<Observation xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../fhir-all-xsd/observation.xsd">
  <!--        TRILLIUM II Project
		Example of imaging observation including numeric results and text
    -->
  <id value="trilliumII-example-imaging-5" />
  <!-- UPDATE THE Narrative -->
  <!-- to be decided how to deal wioth narratives here ? at the seciton level ? both ? -->
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>SPECT Heart perfusion and wall motion at rest and W stress and W Tl-201 IV and W Tc-99m Sestamibi IV</b>
      </p>
      <ul>
        <li> Stress test is negative for dobutamine-induced myocardial ischemia.</li>
        <li> Normal left ventricular size, regional wall motion, and ejection fraction</li>
      </ul>
    </div>
  </text>
  <!-- used the documentReference beacuse of the missing study and seires information -->
  <extension url="http://trilliumbridge.eu/fhir/StructureDefinition/derivedfrom-observation-uv-trillium2">
    <extension url="reference">
      <valueReference>
        <reference value="DocumentReference/1.2.276.0.7230010.3.1.3.1787205428.3112.1522315594.397907" />
      </valueReference>
    </extension>
    <extension url="referenceType">
      <valueCodeableConcept>
        <coding>
          <system value="http://dicom.nema.org/resources/ontology/DCM" />
          <code value="121080" />
          <display value="Best illustration of finding" />
        </coding>
      </valueCodeableConcept>
    </extension>
  </extension>
  <extension url="http://trilliumbridge.eu/fhir/StructureDefinition/derivedfrom-observation-uv-trillium2">
    <extension url="reference">
      <valueReference>
        <reference value="DocumentReference/1.2.276.0.7230010.3.1.2.1787205428.2952.1522314310.246518" />
      </valueReference>
    </extension>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/event-reasonCode">
    <valueCodeableConcept>
      <text value="Chest pain, hypertension, type II diabetes mellitus." />
    </valueCodeableConcept>
  </extension>
  <status value="final" />
  <category>
    <coding>
      <system value="http://hl7.org/fhir/observation-category" />
      <code value="imaging" />
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://loinc.org/" />
      <code value="49569-7" />
      <display value="SPECT Heart perfusion and wall motion at rest and W stress and W Tl-201 IV and W Tc-99m Sestamibi IV" />
    </coding>
    <text value="SPECT Heart perfusion and wall motion at rest and W stress and W Tl-201 IV and W Tc-99m Sestamibi IV (example-5)" />
  </code>
  <!-- in the profile effectiveTime is 0...1 -->
  <subject>
    <!-- revise the URL if needed -->
    <reference value="Patient/GE0514" />
  </subject>
  <effectiveDateTime value="2012-12-12" />
  <performer>
    <!-- revise the URL if needed ; -->
    <reference value="Practitioner/TII-Practitioner1" />
  </performer>
  <performer>
    <!-- revise the URL if needed -->
    <reference value="Organization/TII-Organization1" />
  </performer>
  <valueString value="1. Stress test is negative for dobutamine-induced myocardial ischemia. 2. Normal left ventricular size, regional wall motion, and ejection fraction." />
  <bodySite>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="80891009" />
      <display value="Heart" />
    </coding>
  </bodySite>
  <related>
    <type value="has-member" />
    <target>
      <reference value="Observation/trilliumII-example-img-subobs-5-1" />
    </target>
  </related>
  <related>
    <type value="has-member" />
    <target>
      <reference value="Observation/trilliumII-example-img-subobs-5-2" />
    </target>
  </related>
  <component>
    <code>
      <coding>
        <system value="http://dicom.nema.org/resources/ontology/DCM" />
        <code value="121065" />
        <display value="Procedure Description" />
      </coding>
    </code>
    <valueString value="Dobutamine Myoview stress test." />
  </component>
</Observation>