{ "resourceType": "StructureDefinition", "id": "SHxObservation-PS-AB-v01-CA-v03", "text": { "status": "extensions", "div": "
\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\" Observation 0..*ObservationSocialHistoryPSCAMeasurements and simple assertions
\".\"\".\"\".\" text S0..1NarrativeTo contain the mapped description element 'Lifestyle_Risk_Factor_Description' as narrative for human consumer
\".\"\".\"\".\" Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
\".\"\".\"\".\" EffectiveDate-derived-from-EffectiveDateR4 S0..1dateEffectiveDate of SH Observation
URL: http://fhir.alberta.ca/fhir/psab/StructureDefinition/EffectiveDate-derived-from-EffectiveDateR4
\".\"\".\"\".\" Slices for identifier 1..*IdentifierBusiness Identifier for observation. In AB, multiple busID can be applied here, such as ULI.
Slice: Unordered, Open by pattern:system
\".\"\".\"\".\"\".\" identifier:ULI S1..1IdentifierBusiness Identifier for observation
\".\"\".\"\".\"\".\"\".\" id 0..1stringUnique id for inter-element referencing
Required Pattern: id.ULI
\".\"\".\"\".\"\".\"\".\" system 1..1uriA ULI id for any recipient of Alberta Health System
Required Pattern: urn:oid:2.16.840.1.113883.4.20
\".\"\".\"\".\"\".\"\".\" assigner
\".\"\".\"\".\"\".\"\".\"\".\" reference 0..1stringLiteral reference, Relative, internal or absolute URL
Required Pattern: https://www.alberta.ca/health.aspx
\".\"\".\"\".\"\".\"\".\"\".\" type 0..1uriType the reference refers to (e.g. "Patient")
Required Pattern: https://www.alberta.ca/health.aspx
\".\"\".\"\".\"\".\"\".\"\".\" display 0..1stringText alternative for the resource
Required Pattern: Alberta Health
\".\"\".\"\".\" status 1..1coderegistered | preliminary | final | amended +
\".\"\".\"\".\" category 1..*CodeableConceptJust for a collection of any social history events in AB
\".\"\".\"\".\" category:social-history 1..1CodeableConceptClassification of type of observation
Required Pattern: At least the following
\".\"\".\"\".\"\".\" coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
\".\"\".\"\".\"\".\"\".\" system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
\".\"\".\"\".\"\".\"\".\" code1..1codeSymbol in syntax defined by the system
Fixed Value: social-history
\".\"\".\"\".\"\".\"\".\" display1..1stringRepresentation defined by the system
Fixed Value: Social History
\".\"\".\"\".\" code 1..1CodeableConceptPSCAConcept - reference to a terminology or just text
\".\"\".\"\".\" subject 1..1Reference(Patient in AB)Who and/or what the observation is about
\".\"\".\"\".\"\".\" reference S1..1stringLiteral reference, Relative, internal or absolute URL
\".\"\".\"\".\"\".\" type 0..1uriType the reference refers to (e.g. "Patient")
Required Pattern: Patient
\".\"\".\"\".\" value[x] 0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual result
\".\"\".\"\".\" note
\".\"\".\"\".\"\".\" text S1..1markdownMapping to Lifestyle_Risk_Factor_Notes to provide specific information \n besides the description.

\"doco\" Documentation for this format
" }, "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-category", "valueString": "Clinical.Diagnostics" }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category", "valueCode": "patient" } ], "url": "http://fhir.alberta.ca/fhir/psab/StructureDefinition/SHxObservation-PS-AB-v01-CA-v03", "version": "0.1.1", "name": "ABSHxObservation", "title": "Social History Observation in AB profiled from PSCA", "status": "active", "date": "2022-08-05T00:08:35+00:00", "publisher": "Alberta Health", "contact": [ { "name": "Alberta Health", "telecom": [ { "system": "url", "value": "http://alberta.ca/hisca" } ] } ], "description": "A Social History profile derived from the FHIR Observation resource.", "jurisdiction": [ { "coding": [ { "system": "urn:iso:std:iso:3166", "code": "CA", "display": "Canada" } ] } ], "fhirVersion": "4.0.1", "mapping": [ { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "identity": "sct-concept", "uri": "http://snomed.info/conceptdomain", "name": "SNOMED CT Concept Domain Binding" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" }, { "identity": "sct-attr", "uri": "http://snomed.org/attributebinding", "name": "SNOMED CT Attribute Binding" } ], "kind": "resource", "abstract": false, "type": "Observation", "baseDefinition": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps", "derivation": "constraint", "differential": { "element": [ { "id": "Observation", "path": "Observation" }, { "id": "Observation.text", "path": "Observation.text", "short": "To contain the mapped description element 'Lifestyle_Risk_Factor_Description' as narrative for human consumer", "comment": "Rolling back to optional Card with MS to be robust for both current and future development.", "mustSupport": true }, { "id": "Observation.extension", "path": "Observation.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" } }, { "id": "Observation.extension:effectiveDateHL7", "path": "Observation.extension", "sliceName": "effectiveDateHL7", "comment": "To carry the update date of the note.text in the SHxObservation. It may also serve as the update date of the text. this needs further clarification.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://fhir.alberta.ca/fhir/psab/StructureDefinition/EffectiveDate-derived-from-EffectiveDateR4" ] } ], "mustSupport": true }, { "id": "Observation.identifier", "path": "Observation.identifier", "slicing": { "discriminator": [ { "type": "pattern", "path": "system" } ], "rules": "open" }, "short": "Business Identifier for observation. In AB, multiple busID can be applied here, such as ULI.", "min": 1 }, { "id": "Observation.identifier:ULI", "path": "Observation.identifier", "sliceName": "ULI", "min": 1, "max": "1", "mustSupport": true }, { "id": "Observation.identifier:ULI.id", "path": "Observation.identifier.id", "patternString": "id.ULI" }, { "id": "Observation.identifier:ULI.system", "path": "Observation.identifier.system", "short": "A ULI id for any recipient of Alberta Health System", "min": 1, "patternUri": "urn:oid:2.16.840.1.113883.4.20" }, { "id": "Observation.identifier:ULI.assigner.reference", "path": "Observation.identifier.assigner.reference", "patternString": "https://www.alberta.ca/health.aspx" }, { "id": "Observation.identifier:ULI.assigner.type", "path": "Observation.identifier.assigner.type", "patternUri": "https://www.alberta.ca/health.aspx" }, { "id": "Observation.identifier:ULI.assigner.display", "path": "Observation.identifier.assigner.display", "patternString": "Alberta Health" }, { "id": "Observation.status", "path": "Observation.status", "comment": "This might be able to implement as a fixed value in phase one" }, { "id": "Observation.category", "path": "Observation.category", "short": "Just for a collection of any social history events in AB" }, { "id": "Observation.category:social-history", "path": "Observation.category", "sliceName": "social-history", "patternCodeableConcept": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "social-history", "display": "Social History" } ] } }, { "id": "Observation.code", "path": "Observation.code", "comment": "One challenge with a generic social history profile is that there is uneven terminology coverage for \n broad social history concepts (e.g., lifestyle risk factors, Social Determinants of Health factors) \n and specific social history concepts (e.g., tobacco use assessment) across both LOINC and SNOMED CT terminologies, as well as a lack of consistency in implementation across international implementation guides & vendors. In places where the International Patient Summary guide has defined terminology for a specific social history concept (e.g., tobacco use) via a specific profile, that terminology is governed by the specialized profile. However, in broader profiles where the terminology is not defined by external requirements and not well known, the terminology options will be expressed as examples rather than bindings or sliced value sets until further use is known regarding use & harmonization in the Canadian and International patient summary space. \r\n At minimum text is expected to be supplied for this element given that code is mandatory in FHIR and codings may not be supported by every implementation." }, { "id": "Observation.subject", "path": "Observation.subject", "type": [ { "code": "Reference", "targetProfile": [ "http://fhir.alberta.ca/fhir/psab/StructureDefinition/Patient-PS-AB-v01-CA-v03" ] } ] }, { "id": "Observation.subject.reference", "path": "Observation.subject.reference", "min": 1, "mustSupport": true }, { "id": "Observation.subject.type", "path": "Observation.subject.type", "patternUri": "Patient" }, { "id": "Observation.value[x]", "path": "Observation.value[x]", "comment": "While the ability to use structured data is desireable, \nthe practice of documenting social history is still varied \nand some systems may not have the ability to differentiate individual\nhistory details. Unlike FamilyMemberHistory, Observation has the expectation that value be populated in most cases \n(even if using a valueString). The supply of string values also has considerable support \nfrom consuming systems that are familiar with receiving free text \nin the valueString and therefore it is recommended for usage over note in this profile. \nFor initial pilots, implementers should anticipate that some of this information may still \nbe populated as free text in the Observation.note element. \n\n \nBase Resource Comment: An observation may have; 1) a single value here, 2) \nboth a value and a set of related or component values, or 3) \nonly a set of related or component values. If a value is present, \nthe datatype for this element should be determined by Observation.code. \nA CodeableConcept with just a text would be used instead of a string if the field was usually coded, \nor if the type associated with the Observation.code defines a coded value. \nFor additional guidance, see the [Notes section](observation.html#notes) below." }, { "id": "Observation.note.text", "path": "Observation.note.text", "short": "Mapping to Lifestyle_Risk_Factor_Notes to provide specific information \n besides the description.", "mustSupport": true } ] } }