code value="Range" /> </type> </element> <element id="Observation.related"> <path value="Observation.related" /> <min value="0" /> <max value="0" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/diagnosticreport-genetics" /> <resource> <StructureDefinition> <id value="diagnosticreport-genetics" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <url value="http://hl7.org/fhir/StructureDefinition/diagnosticreport-genetics" /> <name value="DiagnosticReport-Genetics" /> <status value="draft" /> <experimental value="false" /> <date value="2015-10-09" /> <publisher value="Health Level Seven International (Clinical Genomics)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/clingenomics" /> </telecom> </contact> <description value="Describes how the DiagnosticReport resource is used to report structured genetic test results" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="DiagnosticReport" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> <derivation value="constraint" /> <snapshot> <element id="DiagnosticReport"> <path value="DiagnosticReport" /> <short value="A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports" /> <definition value="The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports." /> <comment value="This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing." /> <alias value="Report" /> <alias value="Test" /> <alias value="Result" /> <alias value="Results" /> <alias value="Labs" /> <alias value="Laboratory" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport" /> <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="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="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="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="DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="v2" /> <map value="ORU -> OBR" /> </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="DiagnosticReport.id"> <path value="DiagnosticReport.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> <isSummary value="true" /> </element> <element id="DiagnosticReport.meta"> <path value="DiagnosticReport.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> <isSummary value="true" /> </element> <element id="DiagnosticReport.implicitRules"> <path value="DiagnosticReport.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="DiagnosticReport.language"> <path value="DiagnosticReport.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="DiagnosticReport.text"> <path value="DiagnosticReport.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="DiagnosticReport.contained"> <path value="DiagnosticReport.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="N/A" /> </mapping> </element> <element id="DiagnosticReport.extension"> <path value="DiagnosticReport.extension" /> <slicing id="4"> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> </element> <element id="DiagnosticReport.extension:assessedcondition"> <path value="DiagnosticReport.extension" /> <sliceName value="AssessedCondition" /> <short value="AssessedCondition" /> <definition value="Used to denote condition context for genetic testing, which may influence reported variants and interpretation for large genomic testing panels e.g. lung cancer or familial breast cancer." /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.extension:familymemberhistory"> <path value="DiagnosticReport.extension" /> <sliceName value="FamilyMemberHistory" /> <short value="FamilyHistory" /> <definition value="Significant health events and conditions for a person related to the patient relevant in the context of care for the patient." /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.extension:analysis"> <path value="DiagnosticReport.extension" /> <sliceName value="Analysis" /> <short value="Analysis" /> <definition value="Knowledge-based comments on the effect of the sequence on patient's condition/medication reaction." /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.modifierExtension"> <path value="DiagnosticReport.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.identifier"> <path value="DiagnosticReport.identifier" /> <short value="Business identifier for report" /> <definition value="Identifiers assigned to this report by the performer or other systems." /> <comment value="Usually assigned by the Information System of the diagnostic service provider (filler id)." /> <requirements value="Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context." /> <alias value="ReportID" /> <alias value="Filler ID" /> <alias value="Placer ID" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-51" /> </mapping> <mapping> <identity value="rim" /> <map value="id" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="DiagnosticReport.basedOn"> <path value="DiagnosticReport.basedOn" /> <short value="What was requested" /> <definition value="Details concerning a test or procedure requested." /> <comment value="Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports." /> <requirements value="This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon." /> <alias value="Request" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.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/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> <mapping> <identity value="workflow" /> <map value="Event.basedOn" /> </mapping> <mapping> <identity value="v2" /> <map value="ORC? OBR-2/3?" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=FLFS].target" /> </mapping> </element> <element id="DiagnosticReport.status"> <path value="DiagnosticReport.status" /> <short value="registered | partial | preliminary | final +" /> <definition value="The status of the diagnostic report as a whole." /> <comment value="This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn." /> <requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportStatus" /> </extension> <strength value="required" /> <description value="The status of the diagnostic report as a whole." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/diagnostic-report-status" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-25 (not 1:1 mapping)" /> </mapping> <mapping> <identity value="rim" /> <map value="statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"" /> </mapping> <mapping> <identity value="w5" /> <map value="status" /> </mapping> </element> <element id="DiagnosticReport.category"> <path value="DiagnosticReport.category" /> <short value="Service category" /> <definition value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes." /> <comment value="The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code." /> <alias value="Department" /> <alias value="Sub-department" /> <alias value="Service" /> <alias value="Discipline" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.category" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticServiceSection" /> </extension> <strength value="example" /> <description value="Codes for diagnostic service sections." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OBR-24" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code" /> <short value="Name/Code for this diagnostic report" /> <definition value="A code or name that describes this diagnostic report." /> <alias value="Type" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportCodes" /> </extension> <strength value="preferred" /> <description value="Codes that describe Diagnostic Reports." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/report-codes" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.code" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="DiagnosticReport.subject"> <path value="DiagnosticReport.subject" /> <short value="The subject of the report - usually, but not always, the patient" /> <definition value="The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources." /> <requirements value="SHALL know the subject context." /> <alias value="Patient" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.subject" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.subject" /> </mapping> <mapping> <identity value="v2" /> <map value="PID-3 (no HL7 v2 mapping for Group or Device)" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.focus" /> </mapping> </element> <element id="DiagnosticReport.context"> <path value="DiagnosticReport.context" /> <short value="Health care event when test ordered" /> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about." /> <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="Links the request to the Encounter context." /> <alias value="Encounter" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.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> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.context" /> </mapping> <mapping> <identity value="v2" /> <map value="PV1-19" /> </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="DiagnosticReport.effective[x]"> <path value="DiagnosticReport.effective[x]" /> <short value="Clinically relevant time/time-period for report" /> <definition value="The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself." /> <comment value="If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic." /> <requirements value="Need to know where in the patient history to file/present this report." /> <alias value="Observation time" /> <alias value="Effective Time" /> <alias value="Occurrence" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.occurrence[x]" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-7" /> </mapping> <mapping> <identity value="rim" /> <map value="effectiveTime" /> </mapping> <mapping> <identity value="w5" /> <map value="when.done" /> </mapping> </element> <element id="DiagnosticReport.issued"> <path value="DiagnosticReport.issued" /> <short value="DateTime this version was released" /> <definition value="The date and time that this version of the report was released from the source diagnostic service." /> <comment value="May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report." /> <requirements value="Clinicians need to be able to check the date that the report was released." /> <alias value="Date Created" /> <alias value="Date published" /> <alias value="Date Issued" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OBR-22" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=VRF or AUT].time" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="DiagnosticReport.performer"> <path value="DiagnosticReport.performer" /> <short value="Participants in producing the report" /> <definition value="Indicates who or what participated in producing the report." /> <alias value="Laboratory" /> <alias value="Service" /> <alias value="Practitioner" /> <alias value="Department" /> <alias value="Company" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.performer" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.performer" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".participation[typeCode=PRF]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="DiagnosticReport.performer.id"> <path value="DiagnosticReport.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.performer.extension"> <path value="DiagnosticReport.performer.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.performer.modifierExtension"> <path value="DiagnosticReport.performer.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.performer.role"> <path value="DiagnosticReport.performer.role" /> <short value="Type of performer" /> <definition value="Describes the type of participation (e.g. a responsible party, author, or verifier)." /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.performer.role" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Role" /> </extension> <strength value="example" /> <description value="Indicate a role of diagnostic report performer" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/performer-role" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.performer.role" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".functionCode" /> </mapping> </element> <element id="DiagnosticReport.performer.actor"> <path value="DiagnosticReport.performer.actor" /> <short value="Practitioner or Organization participant" /> <definition value="The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report." /> <comment value="This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report." /> <requirements value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.performer.actor" /> <min value="1" /> <max value="1" /> </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/Organization" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.performer.actor" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".role" /> </mapping> </element> <element id="DiagnosticReport.specimen"> <path value="DiagnosticReport.specimen" /> <short value="Specimens this report is based on" /> <definition value="Details about the specimens on which this diagnostic report is based." /> <comment value="If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group." /> <requirements value="Need to be able to report information about the collected specimens on which the report is based." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.specimen" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" /> </type> <mapping> <identity value="v2" /> <map value="SPM" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result" /> <short value="Observations - simple, or complex nested groups" /> <definition value="Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. "atomic" results), or they can be grouping observations that include references to other members of the group (e.g. "panels")." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> </type> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.imagingStudy"> <path value="DiagnosticReport.imagingStudy" /> <short value="Reference to full details of imaging associated with the diagnostic report" /> <definition value="One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images." /> <comment value="ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.imagingStudy" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingManifest" /> </type> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]" /> </mapping> </element> <element id="DiagnosticReport.image"> <path value="DiagnosticReport.image" /> <short value="Key images associated with this report" /> <definition value="A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest)." /> <requirements value="Many diagnostic services include images in the report as part of their service." /> <alias value="DICOM" /> <alias value="Slides" /> <alias value="Scans" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.image" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OBX?" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.image.id"> <path value="DiagnosticReport.image.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.image.extension"> <path value="DiagnosticReport.image.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.image.modifierExtension"> <path value="DiagnosticReport.image.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.image.comment"> <path value="DiagnosticReport.image.comment" /> <short value="Comment about the image (e.g. explanation)" /> <definition value="A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features." /> <comment value="The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion." /> <requirements value="The provider of the report should make a comment about each image included in the report." /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.image.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value" /> </mapping> </element> <element id="DiagnosticReport.image.link"> <path value="DiagnosticReport.image.link" /> <short value="Reference to the image source" /> <definition value="Reference to the image source." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.image.link" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".value.reference" /> </mapping> </element> <element id="DiagnosticReport.conclusion"> <path value="DiagnosticReport.conclusion" /> <short value="Clinical Interpretation of test results" /> <definition value="Concise and clinically contextualized impression / summary of the diagnostic report." /> <requirements value="Need to be able to provide a conclusion that is not lost among the basic result data." /> <alias value="Report" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.conclusion" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)" /> </mapping> </element> <element id="DiagnosticReport.codedDiagnosis"> <path value="DiagnosticReport.codedDiagnosis" /> <short value="Codes for the conclusion" /> <definition value="Codes for the conclusion." /> <min value="0" /> <max value="0" /> <base> <path value="DiagnosticReport.codedDiagnosis" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjunctDiagnosis" /> </extension> <strength value="example" /> <description value="Diagnosis codes provided as adjuncts to the report." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/clinical-findings" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)" /> </mapping> </element> <element id="DiagnosticReport.presentedForm"> <path value="DiagnosticReport.presentedForm" /> <short value="Entire report as issued" /> <definition value="Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent." /> <comment value=""application/pdf" is recommended as the most reliable and interoperable in this context." /> <requirements value="Gives laboratory the ability to provide its own fully formatted report for clinical fidelity." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.presentedForm" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Attachment" /> </type> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="text (type=ED)" /> </mapping> </element> </snapshot> <differential> <element id="DiagnosticReport"> <path value="DiagnosticReport" /> <min value="0" /> <max value="*" /> </element> <element id="DiagnosticReport.extension:assessedcondition"> <path value="DiagnosticReport.extension" /> <sliceName value="AssessedCondition" /> <short value="AssessedCondition" /> <definition value="Used to denote condition context for genetic testing, which may influence reported variants and interpretation for large genomic testing panels e.g. lung cancer or familial breast cancer." /> <min value="0" /> <max value="*" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAssessedCondition" /> </type> </element> <element id="DiagnosticReport.extension:familymemberhistory"> <path value="DiagnosticReport.extension" /> <sliceName value="FamilyMemberHistory" /> <short value="FamilyHistory" /> <definition value="Significant health events and conditions for a person related to the patient relevant in the context of care for the patient." /> <min value="0" /> <max value="*" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsFamilyMemberHistory" /> </type> </element> <element id="DiagnosticReport.extension:analysis"> <path value="DiagnosticReport.extension" /> <sliceName value="Analysis" /> <short value="Analysis" /> <definition value="Knowledge-based comments on the effect of the sequence on patient's condition/medication reaction." /> <min value="0" /> <max value="*" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport-geneticsAnalysis" /> </type> </element> <element id="DiagnosticReport.codedDiagnosis"> <path value="DiagnosticReport.codedDiagnosis" /> <min value="0" /> <max value="0" /> <type> <code value="CodeableConcept" /> </type> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/hlaresult" /> <resource> <StructureDefinition> <id value="hlaresult" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <url value="http://hl7.org/fhir/StructureDefinition/hlaresult" /> <name value="Profile for HLA Genotyping Results" /> <status value="draft" /> <experimental value="false" /> <date value="2015-10-09" /> <publisher value="Health Level Seven International (Clinical Genomics)" /> <contact> <telecom> <system value="url" /> <value value="http://www.hl7.org/Special/committees/clingenomics" /> </telecom> </contact> <description value="Describes how the HLA genotyping results" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="workflow" /> <uri value="http://hl7.org/fhir/workflow" /> <name value="Workflow Mapping" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="DiagnosticReport" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> <derivation value="constraint" /> <snapshot> <element id="DiagnosticReport"> <path value="DiagnosticReport" /> <short value="A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports" /> <definition value="The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports." /> <comment value="This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing." /> <alias value="Report" /> <alias value="Test" /> <alias value="Result" /> <alias value="Results" /> <alias value="Labs" /> <alias value="Laboratory" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport" /> <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="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="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="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="DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="workflow" /> <map value="Event" /> </mapping> <mapping> <identity value="v2" /> <map value="ORU -> OBR" /> </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="DiagnosticReport.id"> <path value="DiagnosticReport.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> <isSummary value="true" /> </element> <element id="DiagnosticReport.meta"> <path value="DiagnosticReport.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> <isSummary value="true" /> </element> <element id="DiagnosticReport.implicitRules"> <path value="DiagnosticReport.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="DiagnosticReport.language"> <path value="DiagnosticReport.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="DiagnosticReport.text"> <path value="DiagnosticReport.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="DiagnosticReport.contained"> <path value="DiagnosticReport.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="N/A" /> </mapping> </element> <element id="DiagnosticReport.extension"> <path value="DiagnosticReport.extension" /> <slicing id="5"> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> </element> <element id="DiagnosticReport.extension:allele-database"> <path value="DiagnosticReport.extension" /> <sliceName value="allele-database" /> <short value="Allele Database" /> <definition value="Allele Database." /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.extension:glstring"> <path value="DiagnosticReport.extension" /> <sliceName value="glstring" /> <short value="Glstring" /> <definition value="Glstring." /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.extension:haploid"> <path value="DiagnosticReport.extension" /> <sliceName value="haploid" /> <short value="Haploid" /> <definition value="Haploid." /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-haploid" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.extension:method"> <path value="DiagnosticReport.extension" /> <sliceName value="method" /> <short value="The platform, methodology and software applied at the time of the genotyping" /> <definition value="The platform, methodology and software applied at the time of the genotyping." /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-method" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="DiagnosticReport.modifierExtension"> <path value="DiagnosticReport.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.identifier"> <path value="DiagnosticReport.identifier" /> <short value="Business identifier for report" /> <definition value="Identifiers assigned to this report by the performer or other systems." /> <comment value="Usually assigned by the Information System of the diagnostic service provider (filler id)." /> <requirements value="Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context." /> <alias value="ReportID" /> <alias value="Filler ID" /> <alias value="Placer ID" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.identifier" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-51" /> </mapping> <mapping> <identity value="rim" /> <map value="id" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="DiagnosticReport.basedOn"> <path value="DiagnosticReport.basedOn" /> <short value="What was requested" /> <definition value="Details concerning a test or procedure requested." /> <comment value="Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports." /> <requirements value="This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon." /> <alias value="Request" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.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/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> <mapping> <identity value="workflow" /> <map value="Event.basedOn" /> </mapping> <mapping> <identity value="v2" /> <map value="ORC? OBR-2/3?" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=FLFS].target" /> </mapping> </element> <element id="DiagnosticReport.status"> <path value="DiagnosticReport.status" /> <short value="registered | partial | preliminary | final +" /> <definition value="The status of the diagnostic report as a whole." /> <comment value="This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn." /> <requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportStatus" /> </extension> <strength value="required" /> <description value="The status of the diagnostic report as a whole." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/diagnostic-report-status" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.status" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-25 (not 1:1 mapping)" /> </mapping> <mapping> <identity value="rim" /> <map value="statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"" /> </mapping> <mapping> <identity value="w5" /> <map value="status" /> </mapping> </element> <element id="DiagnosticReport.category"> <path value="DiagnosticReport.category" /> <short value="Service category" /> <definition value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes." /> <comment value="The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code." /> <alias value="Department" /> <alias value="Sub-department" /> <alias value="Service" /> <alias value="Discipline" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.category" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticServiceSection" /> </extension> <strength value="example" /> <description value="Codes for diagnostic service sections." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OBR-24" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="DiagnosticReport.code"> <path value="DiagnosticReport.code" /> <short value="Name/Code for this diagnostic report" /> <definition value="A code or name that describes this diagnostic report." /> <alias value="Type" /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosticReportCodes" /> </extension> <strength value="preferred" /> <description value="Codes that describe Diagnostic Reports." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/report-codes" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.code" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)" /> </mapping> <mapping> <identity value="rim" /> <map value="code" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="DiagnosticReport.subject"> <path value="DiagnosticReport.subject" /> <short value="The subject of the report - usually, but not always, the patient" /> <definition value="The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources." /> <requirements value="SHALL know the subject context." /> <alias value="Patient" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.subject" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.subject" /> </mapping> <mapping> <identity value="v2" /> <map value="PID-3 (no HL7 v2 mapping for Group or Device)" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.focus" /> </mapping> </element> <element id="DiagnosticReport.context"> <path value="DiagnosticReport.context" /> <short value="Health care event when test ordered" /> <definition value="The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about." /> <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="Links the request to the Encounter context." /> <alias value="Encounter" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.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> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.context" /> </mapping> <mapping> <identity value="v2" /> <map value="PV1-19" /> </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="DiagnosticReport.effective[x]"> <path value="DiagnosticReport.effective[x]" /> <short value="Clinically relevant time/time-period for report" /> <definition value="The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself." /> <comment value="If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic." /> <requirements value="Need to know where in the patient history to file/present this report." /> <alias value="Observation time" /> <alias value="Effective Time" /> <alias value="Occurrence" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.effective[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.occurrence[x]" /> </mapping> <mapping> <identity value="v2" /> <map value="OBR-7" /> </mapping> <mapping> <identity value="rim" /> <map value="effectiveTime" /> </mapping> <mapping> <identity value="w5" /> <map value="when.done" /> </mapping> </element> <element id="DiagnosticReport.issued"> <path value="DiagnosticReport.issued" /> <short value="DateTime this version was released" /> <definition value="The date and time that this version of the report was released from the source diagnostic service." /> <comment value="May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report." /> <requirements value="Clinicians need to be able to check the date that the report was released." /> <alias value="Date Created" /> <alias value="Date published" /> <alias value="Date Issued" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.issued" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OBR-22" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=VRF or AUT].time" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="DiagnosticReport.performer"> <path value="DiagnosticReport.performer" /> <short value="Participants in producing the report" /> <definition value="Indicates who or what participated in producing the report." /> <alias value="Laboratory" /> <alias value="Service" /> <alias value="Practitioner" /> <alias value="Department" /> <alias value="Company" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.performer" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.performer" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".participation[typeCode=PRF]" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="DiagnosticReport.performer.id"> <path value="DiagnosticReport.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.performer.extension"> <path value="DiagnosticReport.performer.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.performer.modifierExtension"> <path value="DiagnosticReport.performer.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.performer.role"> <path value="DiagnosticReport.performer.role" /> <short value="Type of performer" /> <definition value="Describes the type of participation (e.g. a responsible party, author, or verifier)." /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.performer.role" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Role" /> </extension> <strength value="example" /> <description value="Indicate a role of diagnostic report performer" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/performer-role" /> </valueSetReference> </binding> <mapping> <identity value="workflow" /> <map value="Event.performer.role" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".functionCode" /> </mapping> </element> <element id="DiagnosticReport.performer.actor"> <path value="DiagnosticReport.performer.actor" /> <short value="Practitioner or Organization participant" /> <definition value="The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report." /> <comment value="This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report." /> <requirements value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.performer.actor" /> <min value="1" /> <max value="1" /> </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/Organization" /> </type> <isSummary value="true" /> <mapping> <identity value="workflow" /> <map value="Event.performer.actor" /> </mapping> <mapping> <identity value="v2" /> <map value="PRT-8 (where this PRT-4-Participation = "PO")" /> </mapping> <mapping> <identity value="rim" /> <map value=".role" /> </mapping> </element> <element id="DiagnosticReport.specimen"> <path value="DiagnosticReport.specimen" /> <short value="Specimens this report is based on" /> <definition value="Details about the specimens on which this diagnostic report is based." /> <comment value="If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group." /> <requirements value="Need to be able to report information about the collected specimens on which the report is based." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.specimen" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" /> </type> <mapping> <identity value="v2" /> <map value="SPM" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=SBJ]" /> </mapping> </element> <element id="DiagnosticReport.result"> <path value="DiagnosticReport.result" /> <short value="Observations - simple, or complex nested groups" /> <definition value="Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. "atomic" results), or they can be grouping observations that include references to other members of the group (e.g. "panels")." /> <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." /> <alias value="Data" /> <alias value="Atomic Value" /> <alias value="Result" /> <alias value="Atomic result" /> <alias value="Data" /> <alias value="Test" /> <alias value="Analyte" /> <alias value="Battery" /> <alias value="Organizer" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.result" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> </type> <mapping> <identity value="v2" /> <map value="OBXs" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.imagingStudy"> <path value="DiagnosticReport.imagingStudy" /> <short value="Reference to full details of imaging associated with the diagnostic report" /> <definition value="One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images." /> <comment value="ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.imagingStudy" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingManifest" /> </type> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]" /> </mapping> </element> <element id="DiagnosticReport.image"> <path value="DiagnosticReport.image" /> <short value="Key images associated with this report" /> <definition value="A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest)." /> <requirements value="Many diagnostic services include images in the report as part of their service." /> <alias value="DICOM" /> <alias value="Slides" /> <alias value="Scans" /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.image" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OBX?" /> </mapping> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode=COMP].target" /> </mapping> </element> <element id="DiagnosticReport.image.id"> <path value="DiagnosticReport.image.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.image.extension"> <path value="DiagnosticReport.image.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="DiagnosticReport.image.modifierExtension"> <path value="DiagnosticReport.image.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="DiagnosticReport.image.comment"> <path value="DiagnosticReport.image.comment" /> <short value="Comment about the image (e.g. explanation)" /> <definition value="A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features." /> <comment value="The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion." /> <requirements value="The provider of the report should make a comment about each image included in the report." /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.image.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value" /> </mapping> </element> <element id="DiagnosticReport.image.link"> <path value="DiagnosticReport.image.link" /> <short value="Reference to the image source" /> <definition value="Reference to the image source." /> <min value="1" /> <max value="1" /> <base> <path value="DiagnosticReport.image.link" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Media" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".value.reference" /> </mapping> </element> <element id="DiagnosticReport.conclusion"> <path value="DiagnosticReport.conclusion" /> <short value="Clinical Interpretation of test results" /> <definition value="Concise and clinically contextualized impression / summary of the diagnostic report." /> <requirements value="Need to be able to provide a conclusion that is not lost among the basic result data." /> <alias value="Report" /> <min value="0" /> <max value="1" /> <base> <path value="DiagnosticReport.conclusion" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)" /> </mapping> </element> <element id="DiagnosticReport.codedDiagnosis"> <path value="DiagnosticReport.codedDiagnosis" /> <short value="Codes for the conclusion" /> <definition value="Codes for the conclusion." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.codedDiagnosis" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdjunctDiagnosis" /> </extension> <strength value="example" /> <description value="Diagnosis codes provided as adjuncts to the report." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/clinical-findings" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)" /> </mapping> </element> <element id="DiagnosticReport.presentedForm"> <path value="DiagnosticReport.presentedForm" /> <short value="Entire report as issued" /> <definition value="Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent." /> <comment value=""application/pdf" is recommended as the most reliable and interoperable in this context." /> <requirements value="Gives laboratory the ability to provide its own fully formatted report for clinical fidelity." /> <min value="0" /> <max value="*" /> <base> <path value="DiagnosticReport.presentedForm" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Attachment" /> </type> <mapping> <identity value="v2" /> <map value="OBX" /> </mapping> <mapping> <identity value="rim" /> <map value="text (type=ED)" /> </mapping> </element> </snapshot> <differential> <element id="DiagnosticReport"> <path value="DiagnosticReport" /> <min value="0" /> <max value="*" /> </element> <element id="DiagnosticReport.extension:allele-database"> <path value="DiagnosticReport.extension" /> <sliceName value="allele-database" /> <short value="Allele Database" /> <definition value="Allele Database." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database" /> </type> </element> <element id="DiagnosticReport.extension:glstring"> <path value="DiagnosticReport.extension" /> <sliceName value="glstring" /> <short value="Glstring" /> <definition value="Glstring." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring" /> </type> </element> <element id="DiagnosticReport.extension:haploid"> <path value="DiagnosticReport.extension" /> <sliceName value="haploid" /> <short value="Haploid" /> <definition value="Haploid." /> <min value="0" /> <max value="*" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-haploid" /> </type> </element> <element id="DiagnosticReport.extension:method"> <path value="DiagnosticReport.extension" /> <sliceName value="method" /> <short value="The platform, methodology and software applied at the time of the genotyping" /> <definition value="The platform, methodology and software applied at the time of the genotyping." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-method" /> </type> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/clinicaldocument" /> <resource> <StructureDefinition> <id value="clinicaldocument" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <url value="http://hl7.org/fhir/StructureDefinition/clinicaldocument" /> <name value="Clinical Document Profile for Composition" /> <status value="draft" /> <experimental value="false" /> <date value="2015-03-17" /> <publisher value="Health Level Seven, Inc. - Structured Documents WG" /> <contact> <telecom> <system value="url" /> <value value="http://hl7.org/special/committees/structure" /> </telecom> </contact> <description value="The base Composition is a general resource for compositions or documents about any kind of subject that might be encountered in healthcare including such things as guidelines, medicines, etc. A clinical document is focused on documents related to the provision of care process, where the subject is a patient, a group of patients, or a closely related concept. A clinical document has additional reqiurements around confidentiality that do not apply in the same way to other kinds of documents" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="cda" /> <uri value="http://hl7.org/v3/cda" /> <name value="CDA (R2)" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Composition" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Composition" /> <derivation value="constraint" /> <snapshot> <element id="Composition"> <path value="Composition" /> <short value="A set of resources composed into a single coherent clinical statement with clinical attestation" /> <definition value="A set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained." /> <comment value="While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical." /> <min value="0" /> <max value="*" /> <base> <path value="Composition" /> <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="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="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="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="DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="Document[classCode="DOC" and moodCode="EVN" and isNormalAct()]" /> </mapping> <mapping> <identity value="cda" /> <map value="ClinicalDocument" /> </mapping> <mapping> <identity value="w5" /> <map value="infrastructure.documents" /> </mapping> </element> <element id="Composition.id"> <path value="Composition.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> <isSummary value="true" /> </element> <element id="Composition.meta"> <path value="Composition.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> <isSummary value="true" /> </element> <element id="Composition.implicitRules"> <path value="Composition.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="Composition.language"> <path value="Composition.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="Composition.text"> <path value="Composition.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="Composition.contained"> <path value="Composition.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="N/A" /> </mapping> </element> <element id="Composition.extension"> <path value="Composition.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Composition.modifierExtension"> <path value="Composition.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Composition.identifier"> <path value="Composition.identifier" /> <short value="Logical identifier of composition (version-independent)" /> <definition value="Logical identifier for the composition, assigned when created. This identifier stays constant as the composition is changed over time." /> <comment value="See discussion in resource definition for how these relate." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.identifier" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="Document.id / Document.setId" /> </mapping> <mapping> <identity value="cda" /> <map value=".setId" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="Composition.status"> <path value="Composition.status" /> <short value="preliminary | final | amended | entered-in-error" /> <definition value="The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document." /> <comment value="If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required." /> <requirements value="Need to be able to mark interim, amended, or withdrawn compositions or documents." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CompositionStatus" /> </extension> <strength value="required" /> <description value="The workflow/clinical status of the composition." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/composition-status" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active"; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"" /> </mapping> <mapping> <identity value="cda" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="status" /> </mapping> </element> <element id="Composition.type"> <path value="Composition.type" /> <short value="Kind of composition (LOINC if possible)" /> <definition value="Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition." /> <comment value="For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding." /> <requirements value="Key metadata element describing the composition, used in searching/filtering." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentType" /> </extension> <strength value="preferred" /> <description value="Type of a composition." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/doc-typecodes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="cda" /> <map value=".code" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="Composition.class"> <path value="Composition.class" /> <short value="Categorization of Composition" /> <definition value="A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type." /> <comment value="This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD))." /> <requirements value="Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.class" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentClass" /> </extension> <strength value="example" /> <description value="High-level kind of a clinical document at a macro level." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/doc-classcodes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code" /> </mapping> <mapping> <identity value="cda" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="Composition.subject"> <path value="Composition.subject" /> <short value="Who and/or what the composition is about" /> <definition value="Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure)." /> <comment value="For clinical documents, this is usually the patient." /> <requirements value="Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.subject" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode="SBJ"].role[typeCode="PAT"]" /> </mapping> <mapping> <identity value="cda" /> <map value=".recordTarget" /> </mapping> <mapping> <identity value="w5" /> <map value="who.focus" /> </mapping> </element> <element id="Composition.encounter"> <path value="Composition.encounter" /> <short value="Context of the Composition" /> <definition value="Describes the clinical encounter or type of care this documentation is associated with." /> <requirements value="Provides context for the composition and supports searching." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.encounter" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])" /> </mapping> <mapping> <identity value="cda" /> <map value=".componentOf.encompassingEncounter" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="Composition.date"> <path value="Composition.date" /> <short value="Composition editing time" /> <definition value="The composition editing time, when the composition was last logically changed by the author." /> <comment value="The Last Modified Date on the composition may be after the date of the document was attested without being changed." /> <requirements value="dateTime is used for tracking, organizing versions and searching." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.date" /> <min value="1" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".effectiveTime[type="TS"]" /> </mapping> <mapping> <identity value="cda" /> <map value=".effectiveTime" /> </mapping> <mapping> <identity value="w5" /> <map value="when.done" /> </mapping> </element> <element id="Composition.author"> <path value="Composition.author" /> <short value="Who and/or what authored the composition" /> <definition value="Identifies who is responsible for the information in the composition, not necessarily who typed it in." /> <requirements value="Identifies who is responsible for the content." /> <min value="1" /> <max value="*" /> <base> <path value="Composition.author" /> <min value="1" /> <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/Device" /> </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> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode="AUT"].role[classCode="ASSIGNED"]" /> </mapping> <mapping> <identity value="cda" /> <map value=".author.assignedAuthor" /> </mapping> <mapping> <identity value="w5" /> <map value="who.author" /> </mapping> </element> <element id="Composition.title"> <path value="Composition.title" /> <short value="Human Readable name/title" /> <definition value="Official human-readable label for the composition." /> <comment value="For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.title" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./title" /> </mapping> <mapping> <identity value="cda" /> <map value=".title" /> </mapping> </element> <element id="Composition.confidentiality"> <path value="Composition.confidentiality" /> <short value="As defined by affinity domain" /> <definition value="The code specifying the level of confidentiality of the Composition." /> <comment value="The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.confidentiality" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentConfidentiality" /> </extension> <strength value="required" /> <description value="Codes specifying the level of confidentiality of the composition." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ConfidentialityClassification" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".confidentialityCode" /> </mapping> <mapping> <identity value="cda" /> <map value=".confidentialityCode" /> </mapping> </element> <element id="Composition.attester"> <path value="Composition.attester" /> <short value="Attests to accuracy of composition" /> <definition value="A participant who has attested to the accuracy of the composition/document." /> <comment value="Only list each attester once." /> <requirements value="Identifies responsibility for the accuracy of the composition content." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.attester" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode="AUTHEN"].role[classCode="ASSIGNED"]" /> </mapping> <mapping> <identity value="cda" /> <map value=".authenticator/.legalAuthenticator" /> </mapping> </element> <element id="Composition.attester.id"> <path value="Composition.attester.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.attester.extension"> <path value="Composition.attester.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.attester.modifierExtension"> <path value="Composition.attester.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Composition.attester.mode"> <path value="Composition.attester.mode" /> <short value="personal | professional | legal | official" /> <definition value="The type of attestation the authenticator offers." /> <comment value="Use more than one code where a single attester has more than one mode (professional and legal are often paired)." /> <requirements value="Indicates the level of authority of the attestation." /> <min value="1" /> <max value="*" /> <base> <path value="Composition.attester.mode" /> <min value="1" /> <max value="*" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CompositionAttestationMode" /> </extension> <strength value="required" /> <description value="The way in which a person authenticated a composition." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/composition-attestation-mode" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="unique(./modeCode)" /> </mapping> <mapping> <identity value="cda" /> <map value="implied by .authenticator/.legalAuthenticator" /> </mapping> </element> <element id="Composition.attester.time"> <path value="Composition.attester.time" /> <short value="When the composition was attested" /> <definition value="When the composition was attested by the party." /> <requirements value="Identifies when the information in the composition was deemed accurate. (Things may have changed since then.)." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.attester.time" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./time[type="TS" and isNormalDatatype()]" /> </mapping> <mapping> <identity value="cda" /> <map value=".authenticator.time" /> </mapping> </element> <element id="Composition.attester.party"> <path value="Composition.attester.party" /> <short value="Who attested the composition" /> <definition value="Who attested the composition in the specified way." /> <requirements value="Identifies who has taken on the responsibility for accuracy of the composition content." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.attester.party" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST" and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode="ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST" and classCode="ORG" and isNormalEntity()]" /> </mapping> <mapping> <identity value="cda" /> <map value=".authenticator.assignedEnttty" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="Composition.custodian"> <path value="Composition.custodian" /> <short value="Organization which maintains the composition" /> <definition value="Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information." /> <comment value="This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged." /> <requirements value="Identifies where to go to find the current version, where to report issues, etc." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.custodian" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]" /> </mapping> <mapping> <identity value="cda" /> <map value=".custodian.assignedCustodian" /> </mapping> </element> <element id="Composition.relatesTo"> <path value="Composition.relatesTo" /> <short value="Relationships to other compositions/documents" /> <definition value="Relationships that this composition has with other compositions or documents that already exist." /> <comment value="A document is a version specific composition." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.relatesTo" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".outboundRelationship" /> </mapping> <mapping> <identity value="cda" /> <map value=".relatedDocument" /> </mapping> </element> <element id="Composition.relatesTo.id"> <path value="Composition.relatesTo.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.relatesTo.extension"> <path value="Composition.relatesTo.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.relatesTo.modifierExtension"> <path value="Composition.relatesTo.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Composition.relatesTo.code"> <path value="Composition.relatesTo.code" /> <short value="replaces | transforms | signs | appends" /> <definition value="The type of relationship that this composition has with anther composition or document." /> <comment value="If this document appends another document, then the document cannot be fully understood without also accessing the referenced document." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.relatesTo.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentRelationshipType" /> </extension> <strength value="required" /> <description value="The type of relationship between documents." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/document-relationship-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".outboundRelationship.typeCode" /> </mapping> <mapping> <identity value="cda" /> <map value=".relatedDocument.typeCode" /> </mapping> </element> <element id="Composition.relatesTo.target[x]"> <path value="Composition.relatesTo.target[x]" /> <short value="Target of the relationship" /> <definition value="The target composition/document of this relationship." /> <min value="1" /> <max value="1" /> <base> <path value="Composition.relatesTo.target[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Composition" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".target[classCode="DOC", moodCode="EVN"].id" /> </mapping> <mapping> <identity value="cda" /> <map value=".relatedDocument.id" /> </mapping> </element> <element id="Composition.event"> <path value="Composition.event" /> <short value="The clinical service(s) being documented" /> <definition value="The clinical service, such as a colonoscopy or an appendectomy, being documented." /> <comment value="The event needs to be consistent with the type element, though can provide further information if desired." /> <requirements value="Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.event" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="outboundRelationship[typeCode="SUBJ"].target[classCode<'ACT']" /> </mapping> <mapping> <identity value="cda" /> <map value=".documentationOf.serviceEvent" /> </mapping> </element> <element id="Composition.event.id"> <path value="Composition.event.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.event.extension"> <path value="Composition.event.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.event.modifierExtension"> <path value="Composition.event.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Composition.event.code"> <path value="Composition.event.code" /> <short value="Code(s) that apply to the event being documented" /> <definition value="This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act." /> <comment value="An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.event.code" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DocumentEventType" /> </extension> <strength value="example" /> <description value="This list of codes represents the main clinical acts being documented." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActCode" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code" /> </mapping> <mapping> <identity value="cda" /> <map value=".code" /> </mapping> </element> <element id="Composition.event.period"> <path value="Composition.event.period" /> <short value="The period covered by the documentation" /> <definition value="The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.event.period" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".effectiveTime" /> </mapping> <mapping> <identity value="cda" /> <map value=".effectiveTime" /> </mapping> </element> <element id="Composition.event.detail"> <path value="Composition.event.detail" /> <short value="The event(s) being documented" /> <definition value="The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.event.detail" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode="SUBJ"].target" /> </mapping> <mapping> <identity value="cda" /> <map value="n/a" /> </mapping> </element> <element id="Composition.section"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Section" /> </extension> <path value="Composition.section" /> <short value="Composition is broken into sections" /> <definition value="The root of the sections that make up the composition." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.section" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="cmp-1" /> <severity value="error" /> <human value="A section must at least one of text, entries, or sub-sections" /> <expression value="text.exists() or entry.exists() or section.exists()" /> <xpath value="exists(f:text) or exists(f:entry) or exists(f:section)" /> </constraint> <constraint> <key value="cmp-2" /> <severity value="error" /> <human value="A section can only have an emptyReason if it is empty" /> <expression value="emptyReason.empty() or entry.empty()" /> <xpath value="not(exists(f:emptyReason) and exists(f:entry))" /> </constraint> <mapping> <identity value="rim" /> <map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" /> </mapping> <mapping> <identity value="cda" /> <map value=".component.structuredBody.component.section" /> </mapping> </element> <element id="Composition.section.id"> <path value="Composition.section.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.section.extension"> <path value="Composition.section.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Composition.section.modifierExtension"> <path value="Composition.section.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Composition.section.title"> <path value="Composition.section.title" /> <short value="Label for section (e.g. for ToC)" /> <definition value="The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents." /> <comment value="The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element." /> <requirements value="Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized." /> <alias value="header" /> <alias value="label" /> <alias value="caption" /> <min value="0" /> <max value="1" /> <base> <path value="Composition.section.title" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="./title" /> </mapping> <mapping> <identity value="cda" /> <map value=".title" /> </mapping> </element> <element id="Composition.section.code"> <path value="Composition.section.code" /> <short value="Classification of section (recommended)" /> <definition value="A code identifying the kind of content contained within the section. This must be consistent with the section title." /> <comment value="The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code." /> <requirements value="Provides computable standardized labels to topics within the document." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.section.code" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CompositionSectionType" /> </extension> <strength value="example" /> <description value="Classification of a section of a composition/document." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/doc-section-codes" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="./code" /> </mapping> <mapping> <identity value="cda" /> <map value=".code" /> </mapping> </element> <element id="Composition.section.text"> <path value="Composition.section.text" /> <short value="Text summary of the section, for human interpretation" /> <definition value="A human-readable narrative that contains the attested content of the section, 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." /> <comment value="Document profiles may define what content should be represented in the narrative to ensure clinical safety." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.section.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Narrative" /> </type> <condition value="cmp-1" /> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> <mapping> <identity value="cda" /> <map value=".text" /> </mapping> </element> <element id="Composition.section.mode"> <path value="Composition.section.mode" /> <short value="working | snapshot | changes" /> <definition value="How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted." /> <comment value="This element is labeled as a modifier because a change list must not be mis-understood as a complete list." /> <requirements value="Sections are used in various ways, and it must be known in what way it is safe to use the entries in them." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.section.mode" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SectionMode" /> </extension> <strength value="required" /> <description value="The processing mode that applies to this section." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/list-mode" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value" /> </mapping> <mapping> <identity value="cda" /> <map value="n/a" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="Composition.section.orderedBy"> <path value="Composition.section.orderedBy" /> <short value="Order of section entries" /> <definition value="Specifies the order applied to the items in the section entries." /> <comment value="Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order." /> <requirements value="Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.section.orderedBy" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SectionEntryOrder" /> </extension> <strength value="preferred" /> <description value="What order applies to the items in the entry." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/list-order" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=COMP].sequenceNumber > 1" /> </mapping> <mapping> <identity value="cda" /> <map value="n/a" /> </mapping> </element> <element id="Composition.section.entry"> <path value="Composition.section.entry" /> <short value="A reference to data that supports this section" /> <definition value="A reference to the actual resource from which the narrative in the section is derived." /> <comment value="If there are no entries in the list, an emptyReason SHOULD be provided." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.section.entry" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <condition value="cmp-2" /> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" /> </mapping> <mapping> <identity value="cda" /> <map value=".entry" /> </mapping> </element> <element id="Composition.section.emptyReason"> <path value="Composition.section.emptyReason" /> <short value="Why the section is empty" /> <definition value="If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason." /> <comment value="The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases." /> <requirements value="Allows capturing things like "none exist" or "not asked" which can be important for most lists." /> <min value="0" /> <max value="1" /> <base> <path value="Composition.section.emptyReason" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="cmp-2" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SectionEmptyReason" /> </extension> <strength value="preferred" /> <description value="If a section is empty, why it is empty." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/list-empty-reason" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".inboundRelationship[typeCode=SUBJ,code<{ListEmptyReason}].value[type=CD]" /> </mapping> <mapping> <identity value="cda" /> <map value="n/a" /> </mapping> </element> <element id="Composition.section.section"> <path value="Composition.section.section" /> <short value="Nested Section" /> <definition value="A nested sub-section within this section." /> <comment value="Nested sections are primarily used to help human readers navigate to particular portions of the document." /> <min value="0" /> <max value="*" /> <base> <path value="Composition.section.section" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#Composition.section" /> <condition value="cmp-1" /> <mapping> <identity value="rim" /> <map value="./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]" /> </mapping> <mapping> <identity value="cda" /> <map value=".component.section" /> </mapping> </element> </snapshot> <differential> <element id="Composition"> <path value="Composition" /> <min value="0" /> <max value="*" /> </element> <element id="Composition.subject"> <path value="Composition.subject" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/elementdefinition-de" /> <resource> <StructureDefinition> <id value="elementdefinition-de" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fhir" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/elementdefinition-de" /> <name value="DataElement constraint on ElementDefinition data type" /> <status value="draft" /> <experimental value="false" /> <date value="2015-02-28" /> <publisher value="Health Level Seven International (Orders and Observations)" /> <contact> <telecom> <system value="url" /> <value value="http://hl7.org/special/committees/FHIR" /> </telecom> </contact> <description value="Identifies how the ElementDefinition data type is used when it appears within a data element" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="dex" /> <uri value="http://wiki.ihe.net/index.php?title=Data_Element_Exchange" /> <name value="IHE Data Element Exchange (DEX)" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="iso11179" /> <uri value="http://metadata-standards.org/11179/" /> <name value="ISO 11179" /> </mapping> <mapping> <identity value="loinc" /> <uri value="http://loinc.org" /> <name value="LOINC code for the element" /> </mapping> <kind value="complex-type" /> <abstract value="false" /> <type value="ElementDefinition" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ElementDefinition" /> <derivation value="constraint" /> <snapshot> <element id="ElementDefinition"> <path value="ElementDefinition" /> <short value="Definition of an element in a resource or extension" /> <definition value="Captures constraints on each element within the resource, profile, or extension." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition" /> <min value="0" /> <max value="*" /> </base> <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="Element" /> </constraint> <constraint> <key value="eld-2" /> <severity value="error" /> <human value="Min <= Max" /> <expression value="min.empty() or max.empty() or (max = '*') or (min <= max.toInteger())" /> <xpath value="not(exists(f:min)) or not(exists(f:max)) or (not(f:max/@value) and not(f:min/@value)) or (f:max/@value = '*') or (number(f:max/@value) >= f:min/@value)" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-5" /> <severity value="error" /> <human value="if the element definition has a contentReference, it cannot have type, defaultValue, fixed, pattern, example, minValue, maxValue, maxLength, or binding" /> <expression value="contentReference.empty() or (type.empty() and defaultValue.empty() and fixed.empty() and pattern.empty() and example.empty() and minValue.empty() and maxValue.empty() and maxLength.empty() and binding.empty())" /> <xpath value="not(exists(f:contentReference) and (exists(f:type) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:*[starts-with(local-name(.), 'defaultValue')]) or exists(f:*[starts-with(local-name(.), 'fixed')]) or exists(f:*[starts-with(local-name(.), 'pattern')]) or exists(f:*[starts-with(local-name(.), 'example')]) or exists(f:*[starts-with(local-name(.), 'f:minValue')]) or exists(f:*[starts-with(local-name(.), 'f:maxValue')]) or exists(f:maxLength) or exists(f:binding)))" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-7" /> <severity value="error" /> <human value="Pattern may only be specified if there is one type" /> <expression value="pattern.empty() or (type.count() <= 1)" /> <xpath value="not(exists(f:*[starts-with(local-name(.), 'pattern')])) or (count(f:type)<=1)" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-6" /> <severity value="error" /> <human value="Fixed value may only be specified if there is one type" /> <expression value="fixed.empty() or (type.count() <= 1)" /> <xpath value="not(exists(f:*[starts-with(local-name(.), 'fixed')])) or (count(f:type)<=1)" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-11" /> <severity value="error" /> <human value="Binding can only be present for coded elements, string, and uri" /> <expression value="binding.empty() or type.code.empty() or type.select((code = 'code') or (code = 'Coding') or (code='CodeableConcept') or (code = 'Quantity') or (code = 'Extension') or (code = 'string') or (code = 'uri')).exists()" /> <xpath value="not(exists(f:binding)) or (count(f:type/f:code) = 0) or f:type/f:code/@value=('code','Coding','CodeableConcept','Quantity','Extension', 'string', 'uri')" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-8" /> <severity value="error" /> <human value="Pattern and value are mutually exclusive" /> <expression value="pattern.empty() or fixed.empty()" /> <xpath value="not(exists(f:*[starts-with(local-name(.), 'pattern')])) or not(exists(f:*[starts-with(local-name(.), 'fixed')]))" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-14" /> <severity value="error" /> <human value="Constraints must be unique by key" /> <expression value="constraint.select(key).isDistinct()" /> <xpath value="count(f:constraint) = count(distinct-values(f:constraint/f:key/@value))" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-13" /> <severity value="error" /> <human value="Types must be unique by the combination of code and profile" /> <expression value="type.select(code&profile&targetProfile).isDistinct()" /> <xpath value="not(exists(for $type in f:type return $type/preceding-sibling::f:type[f:code/@value=$type/f:code/@value and f:profile/@value = $type/f:profile/@value]))" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-16" /> <severity value="error" /> <human value="sliceName must be composed of proper tokens separated by "/"" /> <expression value="sliceName.empty() or sliceName.matches('^[a-zA-Z0-9\\/\\-\\_]+$')" /> <xpath value="not(exists(f:sliceName/@value)) or matches(f:sliceName/@value, '^[a-zA-Z0-9\\/\\-\\_]+$')" /> <source value="ElementDefinition" /> </constraint> <constraint> <key value="eld-15" /> <severity value="error" /> <human value="default value and meaningWhenMissing are mutually exclusive" /> <expression value="defaultValue.empty() or meaningWhenMissing.empty()" /> <xpath value="not(exists(f:*[starts-with(local-name(.), 'fixed')])) or not(exists(f:meaningWhenMissing))" /> <source value="ElementDefinition" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="dex" /> <map value="RetrieveMetadata response" /> </mapping> <mapping> <identity value="v2" /> <map value="OM1" /> </mapping> <mapping> <identity value="rim" /> <map value="Observation[classCode=OBS, moodCode=DEFN]" /> </mapping> <mapping> <identity value="iso11179" /> <map value="Data_Element" /> </mapping> </element> <element id="ElementDefinition.id"> <path value="ElementDefinition.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.extension"> <path value="ElementDefinition.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.extension:question"> <path value="ElementDefinition.extension" /> <sliceName value="Question" /> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/elementdefinition-question" /> </type> </element> <element id="ElementDefinition.extension:question.id"> <path value="ElementDefinition.extension.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.extension:question.extension"> <path value="ElementDefinition.extension.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.extension:question.url"> <path value="ElementDefinition.extension.url" /> <representation value="xmlAttr" /> <short value="identifies the meaning of the extension" /> <definition value="Source of the definition for the extension code - a logical name or a URL." /> <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." /> <min value="1" /> <max value="1" /> <base> <path value="Extension.url" /> <min value="1" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://hl7.org/fhir/StructureDefinition/elementdefinition-question" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.extension:question.valueString"> <path value="ElementDefinition.extension.valueString" /> <short value="Value of extension" /> <definition value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)." /> <min value="0" /> <max value="1" /> <base> <path value="Extension.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.extension:allowedunits"> <path value="ElementDefinition.extension" /> <sliceName value="AllowedUnits" /> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="1" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/elementdefinition-allowedUnits" /> </type> </element> <element id="ElementDefinition.extension:allowedunits.id"> <path value="ElementDefinition.extension.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.extension:allowedunits.extension"> <path value="ElementDefinition.extension.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.extension:allowedunits.url"> <path value="ElementDefinition.extension.url" /> <representation value="xmlAttr" /> <short value="identifies the meaning of the extension" /> <definition value="Source of the definition for the extension code - a logical name or a URL." /> <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." /> <min value="1" /> <max value="1" /> <base> <path value="Extension.url" /> <min value="1" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <fixedUri value="http://hl7.org/fhir/StructureDefinition/elementdefinition-allowedUnits" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.extension:allowedunits.value[x]"> <path value="ElementDefinition.extension.value[x]" /> <short value="Value of extension" /> <definition value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)." /> <min value="1" /> <max value="1" /> <base> <path value="Extension.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Units" /> </extension> <strength value="required" /> <description value="Units of measure allowed for an element" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ucum-units" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.path"> <path value="ElementDefinition.path" /> <short value="Path of the element in the hierarchy of elements" /> <definition value="The path identifies the element and is expressed as a "."-separated list of ancestor elements, beginning with the name of the resource or extension." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.path" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="Name, Identifier & Context" /> </mapping> </element> <element id="ElementDefinition.representation"> <path value="ElementDefinition.representation" /> <short value="xmlAttr | xmlText | typeAttr | cdaText | xhtml" /> <definition value="Codes that define how this element is represented in instances, when the deviation varies from the normal case." /> <comment value="In resources, this is rarely used except for special cases where the representation deviates from the normal, and can only be done in the base standard (and profiles must reproduce what the base standard does). This element is used quite commonly in Logical models when the logical models represent a specific serialization format (e.g. CDA, v2 etc)." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.representation" /> <min value="0" /> <max value="*" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PropertyRepresentation" /> </extension> <strength value="required" /> <description value="How a property is represented when serialized." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/property-representation" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.sliceName"> <path value="ElementDefinition.sliceName" /> <short value="Name for this particular element (in a set of slices)" /> <definition value="The name of this element definition slice, when slicing is working. The name must be a token with no dots or spaces. This is a unique name referring to a specific set of constraints applied to this element, used to provide a name to different slices of the same element." /> <comment value="The name SHALL be unique within the structure within the context of the constrained resource element. (Though to avoid confusion, uniqueness across all elements is recommended.)." /> <requirements value="May also be used for code generation purposes." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.sliceName" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.label"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.label" /> <short value="Name for element to display with or prompt for element" /> <definition value="A single preferred label which is the text to display beside the element indicating its meaning or to use to prompt for the element in a user display or form." /> <comment value="See also the extension (http://hl7.org/fhir/StructureDefinition/elementdefinition-question)[extension-elementdefinition-question.html]." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.label" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./code/display" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.code"> <path value="ElementDefinition.code" /> <short value="Corresponding codes in terminologies" /> <definition value="A code that has the same meaning as the element in a particular terminology." /> <comment value="The concept SHALL be properly aligned with the data element definition and other constraints, as defined in the code system, including relationships, of any code listed here. Where multiple codes exist in a terminology that could correspond to the data element, the most granular code(s) should be selected, so long as they are not more restrictive than the data element itself. The mappings may be used to provide more or less granular or structured equivalences in the code system." /> <requirements value="Links the meaning of an element to an external terminology, and is very useful for searching and indexing." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.code" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ElementDefinitionCode" /> </extension> <strength value="example" /> <description value="Codes that indicate the meaning of a data element." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-codes" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OM1.7" /> </mapping> <mapping> <identity value="rim" /> <map value="./code (root or translation)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="(Data_Element).data_element_concept.identifier" /> </mapping> <mapping> <identity value="loinc" /> <map value="LOINC_NUM" /> </mapping> </element> <element id="ElementDefinition.slicing"> <path value="ElementDefinition.slicing" /> <short value="This element is sliced - slices follow" /> <definition value="Indicates that the element is sliced into a set of alternative definitions (i.e. in a structure definition, there are multiple different constraints on a single element in the base resource). Slicing can be used in any resource that has cardinality ..* on the base resource, or any resource with a choice of types. The set of slices is any elements that come after this in the element sequence that have the same path, until a shorter path occurs (the shorter path terminates the set)." /> <comment value="The first element in the sequence, the one that carries the slicing, is the definition that applies to all the slices. This is based on the unconstrained element, but can apply any constraints as appropriate. This may include the common constraints on the children of the element." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.slicing" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Element" /> </type> <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="Element" /> </constraint> <constraint> <key value="eld-1" /> <severity value="error" /> <human value="If there are no discriminators, there must be a definition" /> <expression value="discriminator.exists() or description.exists()" /> <xpath value="(f:discriminator) or (f:description)" /> <source value="ElementDefinition.slicing" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.id"> <path value="ElementDefinition.slicing.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.extension"> <path value="ElementDefinition.slicing.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.discriminator"> <path value="ElementDefinition.slicing.discriminator" /> <short value="Element values that are used to distinguish the slices" /> <definition value="Designates which child elements are used to discriminate between the slices when processing an instance. If one or more discriminators are provided, the value of the child elements in the instance data SHALL completely distinguish which slice the element in the resource matches based on the allowed values for those elements in each of the slices." /> <comment value="If there is no discriminator, the content is hard to process, so this should be avoided. If the base element has a cardinality of ..1, and there is a choice of types, the discriminator must be "@type"." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.slicing.discriminator" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Element" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.discriminator.id"> <path value="ElementDefinition.slicing.discriminator.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.discriminator.extension"> <path value="ElementDefinition.slicing.discriminator.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.discriminator.type"> <path value="ElementDefinition.slicing.discriminator.type" /> <short value="value | exists | pattern | type | profile" /> <definition value="How the element value is interpreted when discrimination is evaluated." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.slicing.discriminator.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiscriminatorType" /> </extension> <strength value="required" /> <description value="How an element value is interpreted when discrimination is evaluated" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/discriminator-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.slicing.discriminator.path"> <path value="ElementDefinition.slicing.discriminator.path" /> <short value="Path to element value" /> <definition value="A FHIRPath expression, using a restricted subset of FHIRPath, that is used to identify the element on which discrimination is based." /> <comment value="The only FHIRPath functions that are allowed are resolve(), and extension(url)." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.slicing.discriminator.path" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.description"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.slicing.description" /> <short value="Text description of how slicing works (or not)" /> <definition value="A human-readable text description of how the slicing works. If there is no discriminator, this is required to be present to provide whatever information is possible about how the slices can be differentiated." /> <comment value="If it's really not possible to differentiate them, the design should be re-evaluated to make the content usable." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.slicing.description" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="eld-1" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.slicing.ordered"> <path value="ElementDefinition.slicing.ordered" /> <short value="If elements must be in same order as slices" /> <definition value="If the matching elements have to occur in the same order as defined in the profile." /> <comment value="Order should only be required when it is a pressing concern for presentation. Profile authors should consider making the order a feature of the rules about the narrative, not the rules about the data - requiring ordered data makes the profile much less re-usable." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.slicing.ordered" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <defaultValueBoolean value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.slicing.rules"> <path value="ElementDefinition.slicing.rules" /> <short value="closed | open | openAtEnd" /> <definition value="Whether additional slices are allowed or not. When the slices are ordered, profile authors can also say that additional slices are only allowed at the end." /> <comment value="Allowing additional elements makes for a much for flexible template - it's open for use in wider contexts, but also means that the content of the resource is not closed, and applications have to decide how to handle content not described by the profile." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.slicing.rules" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SlicingRules" /> </extension> <strength value="required" /> <description value="How slices are interpreted when evaluating an instance." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/resource-slicing-rules" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.short"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.short" /> <short value="Concise definition for space-constrained presentation" /> <definition value="A concise description of what this element means (e.g. for use in autogenerated summaries)." /> <comment value="May change the term to provide language more appropriate to the context of the profile or to reflect slicing." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.short" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="iso11179" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.definition"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.definition" /> <short value="Full formal definition as narrative text" /> <definition value="Provides a complete explanation of the meaning of the data element for human readability. For the case of elements derived from existing elements (e.g. constraints), the definition SHALL be consistent with the base definition, but convey the meaning of the element in the particular context of use of the resource." /> <comment value="It is easy for a different definition to change the meaning of an element and this can have nasty downstream consequences. Please be careful when providing definitions." /> <requirements value="To allow a user to state the usage of an element in a particular context." /> <alias value="Description" /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.definition" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OM1.6, OM1.41" /> </mapping> <mapping> <identity value="rim" /> <map value="./text" /> </mapping> <mapping> <identity value="iso11179" /> <map value="(Designatable_Item).definition.text acceptability=preferred in default context" /> </mapping> <mapping> <identity value="loinc" /> <map value="TERM DEFINITION/DESCRIPTION(S)" /> </mapping> </element> <element id="ElementDefinition.comment"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.comment" /> <short value="Comments about the use of this element" /> <definition value="Explanatory notes and implementation guidance about the data element, including notes about how to use the data properly, exceptions to proper use, etc." /> <comment value="If it is possible to capture usage rules using constraints, that mechanism should be used in preference to this element." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="NTE, OM1.32, OM1.33, OM1.39" /> </mapping> <mapping> <identity value="rim" /> <map value="./inboundRelationship[typeCode=SUBJ]/source[classCode=LIST, moodCode=EVN]/code" /> </mapping> <mapping> <identity value="iso11179" /> <map value="(Administered_Item).explanatory_comment" /> </mapping> <mapping> <identity value="loinc" /> <map value="COMMENTS" /> </mapping> </element> <element id="ElementDefinition.requirements"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.requirements" /> <short value="Why this resource has been created" /> <definition value="This element is for traceability of why the element was created and why the constraints exist as they do. This may be used to point to source materials or specifications that drove the structure of this element." /> <comment value="This element does not describe the usage of the element (that's done in comments), rather it's for traceability of *why* the element is either needed or why the constraints exist as they do. This may be used to point to source materials or specifications that drove the structure of this data element." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.requirements" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./inboundRelationship[typeCode=META]/source[classCode=ACT, moodCode=EVN, isCriterionInd=true]/reasonCode/originalText" /> </mapping> <mapping> <identity value="iso11179" /> <map value="(Registered_item).document_reference[document_type=requirements].notation" /> </mapping> <mapping> <identity value="loinc" /> <map value="R/O/C" /> </mapping> </element> <element id="ElementDefinition.alias"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.alias" /> <short value="Other names" /> <definition value="Identifies additional names by which this element might also be known." /> <requirements value="Allows for better easier recognition of the element by multiple communities, including international communities." /> <alias value="synonym" /> <alias value="other name" /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.alias" /> <min value="0" /> <max value="*" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OM1.8, OM1.52" /> </mapping> <mapping> <identity value="rim" /> <map value="Not currently expressible" /> </mapping> <mapping> <identity value="iso11179" /> <map value="(Designatable_Item).designation.sign acceptability!=preferred or context is other than default" /> </mapping> <mapping> <identity value="loinc" /> <map value="RELATED NAMES (only some of these apply)" /> </mapping> </element> <element id="ElementDefinition.min"> <path value="ElementDefinition.min" /> <short value="Minimum Cardinality" /> <definition value="The minimum number of times this element SHALL appear in the instance." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.min" /> <min value="0" /> <max value="1" /> </base> <type> <code value="unsignedInt" /> </type> <condition value="eld-2" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="Minimum size of data element values?" /> </mapping> </element> <element id="ElementDefinition.max"> <path value="ElementDefinition.max" /> <short value="Maximum Cardinality (a number or *)" /> <definition value="The maximum number of times this element is permitted to appear in the instance." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.max" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="eld-3" /> <condition value="eld-2" /> <constraint> <key value="eld-3" /> <severity value="error" /> <human value="Max SHALL be a number or "*"" /> <expression value="empty() or ($this = '*') or (toInteger() >= 0)" /> <xpath value="@value='*' or (normalize-space(@value)!='' and normalize-space(translate(@value, '0123456789',''))='')" /> </constraint> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OMC.10" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="Maximum size of data element values?" /> </mapping> </element> <element id="ElementDefinition.base"> <path value="ElementDefinition.base" /> <short value="Base definition information for tools" /> <definition value="Information about the base definition of the element, provided to make it unnecessary for tools to trace the deviation of the element through the derived and related profiles. This information is provided when the element definition is not the original definition of an element - i.g. either in a constraint on another type, or for elements from a super type in a snap shot." /> <comment value="The base information does not carry any information that could not be determined from the path and related profiles, but making this determination requires both that the related profiles are available, and that the algorithm to determine them be available. So they are deformalised into this location for tooling convenience, and to ensure that the base information is available without dependencies." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.base" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Element" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.base.id"> <path value="ElementDefinition.base.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.base.extension"> <path value="ElementDefinition.base.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.base.path"> <path value="ElementDefinition.base.path" /> <short value="Path that identifies the base element" /> <definition value="The Path that identifies the base element - this matches the ElementDefinition.path for that element. Across FHIR, there is only one base definition of any element - that is, an element definition on a [StructureDefinition](structuredefinition.html#) without a StructureDefinition.base." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.base.path" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.base.min"> <path value="ElementDefinition.base.min" /> <short value="Min cardinality of the base element" /> <definition value="Minimum cardinality of the base element identified by the path." /> <comment value="This is provided for consistency with max, and may affect code generation of mandatory elements of the base resource are generated differently (some reference implementations have done this)." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.base.min" /> <min value="1" /> <max value="1" /> </base> <type> <code value="unsignedInt" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.base.max"> <path value="ElementDefinition.base.max" /> <short value="Max cardinality of the base element" /> <definition value="Maximum cardinality of the base element identified by the path." /> <comment value="This is provided to code generation, since the serialization representation in JSON differs depending on whether the base element has max > 1. Also, some forms of code generation may differ." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.base.max" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.contentReference"> <path value="ElementDefinition.contentReference" /> <short value="Reference to definition of content for the element" /> <definition value="Identifies the identity of an element defined elsewhere in the profile whose content rules should be applied to the current element." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.contentReference" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="eld-5" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.type"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="TypeRef" /> </extension> <path value="ElementDefinition.type" /> <short value="Data type and Profile for this element" /> <definition value="The data type or resource that the value of this element is permitted to be." /> <comment value="The Type of the element can be left blank in a differential constraint, in which case the type is inherited from the resource. Abstract types are not permitted to appear as a type when multiple types are listed. (I.e. Abstract types cannot be part of a choice)." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.type" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Element" /> </type> <condition value="eld-13" /> <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="Element" /> </constraint> <constraint> <key value="eld-4" /> <severity value="error" /> <human value="Aggregation may only be specified if one of the allowed types for the element is a resource" /> <expression value="aggregation.empty() or (code = 'Reference')" /> <xpath value="not(exists(f:aggregation)) or exists(f:code[@value = 'Reference'])" /> <source value="ElementDefinition.type" /> </constraint> <isSummary value="true" /> <mapping> <identity value="dex" /> <map value="valueDomain.dataType" /> </mapping> <mapping> <identity value="v2" /> <map value="OM1.3, OMC.9" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value=".domain.data+Q14type" /> </mapping> <mapping> <identity value="loinc" /> <map value="HL7_V2_DATATYPE (translation required), HL7_V3_DATATYPE (translation required)" /> </mapping> </element> <element id="ElementDefinition.type.id"> <path value="ElementDefinition.type.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.type.extension"> <path value="ElementDefinition.type.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.type.code"> <path value="ElementDefinition.type.code" /> <short value="Data type or Resource (reference to definition)" /> <definition value="URL of Data type or Resource that is a(or the) type used for this element. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition e.g. "string" is a reference to http://hl7.org/fhir/StructureDefinition/string. Absolute URLs are only allowed in logical models." /> <comment value="If the element is a reference to another resource, this element contains "Reference", and the targetProfile element defines what resources can be referenced. The targetProfile may be a reference to the general definition of a resource (e.g. http://hl7.org/fhir/StructureDefinition/Patient). There would be one pair of type/code for each allowed target resource type." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.type.code" /> <min value="1" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FHIRDefinedTypeExt" /> </extension> <strength value="extensible" /> <description value="Either a resource or a data type, including logical model types" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/defined-types" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="OM1.3" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value=".domain.data+Q14type" /> </mapping> <mapping> <identity value="loinc" /> <map value="HL7_V2_DATATYPE (translation required), HL7_V3_DATATYPE (translation required)" /> </mapping> </element> <element id="ElementDefinition.type.profile"> <path value="ElementDefinition.type.profile" /> <short value="Profile (StructureDefinition) to apply (or IG)" /> <definition value="Identifies a profile structure or implementation Guide that SHALL hold for the datatype this element refers to. Can be a local reference - to a contained StructureDefinition, or a reference to another StructureDefinition or Implementation Guide by a canonical URL. When an implementation guide is specified, the resource SHALL conform to at least one profile defined in the implementation guide." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.type.profile" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.type.targetProfile"> <path value="ElementDefinition.type.targetProfile" /> <short value="Profile (StructureDefinition) to apply to reference target (or IG)" /> <definition value="Identifies a profile structure or implementation Guide that SHALL hold for the target of the reference this element refers to. Can be a local reference - to a contained StructureDefinition, or a reference to another StructureDefinition or Implementation Guide by a canonical URL. When an implementation guide is specified, the resource SHALL conform to at least one profile defined in the implementation guide." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.type.targetProfile" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.type.aggregation"> <path value="ElementDefinition.type.aggregation" /> <short value="contained | referenced | bundled - how aggregated" /> <definition value="If the type is a reference to another resource, how the resource is or can be aggregated - is it a contained resource, or a reference, and if the context is a bundle, is it included in the bundle." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.type.aggregation" /> <min value="0" /> <max value="*" /> </base> <type> <code value="code" /> </type> <condition value="eld-4" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AggregationMode" /> </extension> <strength value="required" /> <description value="How resource references can be aggregated." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/resource-aggregation-mode" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.type.versioning"> <path value="ElementDefinition.type.versioning" /> <short value="either | independent | specific" /> <definition value="Whether this reference needs to be version specific or version independent, or whether either can be used." /> <comment value="The base specification never makes a rule as to which form is allowed, but implementation guides may do this." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.type.versioning" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <defaultValueCode value="either" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ReferenceVersionRules" /> </extension> <strength value="required" /> <description value="Whether a reference needs to be version specific or version independent, or whether either can be used" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/reference-version-rules" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.defaultValue[x]"> <path value="ElementDefinition.defaultValue[x]" /> <short value="Specified value if missing from instance" /> <definition value="The value that should be used if there is no value stated in the instance (e.g. 'if not otherwise specified, the abstract is false')." /> <comment value="Default values can only be specified on a resource, data type, or extension definition, and never in a profile that applies to one of these. Specifying a default value means that the property can never been unknown - it must always have a value. Further, the default value can never be changed. For these reasons, default values are (and should be) used extremely sparingly. This element should only be used on child elements of complex data elements." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.defaultValue[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="base64Binary" /> </type> <type> <code value="boolean" /> </type> <type> <code value="code" /> </type> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="decimal" /> </type> <type> <code value="id" /> </type> <type> <code value="instant" /> </type> <type> <code value="integer" /> </type> <type> <code value="markdown" /> </type> <type> <code value="oid" /> </type> <type> <code value="positiveInt" /> </type> <type> <code value="string" /> </type> <type> <code value="time" /> </type> <type> <code value="unsignedInt" /> </type> <type> <code value="uri" /> </type> <type> <code value="Address" /> </type> <type> <code value="Age" /> </type> <type> <code value="Annotation" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="Coding" /> </type> <type> <code value="ContactPoint" /> </type> <type> <code value="Count" /> </type> <type> <code value="Distance" /> </type> <type> <code value="Duration" /> </type> <type> <code value="HumanName" /> </type> <type> <code value="Identifier" /> </type> <type> <code value="Money" /> </type> <type> <code value="Period" /> </type> <type> <code value="Quantity" /> </type> <type> <code value="Range" /> </type> <type> <code value="Ratio" /> </type> <type> <code value="Reference" /> </type> <type> <code value="SampledData" /> </type> <type> <code value="Signature" /> </type> <type> <code value="Timing" /> </type> <type> <code value="Meta" /> </type> <condition value="eld-15" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.meaningWhenMissing"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.meaningWhenMissing" /> <short value="Implicit meaning when this element is missing" /> <definition value="The Implicit meaning that is to be understood when this element is missing (e.g. 'when this element is missing, the period is ongoing'." /> <comment value="Implicit meanings for missing values can only be specified on a resource, data type, or extension definition, and never in a profile that applies to one of these. An implicit meaning for a missing value can never be changed, and specifying one has the consequence that constraining its use in profiles eliminates use cases as possibilities, not merely moving them out of scope. This element should only be used on child elements of complex data elements." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.meaningWhenMissing" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <condition value="eld-15" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.orderMeaning"> <path value="ElementDefinition.orderMeaning" /> <short value="What the order of the elements means" /> <definition value="If present, indicates that the order of the repeating element has meaning and describes what that meaning is. If absent, it means that the order of the element has no meaning." /> <comment value="This element can only be asserted on repeating elements and can only be introduced when defining resources or data types. It can be further refined profiled elements but if absent in the base type, a profile cannot assert meaning." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.orderMeaning" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.fixed[x]"> <path value="ElementDefinition.fixed[x]" /> <short value="Value must be exactly this" /> <definition value="Specifies a value that SHALL be exactly the value for this element in the instance. For purposes of comparison, non-significant whitespace is ignored, and all values must be an exact match (case and accent sensitive). Missing elements/attributes must also be missing." /> <comment value="This is not recommended for Coding and CodeableConcept since these often have highly contextual properties such as version or display." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.fixed[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="base64Binary" /> </type> <type> <code value="boolean" /> </type> <type> <code value="code" /> </type> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="decimal" /> </type> <type> <code value="id" /> </type> <type> <code value="instant" /> </type> <type> <code value="integer" /> </type> <type> <code value="markdown" /> </type> <type> <code value="oid" /> </type> <type> <code value="positiveInt" /> </type> <type> <code value="string" /> </type> <type> <code value="time" /> </type> <type> <code value="unsignedInt" /> </type> <type> <code value="uri" /> </type> <type> <code value="Address" /> </type> <type> <code value="Age" /> </type> <type> <code value="Annotation" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="Coding" /> </type> <type> <code value="ContactPoint" /> </type> <type> <code value="Count" /> </type> <type> <code value="Distance" /> </type> <type> <code value="Duration" /> </type> <type> <code value="HumanName" /> </type> <type> <code value="Identifier" /> </type> <type> <code value="Money" /> </type> <type> <code value="Period" /> </type> <type> <code value="Quantity" /> </type> <type> <code value="Range" /> </type> <type> <code value="Ratio" /> </type> <type> <code value="Reference" /> </type> <type> <code value="SampledData" /> </type> <type> <code value="Signature" /> </type> <type> <code value="Timing" /> </type> <type> <code value="Meta" /> </type> <condition value="eld-5" /> <condition value="eld-6" /> <condition value="eld-8" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="N/A (only relevant when constraining, which 11179 doesn't do)" /> </mapping> </element> <element id="ElementDefinition.pattern[x]"> <path value="ElementDefinition.pattern[x]" /> <short value="Value must have at least these property values" /> <definition value="Specifies a value that the value in the instance SHALL follow - that is, any value in the pattern must be found in the instance. Other additional values may be found too. This is effectively constraint by example. The values of elements present in the pattern must match exactly (case-sensitive, accent-sensitive, etc.)." /> <comment value="Mostly used for fixing values of CodeableConcept. At present, pattern[x] is not recommended as a basis for slicing while issues related to this are investigated during the STU period." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.pattern[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="base64Binary" /> </type> <type> <code value="boolean" /> </type> <type> <code value="code" /> </type> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="decimal" /> </type> <type> <code value="id" /> </type> <type> <code value="instant" /> </type> <type> <code value="integer" /> </type> <type> <code value="markdown" /> </type> <type> <code value="oid" /> </type> <type> <code value="positiveInt" /> </type> <type> <code value="string" /> </type> <type> <code value="time" /> </type> <type> <code value="unsignedInt" /> </type> <type> <code value="uri" /> </type> <type> <code value="Address" /> </type> <type> <code value="Age" /> </type> <type> <code value="Annotation" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="Coding" /> </type> <type> <code value="ContactPoint" /> </type> <type> <code value="Count" /> </type> <type> <code value="Distance" /> </type> <type> <code value="Duration" /> </type> <type> <code value="HumanName" /> </type> <type> <code value="Identifier" /> </type> <type> <code value="Money" /> </type> <type> <code value="Period" /> </type> <type> <code value="Quantity" /> </type> <type> <code value="Range" /> </type> <type> <code value="Ratio" /> </type> <type> <code value="Reference" /> </type> <type> <code value="SampledData" /> </type> <type> <code value="Signature" /> </type> <type> <code value="Timing" /> </type> <type> <code value="Meta" /> </type> <condition value="eld-5" /> <condition value="eld-7" /> <condition value="eld-8" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.example"> <path value="ElementDefinition.example" /> <short value="Example value (as defined for type)" /> <definition value="A sample value for this element demonstrating the type of information that would typically be found in the element." /> <comment value="Examples will most commonly be present for data where it's not implicitly obvious from either the data type or value set what the values might be. (I.e. Example values for dates or quantities would generally be unnecessary.) If the example value is fully populated, the publication tool can generate an instance automatically." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.example" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Element" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.example.id"> <path value="ElementDefinition.example.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.example.extension"> <path value="ElementDefinition.example.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.example.label"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.example.label" /> <short value="Describes the purpose of this example" /> <definition value="Describes the purpose of this example amoung the set of examples." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.example.label" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.example.value[x]"> <path value="ElementDefinition.example.value[x]" /> <short value="Value of Example (one of allowed types)" /> <definition value="The actual value for the element, which must be one of the types allowed for this element." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.example.value[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="base64Binary" /> </type> <type> <code value="boolean" /> </type> <type> <code value="code" /> </type> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="decimal" /> </type> <type> <code value="id" /> </type> <type> <code value="instant" /> </type> <type> <code value="integer" /> </type> <type> <code value="markdown" /> </type> <type> <code value="oid" /> </type> <type> <code value="positiveInt" /> </type> <type> <code value="string" /> </type> <type> <code value="time" /> </type> <type> <code value="unsignedInt" /> </type> <type> <code value="uri" /> </type> <type> <code value="Address" /> </type> <type> <code value="Age" /> </type> <type> <code value="Annotation" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="CodeableConcept" /> </type> <type> <code value="Coding" /> </type> <type> <code value="ContactPoint" /> </type> <type> <code value="Count" /> </type> <type> <code value="Distance" /> </type> <type> <code value="Duration" /> </type> <type> <code value="HumanName" /> </type> <type> <code value="Identifier" /> </type> <type> <code value="Money" /> </type> <type> <code value="Period" /> </type> <type> <code value="Quantity" /> </type> <type> <code value="Range" /> </type> <type> <code value="Ratio" /> </type> <type> <code value="Reference" /> </type> <type> <code value="SampledData" /> </type> <type> <code value="Signature" /> </type> <type> <code value="Timing" /> </type> <type> <code value="Meta" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value=".example" /> </mapping> <mapping> <identity value="loinc" /> <map value="EXMPL_ANSWERS" /> </mapping> </element> <element id="ElementDefinition.minValue[x]"> <path value="ElementDefinition.minValue[x]" /> <short value="Minimum Allowed Value (for some types)" /> <definition value="The minimum allowed value for the element. The value is inclusive. This is allowed for the types date, dateTime, instant, time, decimal, integer, and Quantity." /> <comment value="Except for date/date/instant, the type of the minValue[x] SHALL be the same as the specified type of the element. For the date/dateTime/instant values, the type of minValue[x] SHALL be either the same, or a a [Duration](datatypes.html#duration) which specifies a relative time limit to the current time. The duration value is positive, and is subtracted from the current clock to determine the minimum allowable value. A minimum value for a Quantity is interpreted as an canonical minimum - e.g. you cannot provide 100mg if the minimum value is 10g." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.minValue[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="instant" /> </type> <type> <code value="time" /> </type> <type> <code value="decimal" /> </type> <type> <code value="integer" /> </type> <type> <code value="positiveInt" /> </type> <type> <code value="unsignedInt" /> </type> <type> <code value="Quantity" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.maxValue[x]"> <path value="ElementDefinition.maxValue[x]" /> <short value="Maximum Allowed Value (for some types)" /> <definition value="The maximum allowed value for the element. The value is inclusive. This is allowed for the types date, dateTime, instant, time, decimal, integer, and Quantity." /> <comment value="Except for date/date/instant, the type of the maxValue[x] SHALL be the same as the specified type of the element. For the date/dateTime/instant values, the type of maxValue[x] SHALL be either the same, or a a [Duration](datatypes.html#duration) which specifies a relative time limit to the current time. The duration value is positive, and is added to the current clock to determine the maximum allowable value. A maximum value for a Quantity is interpreted as an canonical maximum - e.g. you cannot provide 10g if the maximum value is 50mg." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.maxValue[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="instant" /> </type> <type> <code value="time" /> </type> <type> <code value="decimal" /> </type> <type> <code value="integer" /> </type> <type> <code value="positiveInt" /> </type> <type> <code value="unsignedInt" /> </type> <type> <code value="Quantity" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.maxLength"> <path value="ElementDefinition.maxLength" /> <short value="Max length for strings" /> <definition value="Indicates the maximum length in characters that is permitted to be present in conformant instances and which is expected to be supported by conformant consumers that support the element." /> <comment value="Receivers are not required to reject instances that exceed the maximum length. The full length could be stored. In some cases, data might be truncated, though truncation should be undertaken with care and an understanding of the consequences of doing so. If not specified, there is no conformance expectation for length support." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.maxLength" /> <min value="0" /> <max value="1" /> </base> <type> <code value="integer" /> </type> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OMC.12" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value=".domain.maximum_character_quantity" /> </mapping> </element> <element id="ElementDefinition.condition"> <path value="ElementDefinition.condition" /> <short value="Reference to invariant about presence" /> <definition value="A reference to an invariant that may make additional statements about the cardinality or value in the instance." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.condition" /> <min value="0" /> <max value="*" /> </base> <type> <code value="id" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint"> <path value="ElementDefinition.constraint" /> <short value="Condition that must evaluate to true" /> <definition value="Formal constraints such as co-occurrence and other constraints that can be computationally evaluated within the context of the instance." /> <comment value="Constraints should be declared on the "context" element - the lowest element in the hierarchy that is common to all nodes referenced by the constraint." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.constraint" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Element" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="??" /> </mapping> </element> <element id="ElementDefinition.constraint.id"> <path value="ElementDefinition.constraint.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.constraint.extension"> <path value="ElementDefinition.constraint.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.constraint.key"> <path value="ElementDefinition.constraint.key" /> <short value="Target of 'condition' reference above" /> <definition value="Allows identification of which elements have their cardinalities impacted by the constraint. Will not be referenced for constraints that do not affect cardinality." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.key" /> <min value="1" /> <max value="1" /> </base> <type> <code value="id" /> </type> <condition value="eld-14" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint.requirements"> <path value="ElementDefinition.constraint.requirements" /> <short value="Why this constraint is necessary or appropriate" /> <definition value="Description of why this constraint is necessary or appropriate." /> <comment value="To be used if the reason for the constraint may not be intuitive to all implementers." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.requirements" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint.severity"> <path value="ElementDefinition.constraint.severity" /> <short value="error | warning" /> <definition value="Identifies the impact constraint violation has on the conformance of the instance." /> <comment value="This allows constraints to be asserted as "shall" (error) and "should" (warning)." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.severity" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ConstraintSeverity" /> </extension> <strength value="required" /> <description value="SHALL applications comply with this constraint?" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/constraint-severity" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint.human"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.constraint.human" /> <short value="Human description of constraint" /> <definition value="Text that can be used to describe the constraint in messages identifying that the constraint has been violated." /> <comment value="Should be expressed in business terms as much as possible." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.human" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint.expression"> <path value="ElementDefinition.constraint.expression" /> <short value="FHIRPath expression of constraint" /> <definition value="A [FHIRPath](http://hl7.org/fluentpath) expression of constraint that can be executed to see if this constraint is met." /> <requirements value="Used by validation tooling tests of the validity of the resource." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.expression" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint.xpath"> <path value="ElementDefinition.constraint.xpath" /> <short value="XPath expression of constraint" /> <definition value="An XPath expression of constraint that can be executed to see if this constraint is met." /> <comment value="Elements SHALL use "f" as the namespace prefix for the FHIR namespace, and "x" for the xhtml namespace, and SHALL NOT use any other prefixes. Note: we are considering deprecating the xpath element. Implementer feedback is welcome." /> <requirements value="Used in Schematron tests of the validity of the resource." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.xpath" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.constraint.source"> <path value="ElementDefinition.constraint.source" /> <short value="Reference to original source of constraint" /> <definition value="A reference to the original source of the constraint, for traceability purposes." /> <comment value="This is used when, e.g. rendering, where it is not useful to present inherited constraints when rendering the snapshot." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.constraint.source" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.mustSupport"> <path value="ElementDefinition.mustSupport" /> <short value="If the element must supported" /> <definition value="If true, implementations that produce or consume resources SHALL provide "support" for the element in some meaningful way. If false, the element may be ignored and not supported." /> <comment value=""Something useful" is context dependent and impossible to describe in the base FHIR specification. For this reason, tue mustSupport flag is never set to true by the FHIR specification itself - it is only set to true in profiles. This is done in [Resource Profiles](profiling.html#mustsupport), where the profile labels an element as mustSupport=true. When a profile does this, it SHALL also make clear exactly what kind of "support" is required, as this can mean many things. Note that an element that has the property IsModifier is not necessarily a "key" element (e.g. one of the important elements to make use of the resource), nor is it automatically mustSupport - however both of these things are more likely to be true for IsModifier elements than for other elements." /> <requirements value="Allows a profile to set expectations for system capabilities beyond merely respecting cardinality constraints." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.mustSupport" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <defaultValueBoolean value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="??" /> </mapping> </element> <element id="ElementDefinition.isModifier"> <path value="ElementDefinition.isModifier" /> <short value="If this modifies the meaning of other elements" /> <definition value="If true, the value of this element affects the interpretation of the element or resource that contains it, and the value of the element cannot be ignored. Typically, this is used for status, negation and qualification codes. The effect of this is that the element cannot be ignored by systems: they SHALL either recognize the element and process it, and/or a pre-determination has been made that it is not relevant to their particular system." /> <comment value="Only the definition of an element can set IsModifier true - either the specification itself or where an extension is originally defined. Once set, it cannot be changed in derived profiles. An element/extension that has isModifier=true SHOULD also have a minimum cardinality of 1, so that there is no lack of clarity about what to do if it is missing. If it can be missing, the definition SHALL make the meaning of a missing element clear." /> <requirements value="Allows elements to be introduced into a specification that can't safely be ignored by applications that don't recognize them." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.isModifier" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <defaultValueBoolean value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="??" /> </mapping> </element> <element id="ElementDefinition.isSummary"> <path value="ElementDefinition.isSummary" /> <short value="Include when _summary = true?" /> <definition value="Whether the element should be included if a client requests a search with the parameter _summary=true." /> <comment value="Some resources include a set of simple metadata, and some very large data. This element is used to reduce the quantity of data returned in searches. Note that servers may pre-cache summarized resources for optimal performance, so servers may not support per-profile use of the isSummary flag. When a request is made with _summary=true, serailisers only include elements marked as 'isSummary = true'. Other than Attachment.data, all data type properties are included in the summary form. Modifier elements or elements with minimum cardinality = 1 must be marked as summary elements." /> <requirements value="Allow clients to search through large resources quickly." /> <min value="0" /> <max value="0" /> <base> <path value="ElementDefinition.isSummary" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <defaultValueBoolean value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="??" /> </mapping> </element> <element id="ElementDefinition.binding"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="ElementDefinitionBinding" /> </extension> <path value="ElementDefinition.binding" /> <short value="ValueSet details if this is coded" /> <definition value="Binds to a value set if this element is coded (code, Coding, CodeableConcept, Quantity), or the data types (string, uri)." /> <comment value="For a CodeableConcept, when no codes are allowed - only text, use a binding of strength "required" with a description explaining that no coded values are allowed and what sort of information to put in the "text" element." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.binding" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Element" /> </type> <condition value="eld-11" /> <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="Element" /> </constraint> <constraint> <key value="eld-10" /> <severity value="error" /> <human value="provide either a reference or a description (or both)" /> <expression value="valueSet.exists() or description.exists()" /> <xpath value="(exists(f:valueSetUri) or exists(f:valueSetReference)) or exists(f:description)" /> </constraint> <constraint> <key value="eld-12" /> <severity value="error" /> <human value="ValueSet as a URI SHALL start with http:// or https:// or urn:" /> <expression value="valueSet.is(uri).not() or valueSet.as(uri).startsWith('http:') or valueSet.as(uri).startsWith('https') or valueSet.as(uri).startsWith('urn:')" /> <xpath value="not(exists(f:valueSetUri)) or (starts-with(string(f:valueSetUri/@value), 'http:') or starts-with(string(f:valueSetUri/@value), 'https:') or starts-with(string(f:valueSetUri/@value), 'urn:'))" /> </constraint> <isSummary value="true" /> <mapping> <identity value="v2" /> <map value="OM3, OMC.11" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value=".domain" /> </mapping> <mapping> <identity value="loinc" /> <map value="ANSWER LIST, NORMATIVE ANSWER LIST" /> </mapping> </element> <element id="ElementDefinition.binding.id"> <path value="ElementDefinition.binding.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.binding.extension"> <path value="ElementDefinition.binding.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.binding.strength"> <path value="ElementDefinition.binding.strength" /> <short value="required | extensible | preferred | example" /> <definition value="Indicates the degree of conformance expectations associated with this binding - that is, the degree to which the provided value set must be adhered to in the instances." /> <comment value="For further discussion, see [Using Terminologies](terminologies.html)." /> <alias value="conformance" /> <alias value="extensibility" /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.binding.strength" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BindingStrength" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="required" /> <description value="Indication of the degree of conformance expectations associated with a binding." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/binding-strength" /> </valueSetReference> </binding> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="loinc" /> <map value="N/A" /> </mapping> </element> <element id="ElementDefinition.binding.description"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="ElementDefinition.binding.description" /> <short value="Human explanation of the value set" /> <definition value="Describes the intended use of this particular set of codes." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.binding.description" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="eld-10" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value=".domain.description" /> </mapping> </element> <element id="ElementDefinition.binding.valueSet[x]"> <path value="ElementDefinition.binding.valueSet[x]" /> <short value="Source of value set" /> <definition value="Points to the value set or external definition (e.g. implicit value set) that identifies the set of codes to be used. If the binding refers to an explicit value set - the normal case - then use a Reference(ValueSet) preferably containing the canonical URL for the value set. If the reference is to an implicit value set - usually, an IETF RFC that defines a grammar, such as mime types - then use a uri." /> <comment value="For value sets with a referenceResource, the display can contain the value set description. The reference may be version-specific or not." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.binding.valueSet[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet" /> </type> <condition value="eld-10" /> <condition value="eld-12" /> <isSummary value="true" /> <mapping> <identity value="dex" /> <map value="valueDomain.valueSet" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="points to explicit list or expression that evaluates to list of (Enumerated_Value_Domain).member" /> </mapping> <mapping> <identity value="loinc" /> <map value="CODE_TABLE" /> </mapping> </element> <element id="ElementDefinition.mapping"> <path value="ElementDefinition.mapping" /> <short value="Map element to another set of definitions" /> <definition value="Identifies a concept from an external specification that roughly corresponds to this element." /> <comment value="Mappings are not necessarily specific enough for safe translation." /> <requirements value="Provides guidance to implementers familiar with or converting content from other specifications." /> <min value="0" /> <max value="*" /> <base> <path value="ElementDefinition.mapping" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Element" /> </type> <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="Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="dex" /> <map value="mappingSpecification" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="Registered_item).document_reference[document_type=mapping] Also, .meaning linkage to Data_Element_Concept is done as a mapping to a reference model. (Data_Element_Concepts are all defined in some sort of reference model, be that Object_Class and Property or some other mechanism)" /> </mapping> </element> <element id="ElementDefinition.mapping.id"> <path value="ElementDefinition.mapping.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.mapping.extension"> <path value="ElementDefinition.mapping.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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="ElementDefinition.mapping.identity"> <path value="ElementDefinition.mapping.identity" /> <short value="Reference to mapping declaration" /> <definition value="An internal reference to the definition of a mapping." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.mapping.identity" /> <min value="1" /> <max value="1" /> </base> <type> <code value="id" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.mapping.language"> <path value="ElementDefinition.mapping.language" /> <short value="Computable language of mapping" /> <definition value="Identifies the computable language in which mapping.map is expressed." /> <comment value="If omitted, then there can be no expectation of computational interpretation of the mapping." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.mapping.language" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MimeType" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="required" /> <description value="The mime type of an attachment. Any valid mime type is allowed." /> <valueSetUri value="http://www.rfc-editor.org/bcp/bcp13.txt" /> </binding> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> <element id="ElementDefinition.mapping.map"> <path value="ElementDefinition.mapping.map" /> <short value="Details of the mapping" /> <definition value="Expresses what part of the target specification corresponds to this element." /> <comment value="For most mappings, the syntax is undefined. Syntax will be provided for mappings to the RIM. Multiple mappings may be possible and may include constraints on other resource elements that identify when a particular mapping applies." /> <min value="1" /> <max value="1" /> <base> <path value="ElementDefinition.mapping.map" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> <mapping> <identity value="iso11179" /> <map value="ObjectClass, Property (this is one possible data model that can be mapped to - the uri would identify the data model mappingSpecification.mappingScript" /> </mapping> </element> <element id="ElementDefinition.mapping.comment"> <path value="ElementDefinition.mapping.comment" /> <short value="Comments about the mapping or its use" /> <definition value="Comments that provide information about the mapping or its use." /> <min value="0" /> <max value="1" /> <base> <path value="ElementDefinition.mapping.comment" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (MIF territory)" /> </mapping> </element> </snapshot> <differential> <element id="ElementDefinition"> <path value="ElementDefinition" /> <min value="0" /> <max value="*" /> </element> <element id="ElementDefinition.extension:question"> <path value="ElementDefinition.extension" /> <sliceName value="Question" /> <min value="0" /> <max value="*" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/elementdefinition-question" /> </type> </element> <element id="ElementDefinition.extension:allowedunits"> <path value="ElementDefinition.extension" /> <sliceName value="AllowedUnits" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/elementdefinition-allowedUnits" /> </type> </element> <element id="ElementDefinition.representation"> <path value="ElementDefinition.representation" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.slicing"> <path value="ElementDefinition.slicing" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.short"> <path value="ElementDefinition.short" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.contentReference"> <path value="ElementDefinition.contentReference" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.type"> <path value="ElementDefinition.type" /> </element> <element id="ElementDefinition.type.profile"> <path value="ElementDefinition.type.profile" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.type.aggregation"> <path value="ElementDefinition.type.aggregation" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.defaultValue[x]"> <path value="ElementDefinition.defaultValue[x]" /> <comment value="... This element should only be used on child elements of complex data elements." /> </element> <element id="ElementDefinition.meaningWhenMissing"> <path value="ElementDefinition.meaningWhenMissing" /> <comment value="... This element should only be used on child elements of complex data elements." /> </element> <element id="ElementDefinition.fixed[x]"> <path value="ElementDefinition.fixed[x]" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.pattern[x]"> <path value="ElementDefinition.pattern[x]" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.isModifier"> <path value="ElementDefinition.isModifier" /> <min value="0" /> <max value="0" /> </element> <element id="ElementDefinition.isSummary"> <path value="ElementDefinition.isSummary" /> <min value="0" /> <max value="0" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/ehrsrle-auditevent" /> <resource> <StructureDefinition> <id value="ehrsrle-auditevent" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="ehr" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/ehrsrle-auditevent" /> <name value="EHRS FM Record Lifecycle Event - Audit Event" /> <status value="draft" /> <experimental value="false" /> <date value="2014-12-04" /> <publisher value="Health Level Seven International (Electronic Health Record)" /> <contact> <telecom> <system value="url" /> <value value="http://hl7.org/special/committees/ehr.html" /> </telecom> </contact> <description value="Defines the elements to be supported within the AuditEvent resource in order to conform with the Electronic Health Record System Functional Model Record Lifecycle Event standard" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="dicom" /> <uri value="http://nema.org/dicom" /> <name value="DICOM Tag Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="w3c.prov" /> <uri value="http://www.w3.org/ns/prov" /> <name value="W3C PROV" /> </mapping> <mapping> <identity value="fhirprovenance" /> <uri value="http://hl7.org/fhir/provenance" /> <name value="FHIR Provenance" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="AuditEvent" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/AuditEvent" /> <derivation value="constraint" /> <snapshot> <element id="AuditEvent"> <path value="AuditEvent" /> <short value="Event record kept for security purposes" /> <definition value="A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage." /> <comment value="Based on ATNA (RFC 3881)." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent" /> <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="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="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="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="DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="ControlAct[moodCode=EVN]" /> </mapping> <mapping> <identity value="dicom" /> <map value="Message" /> </mapping> <mapping> <identity value="w5" /> <map value="infrastructure.information" /> </mapping> </element> <element id="AuditEvent.id"> <path value="AuditEvent.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> <isSummary value="true" /> </element> <element id="AuditEvent.meta"> <path value="AuditEvent.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> <isSummary value="true" /> </element> <element id="AuditEvent.implicitRules"> <path value="AuditEvent.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="AuditEvent.language"> <path value="AuditEvent.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="AuditEvent.text"> <path value="AuditEvent.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="AuditEvent.contained"> <path value="AuditEvent.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="N/A" /> </mapping> </element> <element id="AuditEvent.extension"> <path value="AuditEvent.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.modifierExtension"> <path value="AuditEvent.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.type"> <path value="AuditEvent.type" /> <short value="Type/identifier of event" /> <definition value="Identifier for a family of the event. For example, a menu item, program, rule, policy, function code, application name or URL. It identifies the performed function." /> <requirements value="This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventType" /> </extension> <strength value="extensible" /> <description value="Type of event." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/audit-event-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code (type, subtype and action are pre-coordinated or sent as translations)" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventId" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.subtype"> <path value="AuditEvent.subtype" /> <short value="More specific type/id for the event" /> <definition value="Identifier for the category of event." /> <requirements value="This field enables queries of messages by implementation-defined event categories." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.subtype" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventSubType" /> </extension> <strength value="extensible" /> <description value="Sub-type of event." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/audit-event-sub-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code (type, subtype and action are pre-coordinated or sent as translations)" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventTypeCode" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.action"> <path value="AuditEvent.action" /> <short value="Type of action performed during the event" /> <definition value="Indicator for type of action performed during the event that generated the audit." /> <requirements value="This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.action" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventAction" /> </extension> <strength value="required" /> <description value="Indicator for type of action performed during the event that generated the event" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/audit-event-action" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code (type, subtype and action are pre-coordinated or sent as translations)" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventActionCode" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.recorded"> <path value="AuditEvent.recorded" /> <short value="Time when the event occurred on source" /> <definition value="The time when the event occurred on the source." /> <comment value="In a distributed system, some sort of common time base (e.g. an NTP [RFC1305] server) is a good implementation tactic." /> <requirements value="This ties an event to a specific date and time. Security audits typically require a consistent time base (e.g. UTC), to eliminate time-zone issues arising from geographical distribution." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.recorded" /> <min value="1" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".effectiveTime" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventDateTime" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.when" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.recorded" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="AuditEvent.outcome"> <path value="AuditEvent.outcome" /> <short value="Whether the event succeeded or failed" /> <definition value="Indicates whether the event succeeded or failed." /> <comment value="In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.outcome" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventOutcome" /> </extension> <strength value="required" /> <description value="Indicates whether the event succeeded or failed" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/audit-event-outcome" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".actionNegationInd" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventOutcomeIndicator" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.outcomeDesc"> <path value="AuditEvent.outcomeDesc" /> <short value="Description of the event outcome" /> <definition value="A free text description of the outcome of the event." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.outcomeDesc" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=OUT].target.text" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventOutcomeDescription" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.purposeOfEvent"> <path value="AuditEvent.purposeOfEvent" /> <short value="The purposeOfUse of the event" /> <definition value="The purposeOfUse (reason) that was used during the event being recorded." /> <comment value="Use AuditEvent.agent.purposeOfUse when you know that it is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.purposeOfEvent" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditPurposeOfUse" /> </extension> <strength value="extensible" /> <description value="The reason the activity took place." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-PurposeOfUse" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="* .reasonCode [ControlActReason when Act.class = CACT Control Act] *.outboundRelationship[typeCode=RSON].target" /> </mapping> <mapping> <identity value="dicom" /> <map value="EventPurposeOfUse" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.Activity" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.reason, Provenance.activity" /> </mapping> <mapping> <identity value="w5" /> <map value="why" /> </mapping> </element> <element id="AuditEvent.agent"> <path value="AuditEvent.agent" /> <short value="Actor involved in the event" /> <definition value="An actor taking an active role in the event or activity that is logged." /> <comment value="Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity. For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity." /> <requirements value="An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility." /> <alias value="ActiveParticipant" /> <min value="1" /> <max value="*" /> <base> <path value="AuditEvent.agent" /> <min value="1" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".participation" /> </mapping> <mapping> <identity value="dicom" /> <map value="ActiveParticipant" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.agent" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.id"> <path value="AuditEvent.agent.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.agent.extension"> <path value="AuditEvent.agent.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.agent.modifierExtension"> <path value="AuditEvent.agent.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.agent.role"> <path value="AuditEvent.agent.role" /> <short value="Agent role in the event" /> <definition value="The security role that the user was acting under, that come from local codes defined by the access control security system (e.g. RBAC, ABAC) used in the local context." /> <comment value="Should be roles relevant to the event. Should not be an exhaustive list of roles." /> <requirements value="This value ties an audited event to a user's role(s). It is an optional value that might be used to group events for analysis by user functional role categories." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.agent.role" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditAgentRole" /> </extension> <strength value="extensible" /> <description value="What security role enabled the agent to participate in the event" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/security-role-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".role and/or .typeCode and/or .functionCode" /> </mapping> <mapping> <identity value="dicom" /> <map value="RoleIdCode" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Attribution" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.agent.role" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.reference"> <path value="AuditEvent.agent.reference" /> <short value="Direct reference to resource" /> <definition value="Direct reference to a resource that identifies the agent." /> <requirements value="This field ties an audit event to a specific resource." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.reference" /> <min value="0" /> <max value="1" /> </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/Organization" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> </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" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Identity" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.agent.actor" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.userId"> <path value="AuditEvent.agent.userId" /> <short value="Unique identifier for the user" /> <definition value="Unique identifier for the user actively participating in the event." /> <comment value="A unique value within the Audit Source ID. For node-based authentication -- where only the system hardware or process, but not a human user, is identified -- User ID would be the node name." /> <requirements value="This field ties an audit event to a specific user." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.userId" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> <mapping> <identity value="dicom" /> <map value="UserId" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Identity" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.agent.userId" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.altId"> <path value="AuditEvent.agent.altId" /> <short value="Alternative User id e.g. authentication" /> <definition value="Alternative agent Identifier. For a human, this should be a user identifier text string from authentication system. This identifier would be one known to a common authentication system (e.g. single sign-on), if available." /> <requirements value="In some situations, a human user may authenticate with one identity but, to access a specific application system, may use a synonymous identify. For example, some "single sign on" implementations will do this. The alternative identifier would then be the original identify used for authentication, and the User ID is the one known to and used by the application." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.altId" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".id (distinguish id type by root)" /> </mapping> <mapping> <identity value="dicom" /> <map value="AlternativeUserId" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Identity" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.name"> <path value="AuditEvent.agent.name" /> <short value="Human-meaningful name for the agent" /> <definition value="Human-meaningful name for the agent." /> <requirements value="The User ID and Authorization User ID may be internal or otherwise obscure values. This field assists the auditor in identifying the actual user." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.name" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".name" /> </mapping> <mapping> <identity value="dicom" /> <map value="UserName" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Identity" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.requestor"> <path value="AuditEvent.agent.requestor" /> <short value="Whether user is initiator" /> <definition value="Indicator that the user is or is not the requestor, or initiator, for the event being audited." /> <comment value="There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator." /> <requirements value="This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.agent.requestor" /> <min value="1" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="If participation.typeCode was author, then true" /> </mapping> <mapping> <identity value="dicom" /> <map value="UserIsRequestor" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="AuditEvent.agent.location"> <path value="AuditEvent.agent.location" /> <short value="Where" /> <definition value="Where the event occurred." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.location" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="* Role.Class =SDLOC *Role.Code = ServiceDeliveryLocationRoleType *Entity.Code = PlaceEntityType = df.Types of places for Entity.Class = PLC *EntityClass = PLC = df.A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant." /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.location" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.location" /> </mapping> <mapping> <identity value="w5" /> <map value="where" /> </mapping> </element> <element id="AuditEvent.agent.policy"> <path value="AuditEvent.agent.policy" /> <short value="Policy that authorized event" /> <definition value="The policy or plan that authorized the activity being recorded. Typically, a single activity may have multiple applicable policies, such as patient consent, guarantor funding, etc. The policy would also indicate the security token used." /> <comment value="For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element." /> <requirements value="This value is used retrospectively to determine the authorization policies." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.agent.policy" /> <min value="0" /> <max value="*" /> </base> <type> <code value="uri" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="ActPolicyType" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantRoleIDCode" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.policy" /> </mapping> <mapping> <identity value="w5" /> <map value="why" /> </mapping> </element> <element id="AuditEvent.agent.media"> <path value="AuditEvent.agent.media" /> <short value="Type of media" /> <definition value="Type of media involved. Used when the event is about exporting/importing onto media." /> <requirements value="Usually, this is used instead of specifying a network address. This field is not used for Media Id (i.e. the serial number of a CD)." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.media" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Coding" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DICOMMediaType" /> </extension> <strength value="extensible" /> <description value="Used when the event is about exporting/importing onto media." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/dicm-405-mediatype" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".player.description.mediaType" /> </mapping> <mapping> <identity value="dicom" /> <map value="MediaType" /> </mapping> <mapping> <identity value="w5" /> <map value="where" /> </mapping> </element> <element id="AuditEvent.agent.network"> <path value="AuditEvent.agent.network" /> <short value="Logical network location for application activity" /> <definition value="Logical network location for application activity, if the activity has a network location." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.network" /> <min value="0" /> <max value="1" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".player.description.reference" /> </mapping> <mapping> <identity value="w5" /> <map value="where" /> </mapping> </element> <element id="AuditEvent.agent.network.id"> <path value="AuditEvent.agent.network.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.agent.network.extension"> <path value="AuditEvent.agent.network.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.agent.network.modifierExtension"> <path value="AuditEvent.agent.network.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.agent.network.address"> <path value="AuditEvent.agent.network.address" /> <short value="Identifier for the network access point of the user device" /> <definition value="An identifier for the network access point of the user device for the audit event." /> <comment value="This could be a device id, IP address or some other identifier associated with a device." /> <requirements value="This datum identifies the user's network access point, which may be distinct from the server that performed the action. It is an optional value that may be used to group events recorded on separate servers for analysis of a specific network access point's data access across all servers." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.network.address" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="pre-coordinated into URL" /> </mapping> <mapping> <identity value="dicom" /> <map value="NetworkAccessPointID" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Location" /> </mapping> <mapping> <identity value="w5" /> <map value="where" /> </mapping> </element> <element id="AuditEvent.agent.network.type"> <path value="AuditEvent.agent.network.type" /> <short value="The type of network access point" /> <definition value="An identifier for the type of network access point that originated the audit event." /> <requirements value="This datum identifies the type of network access point identifier of the user device for the audit event. It is an optional value that may be used to group events recorded on separate servers for analysis of access according to a network access point's type." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.agent.network.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventAgentNetworkType" /> </extension> <strength value="required" /> <description value="The type of network access point of this agent in the audit event" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/network-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="pre-coordinated into URL" /> </mapping> <mapping> <identity value="dicom" /> <map value="NetworkAccessPointTypeCode" /> </mapping> <mapping> <identity value="w5" /> <map value="where" /> </mapping> </element> <element id="AuditEvent.agent.purposeOfUse"> <path value="AuditEvent.agent.purposeOfUse" /> <short value="Reason given for this user" /> <definition value="The reason (purpose of use), specific to this agent, that was used during the event being recorded." /> <comment value="Use AuditEvent.agent.purposeOfUse when you know that is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.agent.purposeOfUse" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditPurposeOfUse" /> </extension> <strength value="extensible" /> <description value="The reason the activity took place." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-PurposeOfUse" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="*.reasonCode [ActHealthInformationPurposeOfUseReason codes/v:PurposeOfUse (2.16.840.1.113883.1.11.20448) * .outboundRelationship[typeCode=RSON or SUBJ].target" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Activity" /> </mapping> <mapping> <identity value="w5" /> <map value="why" /> </mapping> </element> <element id="AuditEvent.source"> <path value="AuditEvent.source" /> <short value="Audit Event Reporter" /> <definition value="The system that is reporting the event." /> <comment value="Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified." /> <requirements value="The event is reported by one source." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.source" /> <min value="1" /> <max value="1" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode=INF].role[classCode=ASSIGN].player[classCode=DEV, determinerCode=INSTANCE]" /> </mapping> <mapping> <identity value="dicom" /> <map value="AuditSourceIdentification" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="AuditEvent.source.id"> <path value="AuditEvent.source.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.source.extension"> <path value="AuditEvent.source.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.source.modifierExtension"> <path value="AuditEvent.source.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.source.site"> <path value="AuditEvent.source.site" /> <short value="Logical source location within the enterprise" /> <definition value="Logical source location within the healthcare enterprise network. For example, a hospital or other provider location within a multi-entity provider group." /> <requirements value="This value differentiates among the sites in a multi-site enterprise health information system." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.source.site" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".scopedRole[classCode=LOCE].player.desc" /> </mapping> <mapping> <identity value="dicom" /> <map value="AuditEnterpriseSiteId" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="AuditEvent.source.identifier"> <path value="AuditEvent.source.identifier" /> <short value="The identity of source detecting the event" /> <definition value="Identifier of the source where the event was detected." /> <requirements value="This field ties the event to a specific source system. It may be used to group events for analysis according to where the event was detected." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.source.identifier" /> <min value="1" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> <mapping> <identity value="dicom" /> <map value="AuditSourceId" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="AuditEvent.source.type"> <path value="AuditEvent.source.type" /> <short value="The type of source where event originated" /> <definition value="Code specifying the type of source where event originated." /> <requirements value="This field indicates which type of source is identified by the Audit Source ID. It is an optional value that may be used to group events for analysis according to the type of source where the event occurred." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.source.type" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventSourceType" /> </extension> <strength value="extensible" /> <description value="Code specifying the type of system that detected and recorded the event." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/audit-source-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code" /> </mapping> <mapping> <identity value="dicom" /> <map value="AuditSourceTypeCode" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="AuditEvent.entity"> <path value="AuditEvent.entity" /> <short value="Data or objects used" /> <definition value="Specific instances of data or objects that have been accessed." /> <comment value="Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values." /> <requirements value="The event may have other entities involved." /> <alias value="ParticipantObject" /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.entity" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="sev-1" /> <severity value="error" /> <human value="Either a name or a query (NOT both)" /> <expression value="name.empty() or query.empty()" /> <xpath value="not(exists(f:name)) or not(exists(f:query))" /> <source value="AuditEvent.entity" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=SUBJ].target or .participation[typeCode=SBJ].role" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectIdentification" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.target, Provenance.entity" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.entity.id"> <path value="AuditEvent.entity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.entity.extension"> <path value="AuditEvent.entity.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.entity.modifierExtension"> <path value="AuditEvent.entity.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.entity.identifier"> <path value="AuditEvent.entity.identifier" /> <short value="Specific instance of object" /> <definition value="Identifies a specific instance of the entity. The reference should always be version specific." /> <comment value="Identifier detail depends on entity type." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.identifier" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Identifier" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".id.extension" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectID and ParticipantObjectIDTypeCode" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.entity.reference"> <path value="AuditEvent.entity.reference" /> <short value="Specific instance of resource" /> <definition value="Identifies a specific instance of the entity. The reference should be version specific." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.reference" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="[self]" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectID" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.target, Provenance.entity.reference" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.entity.type"> <path value="AuditEvent.entity.type" /> <short value="Type of entity involved" /> <definition value="The type of the object that was involved in this audit event." /> <comment value="This value is distinct from the user's role or any user relationship to the entity." /> <requirements value="To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventEntityType" /> </extension> <strength value="extensible" /> <description value="Code for the entity type involved in the audit event" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/audit-entity-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="[self::Act].code or role.player.code" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectTypeCode" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity.type" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.entity.type" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="AuditEvent.entity.role"> <path value="AuditEvent.entity.role" /> <short value="What role the entity played" /> <definition value="Code representing the role the entity played in the event being audited." /> <requirements value="For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.role" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventEntityRole" /> </extension> <strength value="extensible" /> <description value="Code representing the role the entity played in the audit event" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/object-role" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="role.code (not sure what this would mean for an Act)" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectTypeCodeRole" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity.role" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.lifecycle"> <path value="AuditEvent.entity.lifecycle" /> <short value="Life-cycle stage for the entity" /> <definition value="Identifier for the data life-cycle stage for the entity." /> <comment value="This can be used to provide an audit trail for data, over time, as it passes through the system." /> <requirements value="Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.lifecycle" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AuditEventEntityLifecycle" /> </extension> <strength value="extensible" /> <description value="Identifier for the data life-cycle stage for the entity" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/object-lifecycle-events" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="target of ObservationEvent[code="lifecycle"].value" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectDataLifeCycle" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity.role" /> </mapping> <mapping> <identity value="fhirprovenance" /> <map value="Provenance.entity.role" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.securityLabel"> <path value="AuditEvent.entity.securityLabel" /> <short value="Security labels on the entity" /> <definition value="Security labels for the identified entity." /> <comment value="Copied from entity meta security tags." /> <requirements value="This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.entity.securityLabel" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SecurityLabels" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="Security Labels from the Healthcare Privacy and Security Classification System." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/security-labels" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".confidentialityCode" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectSensitivity" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.name"> <path value="AuditEvent.entity.name" /> <short value="Descriptor for entity" /> <definition value="A name of the entity in the audit event." /> <comment value="This field may be used in a query/report to identify audit events for a specific person. For example, where multiple synonymous entity identifiers (patient number, medical record number, encounter number, etc.) have been used." /> <requirements value="Use only where entity can't be identified with an identifier." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.name" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="sev-1" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".title" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectName" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity.Label" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.description"> <path value="AuditEvent.entity.description" /> <short value="Descriptive text" /> <definition value="Text that describes the entity in more detail." /> <requirements value="Use only where entity can't be identified with an identifier." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.description" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectDescription" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.query"> <path value="AuditEvent.entity.query" /> <short value="Query parameters" /> <definition value="The query parameters for a query-type entities." /> <requirements value="For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing." /> <min value="0" /> <max value="1" /> <base> <path value="AuditEvent.entity.query" /> <min value="0" /> <max value="1" /> </base> <type> <code value="base64Binary" /> </type> <condition value="sev-1" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="No mapping" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectQuery" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.detail"> <path value="AuditEvent.entity.detail" /> <short value="Additional Information about the entity" /> <definition value="Tagged value pairs for conveying additional information about the entity." /> <requirements value="Implementation-defined data about specific details of the object accessed or used." /> <min value="0" /> <max value="*" /> <base> <path value="AuditEvent.entity.detail" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mapping> <identity value="rim" /> <map value=".inboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectDetail" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.detail.id"> <path value="AuditEvent.entity.detail.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.entity.detail.extension"> <path value="AuditEvent.entity.detail.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AuditEvent.entity.detail.modifierExtension"> <path value="AuditEvent.entity.detail.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AuditEvent.entity.detail.type"> <path value="AuditEvent.entity.detail.type" /> <short value="Name of the property" /> <definition value="The type of extra detail provided in the value." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.entity.detail.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".code" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectDetail.type" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> <element id="AuditEvent.entity.detail.value"> <path value="AuditEvent.entity.detail.value" /> <short value="Property value" /> <definition value="The details, base64 encoded. Used to carry bulk information." /> <comment value="The value is base64 encoded to enable various encodings or binary content." /> <requirements value="Should not duplicate the entity value unless absolutely necessary." /> <min value="1" /> <max value="1" /> <base> <path value="AuditEvent.entity.detail.value" /> <min value="1" /> <max value="1" /> </base> <type> <code value="base64Binary" /> </type> <mapping> <identity value="rim" /> <map value=".value" /> </mapping> <mapping> <identity value="dicom" /> <map value="ParticipantObjectDetail.value" /> </mapping> <mapping> <identity value="w5" /> <map value="context" /> </mapping> </element> </snapshot> <differential> <element id="AuditEvent"> <path value="AuditEvent" /> <min value="0" /> <max value="*" /> </element> <element id="AuditEvent.type"> <path value="AuditEvent.type" /> <mustSupport value="true" /> </element> <element id="AuditEvent.subtype"> <path value="AuditEvent.subtype" /> <mustSupport value="true" /> </element> <element id="AuditEvent.action"> <path value="AuditEvent.action" /> <mustSupport value="true" /> </element> <element id="AuditEvent.recorded"> <path value="AuditEvent.recorded" /> <mustSupport value="true" /> </element> <element id="AuditEvent.purposeOfEvent"> <path value="AuditEvent.purposeOfEvent" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent"> <path value="AuditEvent.agent" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.role"> <path value="AuditEvent.agent.role" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.reference"> <path value="AuditEvent.agent.reference" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.userId"> <path value="AuditEvent.agent.userId" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.requestor"> <path value="AuditEvent.agent.requestor" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.location"> <path value="AuditEvent.agent.location" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.policy"> <path value="AuditEvent.agent.policy" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.network"> <path value="AuditEvent.agent.network" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.network.address"> <path value="AuditEvent.agent.network.address" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.network.type"> <path value="AuditEvent.agent.network.type" /> <mustSupport value="true" /> </element> <element id="AuditEvent.agent.purposeOfUse"> <path value="AuditEvent.agent.purposeOfUse" /> <mustSupport value="true" /> </element> <element id="AuditEvent.source"> <path value="AuditEvent.source" /> <mustSupport value="true" /> </element> <element id="AuditEvent.source.site"> <path value="AuditEvent.source.site" /> <mustSupport value="true" /> </element> <element id="AuditEvent.source.identifier"> <path value="AuditEvent.source.identifier" /> <mustSupport value="true" /> </element> <element id="AuditEvent.source.type"> <path value="AuditEvent.source.type" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity"> <path value="AuditEvent.entity" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity.identifier"> <path value="AuditEvent.entity.identifier" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity.reference"> <path value="AuditEvent.entity.reference" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity.type"> <path value="AuditEvent.entity.type" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity.role"> <path value="AuditEvent.entity.role" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity.lifecycle"> <path value="AuditEvent.entity.lifecycle" /> <mustSupport value="true" /> </element> <element id="AuditEvent.entity.securityLabel"> <path value="AuditEvent.entity.securityLabel" /> <mustSupport value="true" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/ehrsrle-provenance" /> <resource> <StructureDefinition> <id value="ehrsrle-provenance" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="ehr" /> </extension> <url value="http://hl7.org/fhir/StructureDefinition/ehrsrle-provenance" /> <name value="EHRS FM Record Lifecycle Event - Provenance" /> <status value="draft" /> <experimental value="false" /> <date value="2014-01-31" /> <publisher value="Health Level Seven International (Electronic Health Record)" /> <contact> <telecom> <system value="url" /> <value value="http://hl7.org/special/committees/ehr.html" /> </telecom> </contact> <description value="Defines the elements to be supported within the Provenance resource in order to conform with the Electronic Health Record System Functional Model Record Lifecycle Event standard" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w3c.prov" /> <uri value="http://www.w3.org/ns/prov" /> <name value="W3C PROV" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="fhirauditevent" /> <uri value="http://hl7.org/fhir/auditevent" /> <name value="FHIR AuditEvent" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Provenance" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Provenance" /> <derivation value="constraint" /> <snapshot> <element id="Provenance"> <path value="Provenance" /> <short value="Who, What, When for a set of resources" /> <definition value="Provenance of a resource is a record that describes entities and processes involved in producing and delivering or otherwise influencing that resource. Provenance provides a critical foundation for assessing authenticity, enabling trust, and allowing reproducibility. Provenance assertions are a form of contextual metadata and can themselves become important records with their own provenance. Provenance statement indicates clinical significance in terms of confidence in authenticity, reliability, and trustworthiness, integrity, and stage in lifecycle (e.g. Document Completion - has the artifact been legally authenticated), all of which may impact security, privacy, and trust policies." /> <comment value="Some parties may be duplicated between the target resource and its provenance. For instance, the prescriber is usually (but not always) the author of the prescription resource. This resource is defined with close consideration for W3C Provenance." /> <alias value="History" /> <alias value="Event" /> <alias value="Activity" /> <min value="0" /> <max value="*" /> <base> <path value="Provenance" /> <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="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="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="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="DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="ControlAct[isNormalAct() and subsumes(CACT, classCode) and moodCode=EVN]" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity" /> </mapping> <mapping> <identity value="w5" /> <map value="infrastructure.information" /> </mapping> </element> <element id="Provenance.id"> <path value="Provenance.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> <isSummary value="true" /> </element> <element id="Provenance.meta"> <path value="Provenance.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> <isSummary value="true" /> </element> <element id="Provenance.implicitRules"> <path value="Provenance.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="Provenance.language"> <path value="Provenance.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="Provenance.text"> <path value="Provenance.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="Provenance.contained"> <path value="Provenance.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="N/A" /> </mapping> </element> <element id="Provenance.extension"> <path value="Provenance.extension" /> <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> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Provenance.modifierExtension"> <path value="Provenance.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Provenance.target"> <path value="Provenance.target" /> <short value="Target Reference(s) (usually version specific)" /> <definition value="The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity." /> <comment value="Target references are usually version specific, but may not be, if a version has not been assigned or if the provenance information is part of the set of resources being maintained (i.e. a document). When using the RESTful API, the identity of the resource may not be known (especially not the version specific one); the client may either submit the resource first, and then the provenance, or it may submit both using a single transaction. See the notes on transaction for further discussion." /> <min value="1" /> <max value="*" /> <base> <path value="Provenance.target" /> <min value="1" /> <max value="*" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./outboundRelationship[isNormalActRelationship() and typeCode=SUBJ]/target OR ./participation[isNormalParticipation() and typeCode=SBJ]/role OR ./participation[isNormalParticipation() and typeCode=SBJ]/role[isNormalRole()]/player" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.entity.reference" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity Created/Updated" /> </mapping> <mapping> <identity value="w5" /> <map value="what" /> </mapping> </element> <element id="Provenance.period"> <path value="Provenance.period" /> <short value="When the activity occurred" /> <definition value="The period during which the activity occurred." /> <comment value="The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time." /> <min value="0" /> <max value="1" /> <base> <path value="Provenance.period" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="./effectiveTime[type=IVL_TS]" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.startTime & Activity.endTime" /> </mapping> <mapping> <identity value="w5" /> <map value="when.done" /> </mapping> </element> <element id="Provenance.recorded"> <path value="Provenance.recorded" /> <short value="When the activity was recorded / updated" /> <definition value="The instant of time at which the activity was recorded." /> <comment value="This can be a little different from the time stamp on the resource if there is a delay between recording the event and updating the provenance and target resource." /> <min value="1" /> <max value="1" /> <base> <path value="Provenance.recorded" /> <min value="1" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="unique(./participation[isNormalParticipation() and typeCode=AUT]/time[type=TS])" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.recorded" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.when" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="Provenance.policy"> <path value="Provenance.policy" /> <short value="Policy or plan the activity was defined by" /> <definition value="Policy or plan the activity was defined by. Typically, a single activity may have multiple applicable policy documents, such as patient consent, guarantor funding, etc." /> <comment value="For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element." /> <min value="0" /> <max value="*" /> <base> <path value="Provenance.policy" /> <min value="0" /> <max value="*" /> </base> <type> <code value="uri" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="./inboundRelationship[isNormalActRelationship() and typeCode="SUBJ"]/source[isNormalAct and subsumes(POLICY, classCode) and moodCode=EVN]/text[typeCode='ED'/tel" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.agent.policy" /> </mapping> </element> <element id="Provenance.location"> <path value="Provenance.location" /> <short value="Where the activity occurred, if relevant" /> <definition value="Where the activity occurred, if relevant." /> <min value="0" /> <max value="1" /> <base> <path value="Provenance.location" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="unique(./participation[isNormalParticipation() and typeCode=LOC]/role[isNormalRole() and subsumes(SDLOC, classCode)]/player[isNormalEntity and classCode="LOC" and determinerCode="INST"]" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.agent.location" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.location" /> </mapping> <mapping> <identity value="w5" /> <map value="where" /> </mapping> </element> <element id="Provenance.reason"> <path value="Provenance.reason" /> <short value="Reason the activity is occurring" /> <definition value="The reason that the activity was taking place." /> <min value="0" /> <max value="*" /> <base> <path value="Provenance.reason" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProvenanceReason" /> </extension> <strength value="extensible" /> <description value="The reason the activity took place." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-PurposeOfUse" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="unique(./reasonCode)" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.purposeOfEvent" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.Activity" /> </mapping> <mapping> <identity value="w5" /> <map value="why" /> </mapping> </element> <element id="Provenance.activity"> <path value="Provenance.activity" /> <short value="Activity that occurred" /> <definition value="An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities." /> <min value="0" /> <max value="1" /> <base> <path value="Provenance.activity" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Coding" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProvenanceActivity" /> </extension> <strength value="extensible" /> <description value="The activity that took place." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/provenance-activity-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="Act.code" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.purposeOfEvent" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Activity.Activity" /> </mapping> <mapping> <identity value="w5" /> <map value="why" /> </mapping> </element> <element id="Provenance.agent"> <path value="Provenance.agent" /> <short value="Actor involved" /> <definition value="An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place." /> <comment value="Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa." /> <requirements value="An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility." /> <min value="1" /> <max value="*" /> <base> <path value="Provenance.agent" /> <min value="1" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="./participation[isNormalParticipation()] OR ./outboundRelationship[isNormalActRelationship() and typeCode='DRIV']" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.agent" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent" /> </mapping> <mapping> <identity value="w5" /> <map value="who" /> </mapping> </element> <element id="Provenance.agent.id"> <path value="Provenance.agent.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Provenance.agent.extension"> <path value="Provenance.agent.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Provenance.agent.modifierExtension"> <path value="Provenance.agent.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Provenance.agent.role"> <path value="Provenance.agent.role" /> <short value="What the agents role was" /> <definition value="The function of the agent with respect to the activity. The security role enabling the agent with respect to the activity." /> <comment value="For example: author, performer, enterer, attester, doctor, nurse, clerk, etc." /> <min value="0" /> <max value="*" /> <base> <path value="Provenance.agent.role" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProvenanceAgentRole" /> </extension> <strength value="extensible" /> <description value="The role that a provenance agent played with respect to the activity." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/security-role-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".role and/or .typecode" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.agent.role" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Agent.Attribution" /> </mapping> </element> <element id="Provenance.agent.who[x]"> <path value="Provenance.agent.who[x]" /> <short value="Who participated" /> <definition value="The individual, device or organization that participated in the event." /> <min value="1" /> <max value="1" /> <base> <path value="Provenance.agent.who[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> </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/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> <mapping> <identity value="w5" /> <map value="who.actor" /> </mapping> </element> <element id="Provenance.agent.onBehalfOf[x]"> <path value="Provenance.agent.onBehalfOf[x]" /> <short value="Who the agent is representing" /> <definition value="The individual, device, or organization for whom the change was made." /> <min value="0" /> <max value="1" /> <base> <path value="Provenance.agent.onBehalfOf[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> </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/Device" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="Person, Practitioner, Organization, Device :* .role [classCode = RoleClassMutualRelationship; role.code and * .scopes[Role](classCode=IDENT) and *.plays [Role.Code]" /> </mapping> </element> <element id="Provenance.agent.relatedAgentType"> <path value="Provenance.agent.relatedAgentType" /> <short value="Type of relationship between agents" /> <definition value="The type of relationship between agents." /> <min value="0" /> <max value="1" /> <base> <path value="Provenance.agent.relatedAgentType" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RelatedAgentType" /> </extension> <strength value="example" /> <description value="Type of relationship between two provenance agents." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-RoleLinkType" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".typeCode" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="type" /> </mapping> </element> <element id="Provenance.entity"> <path value="Provenance.entity" /> <short value="An entity used in this activity" /> <definition value="An entity used in this activity." /> <comment value="Multiple userIds may be associated with the same Practitioner or other individual across various appearances, each with distinct privileges." /> <min value="0" /> <max value="*" /> <base> <path value="Provenance.entity" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <mapping> <identity value="rim" /> <map value="./subjectOf" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.entity" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity" /> </mapping> </element> <element id="Provenance.entity.id"> <path value="Provenance.entity.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Provenance.entity.extension"> <path value="Provenance.entity.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Provenance.entity.modifierExtension"> <path value="Provenance.entity.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Provenance.entity.role"> <path value="Provenance.entity.role" /> <short value="derivation | revision | quotation | source | removal" /> <definition value="How the entity was used during the activity." /> <min value="1" /> <max value="1" /> <base> <path value="Provenance.entity.role" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProvenanceEntityRole" /> </extension> <strength value="required" /> <description value="How an entity was used in an activity." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/provenance-entity-role" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="./typeCode" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.entity.lifecycle" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity.role" /> </mapping> </element> <element id="Provenance.entity.what[x]"> <path value="Provenance.entity.what[x]" /> <short value="Identity of entity" /> <definition value="Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative." /> <comment value="Identity may be a reference to a resource or to something else, depending on the type." /> <min value="1" /> <max value="1" /> <base> <path value="Provenance.entity.what[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="./text/reference" /> </mapping> <mapping> <identity value="fhirauditevent" /> <map value="AuditEvent.entity.reference" /> </mapping> <mapping> <identity value="w3c.prov" /> <map value="Entity.Identity" /> </mapping> </element> <element id="Provenance.entity.agent"> <path value="Provenance.entity.agent" /> <short value="Entity is attributed to this agent" /> <definition value="The entity is attributed to an agent to express the agent's responsibility for that entity, possibly along with other agents. This description can be understood as shorthand for saying that the agent was responsible for the activity which generated the entity." /> <comment value="A usecase where one Provenance.entity.agent is used where the Entity that was used in the creation/updating of the Target, is not in the context of the same custodianship as the Target, and thus the meaning of Provenance.entity.agent is to say that the entity referenced is managed elsewhere and that this Agent provided access to it. This would be similar to where the Entity being referenced is managed outside FHIR, such as through HL7 v2, v3, or XDS. This might be where the Entity being referenced is managed in another FHIR resource server. Thus it explains the Provenance of that Entity's use in the context of this Provenance activity." /> <min value="0" /> <max value="*" /> <base> <path value="Provenance.entity.agent" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#Provenance.agent" /> <mapping> <identity value="rim" /> <map value="./author/role" /> </mapping> </element> <element id="Provenance.signature"> <path value="Provenance.signature" /> <short value="Signature on target" /> <definition value="A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated." /> <min value="0" /> <max value="*" /> <base> <path value="Provenance.signature" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Signature" /> </type> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="./signatureText" /> </mapping> </element> </snapshot> <differential> <element id="Provenance"> <path value="Provenance" /> <min value="0" /> <max value="*" /> </element> <element id="Provenance.target"> <path value="Provenance.target" /> <mustSupport value="true" /> </element> <element id="Provenance.period"> <path value="Provenance.period" /> <mustSupport value="true" /> </element> <element id="Provenance.recorded"> <path value="Provenance.recorded" /> <mustSupport value="true" /> </element> <element id="Provenance.policy"> <path value="Provenance.policy" /> <mustSupport value="true" /> </element> <element id="Provenance.location"> <path value="Provenance.location" /> <mustSupport value="true" /> </element> <element id="Provenance.reason"> <path value="Provenance.reason" /> <mustSupport value="true" /> </element> <element id="Provenance.activity"> <path value="Provenance.activity" /> <mustSupport value="true" /> </element> <element id="Provenance.agent"> <path value="Provenance.agent" /> <mustSupport value="true" /> </element> <element id="Provenance.agent.who[x]"> <path value="Provenance.agent.who[x]" /> <mustSupport value="true" /> </element> <element id="Provenance.agent.onBehalfOf[x]"> <path value="Provenance.agent.onBehalfOf[x]" /> <mustSupport value="true" /> </element> <element id="Provenance.signature"> <path value="Provenance.signature" /> <mustSupport value="true" /> </element> </differential> </StructureDefinition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/StructureDefinition/cqif-questionnaire" /> <resource> <StructureDefinition> <id value="cqif-questionnaire" /> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml">to do</div> </text> <url value="http://hl7.org/fhir/StructureDefinition/cqif-questionnaire" /> <name value="CQIF-Questionnaire" /> <status value="draft" /> <experimental value="false" /> <date value="2015-05-30" /> <publisher value="Health Level Seven, Inc. - CDS WG" /> <contact> <telecom> <system value="url" /> <value value="http://hl7.org/special/committees/dss" /> </telecom> </contact> <description value="A questionnaire with the ability to specify behavior associated with questions or groups of questions" /> <fhirVersion value="3.0.1" /> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/w5" /> <name value="W5 Mapping" /> </mapping> <mapping> <identity value="objimpl" /> <uri value="http://hl7.org/fhir/object-implementation" /> <name value="Object Implementation Information" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Questionnaire" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Questionnaire" /> <derivation value="constraint" /> <snapshot> <element id="Questionnaire"> <path value="Questionnaire" /> <short value="A questionnaire with the ability to specify behavior associated with questions or groups of questions" /> <definition value="A CQIF questionnaire is a questionnaire with the added ability to describe behavior associated with questions. For example, whether or not to display a particular question or group of questions, or automatically calculating the value of an answer based on the answers to previous questions." /> <alias value="Form" /> <alias value="CRF" /> <alias value="Survey" /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire" /> <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="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="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="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="DomainResource" /> </constraint> <constraint> <key value="que-2" /> <severity value="error" /> <human value="The link ids for groups and questions must be unique within the questionnaire" /> <expression value="descendants().linkId.isDistinct()" /> <xpath value="count(descendant::f:linkId/@value)=count(distinct-values(descendant::f:linkId/@value))" /> <source value="Questionnaire" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="Observation[moodCode=DEF]" /> </mapping> <mapping> <identity value="w5" /> <map value="infrastructure.information" /> </mapping> </element> <element id="Questionnaire.id"> <path value="Questionnaire.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> <isSummary value="true" /> </element> <element id="Questionnaire.meta"> <path value="Questionnaire.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> <isSummary value="true" /> </element> <element id="Questionnaire.implicitRules"> <path value="Questionnaire.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> <isModifier value="true" /> <isSummary value="true" /> </element> <element id="Questionnaire.language"> <path value="Questionnaire.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> <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> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="A human language." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages" /> </valueSetReference> </binding> </element> <element id="Questionnaire.text"> <path value="Questionnaire.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="dom-1" /> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="Questionnaire.contained"> <path value="Questionnaire.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="N/A" /> </mapping> </element> <element id="Questionnaire.extension"> <path value="Questionnaire.extension" /> <slicing id="6"> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> </element> <element id="Questionnaire.extension:library"> <path value="Questionnaire.extension" /> <sliceName value="library" /> <short value="A library containing logic referenced by the questionnaire" /> <definition value="A CQL or ELM library containing any logic referenced by the questionnaire." /> <alias value="library" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-library" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="Questionnaire.modifierExtension"> <path value="Questionnaire.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 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> <isModifier value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Questionnaire.url"> <path value="Questionnaire.url" /> <short value="Logical URI to reference this questionnaire (globally unique)" /> <definition value="An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this questionnaire is (or will be) published. The URL SHOULD include the major version of the questionnaire. For more information see [Technical and Business Versions](resource.html#versions)." /> <comment value="Can be a urn:uuid: or a urn:oid:, but real http: addresses are preferred. Multiple instances may share the same url if they have a distinct version." /> <requirements value="… This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.url" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".identifier[scope=BUSN;reliability=ISS]" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="Questionnaire.identifier"> <path value="Questionnaire.identifier" /> <short value="Additional identifier for the questionnaire" /> <definition value="A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance." /> <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this questionnaire outside of FHIR, where it is not possible to use the logical URI." /> <requirements value="Allows externally provided and/or usable business identifiers to be easily associated with the module." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".identifier" /> </mapping> <mapping> <identity value="objimpl" /> <map value="no-gen-base" /> </mapping> <mapping> <identity value="w5" /> <map value="id" /> </mapping> </element> <element id="Questionnaire.version"> <path value="Questionnaire.version" /> <short value="Business version of the questionnaire" /> <definition value="The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence." /> <comment value="There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a refrence to a particular business version of the questionnaire with the format [url]|[version]." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.version" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (to add?)" /> </mapping> <mapping> <identity value="w5" /> <map value="id.version" /> </mapping> </element> <element id="Questionnaire.name"> <path value="Questionnaire.name" /> <short value="Name for this questionnaire (computer friendly)" /> <definition value="A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation." /> <comment value="The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly." /> <requirements value="Support human navigation and code generation." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.name" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Questionnaire.title"> <path value="Questionnaire.title" /> <short value="Name for this questionnaire (human friendly)" /> <definition value="A short, descriptive, user-friendly title for the questionnaire." /> <comment value="This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.title" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".title" /> </mapping> </element> <element id="Questionnaire.status"> <path value="Questionnaire.status" /> <short value="draft | active | retired | unknown" /> <definition value="The status of this questionnaire. Enables tracking the life-cycle of the content." /> <comment value="Allows filtering of questionnaires that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use a retired questionnaire without due consideration." /> <min value="1" /> <max value="1" /> <base> <path value="Questionnaire.status" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <isModifier value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PublicationStatus" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="required" /> <description value="The lifecycle status of a Value Set or Concept Map." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/publication-status" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".status" /> </mapping> <mapping> <identity value="w5" /> <map value="status" /> </mapping> </element> <element id="Questionnaire.experimental"> <path value="Questionnaire.experimental" /> <short value="For testing purposes, not real usage" /> <definition value="A boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage." /> <comment value="Allows filtering of questionnaire that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental questionnaire in production." /> <requirements value="Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.experimental" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="w5" /> <map value="class" /> </mapping> </element> <element id="Questionnaire.date"> <path value="Questionnaire.date" /> <short value="Date this was last changed" /> <definition value="The date (and optionally time) when the questionnaire was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes." /> <comment value="Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource." /> <alias value="Revision Date" /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.date" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode=AUT].time" /> </mapping> <mapping> <identity value="w5" /> <map value="when.recorded" /> </mapping> </element> <element id="Questionnaire.publisher"> <path value="Questionnaire.publisher" /> <short value="Name of the publisher (organization or individual)" /> <definition value="The name of the individual or organization that published the questionnaire." /> <comment value="Usually an organization, but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context." /> <requirements value="Helps establish the "authority/credibility" of the questionnaire. May also allow for contact." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.publisher" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode=AUT].role" /> </mapping> <mapping> <identity value="w5" /> <map value="who.witness" /> </mapping> </element> <element id="Questionnaire.description"> <path value="Questionnaire.description" /> <short value="Natural language description of the questionnaire" /> <definition value="A free text natural language description of the questionnaire from a consumer's perspective." /> <comment value="This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile is presumed to be the predominant language in the place the profile was created)." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.description" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> </element> <element id="Questionnaire.purpose"> <path value="Questionnaire.purpose" /> <short value="Why this questionnaire is defined" /> <definition value="Explaination of why this questionnaire is needed and why it has been designed as it has." /> <comment value="This element does not describe the usage of the questionnaire Instead it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.purpose" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <mapping> <identity value="rim" /> <map value=".reasonCode.text" /> </mapping> <mapping> <identity value="objimpl" /> <map value="no-gen-base" /> </mapping> <mapping> <identity value="w5" /> <map value="why" /> </mapping> </element> <element id="Questionnaire.approvalDate"> <path value="Questionnaire.approvalDate" /> <short value="When the questionnaire was approved by publisher" /> <definition value="The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage." /> <comment value="The 'date' element may be more recent than the approval date because of minor changes / editorial corrections." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.approvalDate" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode="SUBJ"].act[classCode=CACT;moodCode=EVN;code="approval"].effectiveTime" /> </mapping> <mapping> <identity value="objimpl" /> <map value="no-gen-base" /> </mapping> </element> <element id="Questionnaire.lastReviewDate"> <path value="Questionnaire.lastReviewDate" /> <short value="When the questionnaire was last reviewed" /> <definition value="The date on which the resource content was last reviewed. Review happens periodically after approval, but doesn't change the original approval date." /> <comment value="If specified, this is usually after the approval date." /> <requirements value="Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.lastReviewDate" /> <min value="0" /> <max value="1" /> </base> <type> <code value="date" /> </type> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode="SUBJ"; subsetCode="RECENT"].act[classCode=CACT;moodCode=EVN;code="review"].effectiveTime" /> </mapping> <mapping> <identity value="objimpl" /> <map value="no-gen-base" /> </mapping> </element> <element id="Questionnaire.effectivePeriod"> <path value="Questionnaire.effectivePeriod" /> <short value="When the questionnaire is expected to be used" /> <definition value="The period during which the questionnaire content was or is planned to be in active use." /> <comment value="The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015." /> <requirements value="Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of a the questionnaire are or are expected to be used instead." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.effectivePeriod" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (to add?)" /> </mapping> <mapping> <identity value="objimpl" /> <map value="no-gen-base" /> </mapping> </element> <element id="Questionnaire.useContext"> <path value="Questionnaire.useContext" /> <short value="Context the content is intended to support" /> <definition value="The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate questionnaire instances." /> <comment value="When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply." /> <requirements value="Assist in searching for appropriate content." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.useContext" /> <min value="0" /> <max value="*" /> </base> <type> <code value="UsageContext" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A (to add?)" /> </mapping> </element> <element id="Questionnaire.jurisdiction"> <path value="Questionnaire.jurisdiction" /> <short value="Intended jurisdiction for questionnaire (if applicable)" /> <definition value="A legal or geographic region in which the questionnaire is intended to be used." /> <comment value="It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.jurisdiction" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Jurisdiction" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="extensible" /> <description value="Countries and regions within which this artifact is targeted for use" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/jurisdiction" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A (to add?)" /> </mapping> </element> <element id="Questionnaire.contact"> <path value="Questionnaire.contact" /> <short value="Contact details for the publisher" /> <definition value="Contact details to assist a user in finding and communicating with the publisher." /> <comment value="May be a web site, an email address, a telephone number, etc." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.contact" /> <min value="0" /> <max value="*" /> </base> <type> <code value="ContactDetail" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".participation[typeCode=CALLBCK].role" /> </mapping> </element> <element id="Questionnaire.copyright"> <path value="Questionnaire.copyright" /> <short value="Use and/or publishing restrictions" /> <definition value="A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire." /> <requirements value="Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content." /> <alias value="License" /> <alias value="Restrictions" /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.copyright" /> <min value="0" /> <max value="1" /> </base> <type> <code value="markdown" /> </type> <mapping> <identity value="rim" /> <map value="N/A (to add?)" /> </mapping> <mapping> <identity value="objimpl" /> <map value="no-gen-base" /> </mapping> </element> <element id="Questionnaire.code"> <path value="Questionnaire.code" /> <short value="Concept that represents the overall questionnaire" /> <definition value="An identifier for this question or group of questions in a particular terminology such as LOINC." /> <requirements value="Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.code" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuestionnaireConcept" /> </extension> <strength value="example" /> <description value="Codes for questionnaires, groups and individual questions" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/questionnaire-questions" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code" /> </mapping> </element> <element id="Questionnaire.subjectType"> <path value="Questionnaire.subjectType" /> <short value="Resource that can be subject of QuestionnaireResponse" /> <definition value="The types of subjects that can be the subject of responses created for the questionnaire." /> <comment value="If none are specified, then the subject is unlimited." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.subjectType" /> <min value="0" /> <max value="*" /> </base> <type> <code value="code" /> </type> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ResourceType" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true" /> </extension> <strength value="required" /> <description value="One of the resource types defined as part of FHIR." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/resource-types" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=META].target[classCode=OBS, moodCode=DEFN, isCriterion=true].participation.role.classCode" /> </mapping> </element> <element id="Questionnaire.item"> <path value="Questionnaire.item" /> <short value="Questions and sections within the Questionnaire" /> <definition value="A particular question, question grouping or display text that is part of the questionnaire." /> <comment value="The content of the questionnaire is constructed from an ordered, hierarchical collection of items." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.item" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="que-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="Element" /> </constraint> <constraint> <key value="que-9" /> <severity value="error" /> <human value="Read-only can't be specified for "display" items" /> <expression value="type!='display' or readOnly.empty()" /> <xpath value="not(f:type/@value='display' and f:readOnly)" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-8" /> <severity value="error" /> <human value="Default values can't be specified for groups or display items" /> <expression value="(type!='group' and type!='display') or initial.empty()" /> <xpath value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-6" /> <severity value="error" /> <human value="Required and repeat aren't permitted for display items" /> <expression value="type!='display' or (required.empty() and repeats.empty())" /> <xpath value="not(f:type/@value='display' and (f:required or f:repeats))" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-5" /> <severity value="error" /> <human value="Only 'choice' items can have options" /> <expression value="(type ='choice' or type = 'open-choice') or (options.empty() and option.empty())" /> <xpath value="f:type/@value=('choice','open-choice') or not(f:option or f:options)" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-4" /> <severity value="error" /> <human value="A question cannot have both option and options" /> <expression value="option.empty() or options.empty()" /> <xpath value="not(f:options and f:option)" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-3" /> <severity value="error" /> <human value="Display items cannot have a "code" asserted" /> <expression value="type!='display' or code.empty()" /> <xpath value="not(f:type/@value='display' and f:code)" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-10" /> <severity value="error" /> <human value="Maximum length can only be declared for simple question types" /> <expression value="(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url')) or maxLength.empty()" /> <xpath value="f:type/@value=('boolean', 'decimal', 'integer', 'open-choice', 'string', 'text', 'url') or not(f:maxLength)" /> <source value="Questionnaire.item" /> </constraint> <constraint> <key value="que-1" /> <severity value="error" /> <human value="Group items must have nested items, display items cannot have nested items" /> <expression value="(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())" /> <xpath value="not((f:type/@value='group' and not(f:item)) or (f:type/@value='display' and f:item))" /> <source value="Questionnaire.item" /> </constraint> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=DEF]" /> </mapping> </element> <element id="Questionnaire.item.id"> <path value="Questionnaire.item.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Questionnaire.item.extension"> <path value="Questionnaire.item.extension" /> <slicing id="7"> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> </element> <element id="Questionnaire.item.extension:condition"> <path value="Questionnaire.item.extension" /> <sliceName value="condition" /> <short value="A condition that determines whether or not the group is applicable" /> <definition value="The name of an expression that determines whether the group on which it appears is applicable. The expression is evaluated within the current context. If the result of evaluating the expression is true, the group is applicable. The expression has access to the current value of answered questions by the linkId of the question." /> <comment value="Note that per Lloyd this extension may not be necessary, it may be able to specified structurally using the elements already available within Questionnaire." /> <alias value="condition" /> <min value="0" /> <max value="1" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-condition" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="Questionnaire.item.extension:initialvalue"> <path value="Questionnaire.item.extension" /> <sliceName value="initialValue" /> <short value="An expression that provides the initial value for the answer to the question" /> <definition value="The name of an expression that determines the initial value for the answer to the question. This expression is evaluated once as part of displaying the form, and does not have access to the answers to other questions." /> <alias value="initialValue" /> <min value="0" /> <max value="1" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-initialValue" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="Questionnaire.item.extension:calculatedvalue"> <path value="Questionnaire.item.extension" /> <sliceName value="calculatedValue" /> <short value="An expression that provides a calculated value for the answer to the question" /> <definition value="The name of an expression that determines a calculated value for the answer to the question. The expression is evaluated as necessary and has access to the answers to other questions by the linkId of the question." /> <alias value="calculatedValue" /> <min value="0" /> <max value="1" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-calculatedValue" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="Questionnaire.item.modifierExtension"> <path value="Questionnaire.item.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Questionnaire.item.linkId"> <path value="Questionnaire.item.linkId" /> <short value="Unique id for item in questionnaire" /> <definition value="An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource." /> <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here." /> <requirements value="[QuestionnaireResponse](questionnaireresponse.html#) does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient." /> <min value="1" /> <max value="1" /> <base> <path value="Questionnaire.item.linkId" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> </element> <element id="Questionnaire.item.definition"> <path value="Questionnaire.item.definition" /> <short value="ElementDefinition - details for the item" /> <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item. If a definition is provided, then the following element values can be inferred from the definition: * code (ElementDefinition.code) * type (ElementDefinition.type) * required (ElementDefinition.min) * repeats (ElementDefinition.max) * maxLength (ElementDefinition.maxLength) * options (ElementDefinition.binding) Any information provided in these elements on a Questionnaire Item overrides the information from the definition." /> <comment value="the URI refers to an ElementDefinition in either a [StructureDefinition](structuredefinition.html#) or a [DataElement](dataelement.html#), and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id [Element.id](element-definitions.html#Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition. Note that [LOINC codes](loinc.html#dataelements) implicitly define DataElement resources." /> <requirements value="A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.definition" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=INST].target[classCode=OBS, moodCode=DEF]" /> </mapping> </element> <element id="Questionnaire.item.code"> <path value="Questionnaire.item.code" /> <short value="Corresponding concept for this item in a terminology" /> <definition value="A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers)." /> <comment value="The value may come from the ElementDefinition referred to by .definition." /> <requirements value="Allows linking of groups of questions to formal terminologies." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.item.code" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="que-3" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuestionnaireConcept" /> </extension> <strength value="example" /> <description value="Codes for questionnaires, groups and individual questions" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/questionnaire-questions" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value=".code" /> </mapping> </element> <element id="Questionnaire.item.prefix"> <path value="Questionnaire.item.prefix" /> <short value="E.g. "1(a)", "2.5.3"" /> <definition value="A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire." /> <comment value="These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire." /> <requirements value="Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used." /> <alias value="label" /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.prefix" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="Not supported" /> </mapping> </element> <element id="Questionnaire.item.text"> <path value="Questionnaire.item.text" /> <short value="Primary text for the item" /> <definition value="The name of a section, the text of a question or text content for a display item." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> </element> <element id="Questionnaire.item.type"> <path value="Questionnaire.item.type" /> <short value="group | display | boolean | decimal | integer | date | dateTime +" /> <definition value="The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.)." /> <comment value="Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition." /> <requirements value="Defines the format in which the user is to be prompted for the answer." /> <min value="1" /> <max value="1" /> <base> <path value="Questionnaire.item.type" /> <min value="1" /> <max value="1" /> </base> <type> <code value="code" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuestionnaireItemType" /> </extension> <strength value="required" /> <description value="Distinguishes groups from questions and display text and indicates data type for questions" /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/item-type" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.enableWhen"> <path value="Questionnaire.item.enableWhen" /> <short value="Only allow data when" /> <definition value="A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true." /> <comment value="If multiple repetitions of this extension are present, the item should be enabled when the condition for *any* of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met." /> <requirements value="Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.item.enableWhen" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <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="Element" /> </constraint> <constraint> <key value="que-7" /> <severity value="error" /> <human value="enableWhen must contain either a 'answer' or a 'hasAnswer' element" /> <expression value="hasAnswer.exists() xor answer.exists()" /> <xpath value="count(f:*[starts-with(local-name(.), 'answer')]|self::f:hasAnswer) = 1" /> </constraint> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.enableWhen.id"> <path value="Questionnaire.item.enableWhen.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Questionnaire.item.enableWhen.extension"> <path value="Questionnaire.item.enableWhen.extension" /> <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> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Questionnaire.item.enableWhen.modifierExtension"> <path value="Questionnaire.item.enableWhen.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Questionnaire.item.enableWhen.question"> <path value="Questionnaire.item.enableWhen.question" /> <short value="Question that determines whether item is enabled" /> <definition value="The linkId for the question whose answer (or lack of answer) governs whether this item is enabled." /> <comment value="If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis." /> <min value="1" /> <max value="1" /> <base> <path value="Questionnaire.item.enableWhen.question" /> <min value="1" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.enableWhen.hasAnswer"> <path value="Questionnaire.item.enableWhen.hasAnswer" /> <short value="Enable when answered or not" /> <definition value="An indication that this item should be enabled only if the specified question is answered (hasAnswer=true) or not answered (hasAnswer=false)." /> <comment value="If answered=false and answer values are also provided, then they are treated as "or". I.e. "Enable if the question is unanswered or the answer is one of the specified values". If answered=true and answers are present, one of the specified answers must be met. (So there's little reason to specify answered=true if answers are present.)." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.enableWhen.hasAnswer" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="que-7" /> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.enableWhen.answer[x]"> <path value="Questionnaire.item.enableWhen.answer[x]" /> <short value="Value question must have" /> <definition value="An answer that the referenced question must match in order for the item to be enabled." /> <comment value="Multiple answers are treated as "or". E.g. Enable if question 1 = A, C or E. Components not specified in the answer do not need to match. For example, if enableWhen specifies code + system for a Coding, it is ok if the answer has a "display" element. I.e. treat the answer as a 'pattern'. The dataType of this element must be the same as the data type of the question being referenced." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.enableWhen.answer[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <type> <code value="decimal" /> </type> <type> <code value="integer" /> </type> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="time" /> </type> <type> <code value="string" /> </type> <type> <code value="uri" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="Coding" /> </type> <type> <code value="Quantity" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <condition value="que-7" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuestionnaireQuestionOption2" /> </extension> <strength value="example" /> <description value="Allowed values to answer questions." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.required"> <path value="Questionnaire.item.required" /> <short value="Whether the item must be included in data results" /> <definition value="An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire." /> <comment value="Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.required" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <defaultValueBoolean value="false" /> <condition value="que-6" /> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.repeats"> <path value="Questionnaire.item.repeats" /> <short value="Whether the item may repeat" /> <definition value="An indication, if true, that the item may occur multiple times in the response, collecting multiple answers answers for questions or multiple sets of answers for groups." /> <comment value="If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition or to simply list each of the answers beneath the question. (Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.). The value may come from the ElementDefinition referred to by .definition." /> <requirements value="Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.repeats" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <defaultValueBoolean value="false" /> <condition value="que-6" /> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.readOnly"> <path value="Questionnaire.item.readOnly" /> <short value="Don't allow human editing" /> <definition value="An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire." /> <comment value="The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers." /> <requirements value="Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.readOnly" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="que-9" /> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.maxLength"> <path value="Questionnaire.item.maxLength" /> <short value="No more than this many characters" /> <definition value="The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse." /> <comment value="For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.maxLength" /> <min value="0" /> <max value="1" /> </base> <type> <code value="integer" /> </type> <condition value="que-10" /> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.options"> <path value="Questionnaire.item.options" /> <short value="Valueset containing permitted answers" /> <definition value="A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question." /> <comment value="LOINC defines many useful value sets for questionnaire responses. See [LOINC Answer Lists](loinc.html#alist). The value may come from the ElementDefinition referred to by .definition." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.options" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet" /> </type> <condition value="que-4" /> <condition value="que-5" /> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.option"> <path value="Questionnaire.item.option" /> <short value="Permitted answer" /> <definition value="One of the permitted answers for a "choice" or "open-choice" question." /> <comment value="This element can be used when the value set machinery of options is deemed too cumbersome or when there's a need to capture options that are not codes." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.item.option" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="que-4" /> <condition value="que-5" /> <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="Element" /> </constraint> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.option.id"> <path value="Questionnaire.item.option.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." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Questionnaire.item.option.extension"> <path value="Questionnaire.item.option.extension" /> <slicing id="8"> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Extension" /> <definition value="An Extension" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> </element> <element id="Questionnaire.item.option.extension:optioncode"> <path value="Questionnaire.item.option.extension" /> <sliceName value="optionCode" /> <short value="Meaning of the response option" /> <definition value="A CodeableConcept that assigns meaning to the response object on which it appears." /> <requirements value="Need to be able to determine the semantics of each potential response in order to interpret the meaning when processing the questionnaire response. For example, the response option "Severe migraines within the past year" to the question "Select all that apply" needs detailed coding (such as via CodeableConcept) at the option level, as well as a way to represent that an affirmation/negative response should result in (perhaps) an Observation in the QuestionnaireResponse tied to a clinical model (such as CIMI). This is key to support sophisticated CDS based on the semantics of the QuestionnaireResponse -- not just the codes." /> <alias value="optionCode" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-optionCode" /> </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="Element" /> </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="Extension" /> </constraint> </element> <element id="Questionnaire.item.option.modifierExtension"> <path value="Questionnaire.item.option.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> <isModifier value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Questionnaire.item.option.value[x]"> <path value="Questionnaire.item.option.value[x]" /> <short value="Answer value" /> <definition value="A potential answer that's allowed as the answer to this question." /> <comment value="The data type of the value must agree with the item.type." /> <min value="1" /> <max value="1" /> <base> <path value="Questionnaire.item.option.value[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="integer" /> </type> <type> <code value="date" /> </type> <type> <code value="time" /> </type> <type> <code value="string" /> </type> <type> <code value="Coding" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuestionnaireQuestionOption" /> </extension> <strength value="example" /> <description value="Allowed values to answer questions." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.initial[x]"> <path value="Questionnaire.item.initial[x]" /> <short value="Default value when item is first rendered" /> <definition value="The value that should be defaulted when initially rendering the questionnaire for user input." /> <comment value="The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that default values can influence results. The data type of initial[x] must agree with the item.type." /> <requirements value="In some workflows, having defaults saves time." /> <min value="0" /> <max value="1" /> <base> <path value="Questionnaire.item.initial[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <type> <code value="decimal" /> </type> <type> <code value="integer" /> </type> <type> <code value="date" /> </type> <type> <code value="dateTime" /> </type> <type> <code value="time" /> </type> <type> <code value="string" /> </type> <type> <code value="uri" /> </type> <type> <code value="Attachment" /> </type> <type> <code value="Coding" /> </type> <type> <code value="Quantity" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" /> </type> <condition value="que-8" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuestionnaireQuestionOption2" /> </extension> <strength value="example" /> <description value="Allowed values to answer questions." /> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers" /> </valueSetReference> </binding> <mapping> <identity value="rim" /> <map value="N/A - MIF rather than RIM level" /> </mapping> </element> <element id="Questionnaire.item.item"> <path value="Questionnaire.item.item" /> <short value="Nested questionnaire items" /> <definition value="Text, questions and other groups to be nested beneath a question or group." /> <comment value="There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting." /> <requirements value="Reports can consist of complex nested groups." /> <min value="0" /> <max value="*" /> <base> <path value="Questionnaire.item.item" /> <min value="0" /> <max value="*" /> </base> <contentReference value="#Questionnaire.item" /> <condition value="que-1" /> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=COMP].target" /> </mapping> </element> </snapshot> <differential> <element id="Questionnaire"> <path value="Questionnaire" /> <short value="A questionnaire with the ability to specify behavior associated with questions or groups of questions" /> <definition value="A CQIF questionnaire is a questionnaire with the added ability to describe behavior associated with questions. For example, whether or not to display a particular question or group of questions, or automatically calculating the value of an answer based on the answers to previous questions." /> <min value="0" /> <max value="*" /> </element> <element id="Questionnaire.extension:library"> <path value="Questionnaire.extension" /> <sliceName value="library" /> <short value="A library containing logic referenced by the questionnaire" /> <definition value="A CQL or ELM library containing any logic referenced by the questionnaire." /> <alias value="library" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-library" /> </type> </element> <element id="Questionnaire.item"> <path value="Questionnaire.item" /> </element> <element id="Questionnaire.item.extension:condition"> <path value="Questionnaire.item.extension" /> <sliceName value="condition" /> <short value="A condition that determines whether or not the group is applicable" /> <definition value="The name of an expression that determines whether the group on which it appears is applicable. The expression is evaluated within the current context. If the result of evaluating the expression is true, the group is applicable. The expression has access to the current value of answered questions by the linkId of the question." /> <comment value="Note that per Lloyd this extension may not be necessary, it may be able to specified structurally using the elements already available within Questionnaire." /> <alias value="condition" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-condition" /> </type> </element> <element id="Questionnaire.item.extension:initialvalue"> <path value="Questionnaire.item.extension" /> <sliceName value="initialValue" /> <short value="An expression that provides the initial value for the answer to the question" /> <definition value="The name of an expression that determines the initial value for the answer to the question. This expression is evaluated once as part of displaying the form, and does not have access to the answers to other questions." /> <alias value="initialValue" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-initialValue" /> </type> </element> <element id="Questionnaire.item.extension:calculatedvalue"> <path value="Questionnaire.item.extension" /> <sliceName value="calculatedValue" /> <short value="An expression that provides a calculated value for the answer to the question" /> <definition value="The name of an expression that determines a calculated value for the answer to the question. The expression is evaluated as necessary and has access to the answers to other questions by the linkId of the question." /> <alias value="calculatedValue" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-calculatedValue" /> </type> </element> <element id="Questionnaire.item.option"> <path value="Questionnaire.item.option" /> </element> <element id="Questionnaire.item.option.extension:optioncode"> <path value="Questionnaire.item.option.extension" /> <sliceName value="optionCode" /> <short value="Meaning of the response option" /> <definition value="A CodeableConcept that assigns meaning to the response object on which it appears." /> <requirements value="Need to be able to determine the semantics of each potential response in order to interpret the meaning when processing the questionnaire response. For example, the response option "Severe migraines within the past year" to the question "Select all that apply" needs detailed coding (such as via CodeableConcept) at the option level, as well as a way to represent that an affirmation/negative response should result in (perhaps) an Observation in the QuestionnaireResponse tied to a clinical model (such as CIMI). This is key to support sophisticated CDS based on the semantics of the QuestionnaireResponse -- not just the codes." /> <alias value="optionCode" /> <min value="0" /> <max value="*" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/cqif-optionCode" /> </type> </element> </differential> </StructureDefinition> </resource> </entry> </Bundle>