MaxMD AMA IG
0.0.1 - CI Build

MaxMD AMA IG - Local Development build (v0.0.1). See the Directory of published versions

Resource Profile: TestObservation2

AMA-IHMI-observation-blood-pressure-1 (alternative to AMA-IHMI-observation-blood-pressure-2)

Additional Description

Blood pressure measurement observations that adhere to this profile may, but do not necessarily, conform to stricter constraints (also referred to in this document as "clinically valid blood pressures") which specify that the measurements should only be at the brachial artery (with laterality), in sitting position, at rest, using an automatic blood pressure monitor with cuff size specified. (Note: To constrain to only "clinically valid blood pressure" observations, use AMA-IHMI-observation-blood-pressure-3.)

This profile allows the Observation Resource to be extended to include body position and exertional status as Observation components (i.e., Observation.component bodyPosition and Observation.component exertionalStatus). This is not the AMA IHMI preferred approach for extending the Observation Resource to include body position and exertional status. However, this option was provided based on feedback from some implementers who expressed a preference for using components to extend the Observation Resource. As an alternative option for implementer feedback, AMA-IHMI-observation-blood-pressure-2 is identical to AMA-IHMI-observation-blood-pressure-1 except that AMA-IHMI-observation-blood-pressure-2 includes body position and exertional status as Observation extension elements (i.e., Observation.extension bodyPosition and Observation.extension exertionalStatus).

AMA-IHMI-observation-blood-pressure-1 is intended to be paired with AMA-IHMI-observation-heart-rate-1 which constrains heart rate measurements using a similar approach.

Additional Guidance

Observation.bodySite

This element references the SNOMED CT refset 5241000207108 American Medical Association Integrated Health Model Initiative, body structure, refset 2, simple type reference set (foundation metadata concept) as follows:

To transform the concept definition of a SNOMED CT blood pressure concept used as an Observation Code or Component Code in this profile (i.e., 4011000207100 Measurement of blood pressure (procedure), 4131000207105 Measurement of diastolic blood pressure (procedure) or 4351000207102 Measurement of systolic blood pressure (procedure)) to arrive at a more granular precoordinated SNOMED CT concept in the AMA IHMI SNOMED CT Extension, the concepts in the SNOMED CT refset for Observation.body.Site correspond to the two SNOMED CT attribute-value pairs as shown in the two right columns.

Observation.bodySite SNOMED CT Refset Member SNOMED CT attribute: 704319004 Inheres in (attribute) SNOMED CT attribute: 405814001 Procedure site - Indirect (attribute)
40983000 Upper arm structure (body structure) 17137000 Structure of brachial artery (body structure) 40983000 Upper arm structure (body structure)
368209003 Right upper arm structure (body structure) 723962009 Structure of right brachial artery (body structure) 368209003 Right upper arm structure (body structure)
368208006 Left upper arm structure (body structure) 723961002 Structure of left brachial artery (body structure) 368208006 Left upper arm structure (body structure)
8205005 Wrist region structure (body structure) 45631007 Structure of radial artery (body structure) 8205005 Wrist region structure (body structure)
9736006 Structure of right wrist (body structure) 368503001 Structure of right radial artery (body structure) 9736006 Structure of right wrist (body structure)
5951000 Structure of left wrist (body structure) 368504007 Structure of left radial artery (body structure) 5951000 Structure of left wrist (body structure)
Observation.device

This element references a URL for an AMA IHMI profile of Type Device as follows:

The referenced AMA-IHMI-device-blood-pressure-2 profile's Device.type.coding.code references the SNOMED CT refset 5251000207105 American Medical Association Integrated Health Model Initiative, device, refset 2, simple type reference set (foundation metadata concept).

To transform the concept definition of a SNOMED CT blood pressure concept used as an Observation Code or Component Code in this profile (i.e., 4011000207100 Measurement of blood pressure (procedure), 4131000207105 Measurement of diastolic blood pressure (procedure) or 4351000207102 Measurement of systolic blood pressure (procedure)) to arrive at a more granular precoordinated SNOMED CT concept in the AMA IHMI SNOMED CT Extension, the concepts in the SNOMED CT refset for Device.type correspond to the SNOMED CT attribute-value pairs as shown in the right column.

Device.type SNOMED CT Refset Member SNOMED CT attribute: 424226004 Using device (attribute)
3901000207100 Automatic blood pressure monitor (physical object) 3901000207100 Automatic blood pressure monitor (physical object)
3941000207103 Automatic blood pressure monitor with small adult cuff (physical object) 3941000207103 Automatic blood pressure monitor with small adult cuff (physical object)
3931000207106 Automatic blood pressure monitor with medium adult cuff (physical object) 3931000207106 Automatic blood pressure monitor with medium adult cuff (physical object)
3921000207108 Automatic blood pressure monitor with large adult cuff (physical object) 3921000207108 Automatic blood pressure monitor with large adult cuff (physical object)
4851000207105 Automatic blood pressure monitor with extra large adult cuff (physical object) 4851000207105 Automatic blood pressure monitor with extra large adult cuff (physical object)
Observation.component (bodyPosition)

This element references the SNOMED CT concept 33586001 Sitting position (finding) as follows:

  • Observation.component.valueCodeableConcept.coding.code
    • ElementDefinition.fixed[x]: 33586001
  • Observation.component.valueCodeableConcept.coding.display
    • ElementDefinition.fixed[x]: Sitting position (finding)

To transform the concept definition of a SNOMED CT blood pressure concept used as an Observation Code or Component Code in this profile (i.e., 4011000207100 Measurement of blood pressure (procedure), 4131000207105 Measurement of diastolic blood pressure (procedure) or 4351000207102 Measurement of systolic blood pressure (procedure)) to arrive at a more granular precoordinated SNOMED CT concept in the AMA IHMI SNOMED CT Extension, the SNOMED CT concepts for Observation.component.valueCodeableConcept (bodyPosition) AND/OR Observation.component.valueCodeableConcept (exertionalStatus) correspond to the SNOMED CT attribute-value pairs as shown in the right column.

Observation.component bodyPosition Observation.component exertionalStatus SNOMED CT attribute: 704326004 Precondition (attribute)
33586001 Sitting position (finding)   33586001 Sitting position (finding)
  128975004 Resting state (finding) 128975004 Resting state (finding)
33586001 Sitting position (finding) 128975004 Resting state (finding) 4001000207103 In sitting position at rest (finding)
Observation.component (exertionalStatus)

For exertionalStatus, the ElementDefinition.short and ElementDefinition.definition (below) were created and added by AMA IHMI.

  • ElementDefinition.short: The state of exertion preceding or during the observation.
  • ElementDefinition.definition: The state of exertion (e.g., resting state) preceding and/or during the observation. To be used only when the exertional state is not precoordinated in the observation code.

exertionalStatus is an AMA IHMI Observation Component extension to capture associated exertional states that may impact the observation result. For example, a blood pressure measurement observation result that specifies "resting state" is intended to indicate that the individual was at rest (e.g., for 5 minutes) prior to the measurement. It is anticipated that this element might evolve or require refinement. For example, as AMA IHMI moves to FHIR R4 (v4.0.0), exertionalStatus could possibly be captured using the FHIR Observation Resource Extension: Precondition (http://hl7.org/fhir/StructureDefinition/observation-precondition).

This element references the SNOMED CT concept 128975004 Resting state (finding) as follows:

  • Observation.component.valueCodeableConcept.coding.code
    • ElementDefinition.fixed[x]: 128975004
  • Observation.component.valueCodeableConcept.coding.display
    • ElementDefinition.fixed[x]: Resting state (finding)

To transform the concept definition of a SNOMED CT blood pressure concept used as an Observation Code or Component Code in this profile (i.e., 4011000207100 Measurement of blood pressure (procedure), 4131000207105 Measurement of diastolic blood pressure (procedure) or 4351000207102 Measurement of systolic blood pressure (procedure)) to arrive at a more granular precoordinated SNOMED CT concept in the AMA IHMI SNOMED CT Extension, the SNOMED CT concepts for Observation.component.valueCodeableConcept (bodyPosition) AND/OR Observation.component.valueCodeableConcept (exertionalStatus) correspond to the SNOMED CT attribute-value pairs as shown in the right column.

Observation.component bodyPosition Observation.component exertionalStatus 704326004 Precondition (attribute)
33586001 Sitting position (finding)   33586001 Sitting position (finding)
  128975004 Resting state (finding) 128975004 Resting state (finding)
33586001 Sitting position (finding) 128975004 Resting state (finding) 4001000207103 In sitting position at rest (finding)

The official URL for this profile is: 

http://example.org/fhir/StructureDefinition/StructureDefinition/TestObservation3

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Observation

Summary

Mandatory: 13 elements (4 nested mandatory elements)
Fixed Value: 7 elements
Prohibited: 6 elements

Extensions

This structure refers to these extensions:

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*ObservationMeasurements and simple assertions
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... Extension-Observation-ExertionalStatus 0..1CodeableConceptThe state of exertion preceding or during the observation.
URL: https://trifolia-fhir-dev.lantanagroup.com/igs/lantana_prod_hapi_r4/MaxMD-AMA-Test-IG/StructureDefinition/Extension-Observation-ExertionalStatus
... status 1..1coderegistered | preliminary | final | amended +
Fixed Value: final
.... coding 1..1CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 65653002
..... display 1..1stringRepresentation defined by the system
Fixed Value: Pulse taking (procedure)
..... userSelected 0..0
... subject 1..1Reference(Patient)Who and/or what the observation is about
... effective[x] 1..1dateTimeClinically relevant time/time-period for observation
... effective[x]:effectiveDateTime 1..1dateTimeClinically relevant time/time-period for observation
... value[x] 1..1QuantityActual result
... value[x]:valueQuantity 1..1QuantityActual result
.... value 1..1decimalNumerical value (with implicit precision)
.... comparator 0..0
.... unit 1..1stringUnit representation
.... system 1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code 1..1codeCoded form of the unit
Fixed Value: /min
... dataAbsentReason 0..0
... interpretation 0..0
... bodySite
.... coding 1..1CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1codeSymbol in syntax defined by the system
Binding: AMA IHMI valueSet body structure 1 instance (required)
..... display 1..1stringRepresentation defined by the system
... method 0..0
... specimen 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*ObservationMeasurements and simple assertions
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... Extension-Observation-ExertionalStatus I0..1CodeableConceptThe state of exertion preceding or during the observation.
URL: https://trifolia-fhir-dev.lantanagroup.com/igs/lantana_prod_hapi_r4/MaxMD-AMA-Test-IG/StructureDefinition/Extension-Observation-ExertionalStatus
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!ΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Fixed Value: final
... category I0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
... code ΣI1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI1..1CodingCode defined by a terminology system
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version ΣI0..1stringVersion of the system - if relevant
..... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 65653002
..... display ΣI1..1stringRepresentation defined by the system
Fixed Value: Pulse taking (procedure)
.... text ΣI0..1stringPlain text representation of the concept
... subject ΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] ΣI1..1(Slice Definition)Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime ΣI1..1dateTimeClinically relevant time/time-period for observation
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] ΣI1..1(Slice Definition)Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity ΣI1..1QuantityActual result
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value ΣI1..1decimalNumerical value (with implicit precision)
..... unit ΣI1..1stringUnit representation
..... system ΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code ΣI1..1codeCoded form of the unit
Fixed Value: /min
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI1..1CodingCode defined by a terminology system
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version ΣI0..1stringVersion of the system - if relevant
..... code ΣI1..1codeSymbol in syntax defined by the system
Binding: AMA IHMI valueSet body structure 1 instance (required)
..... display ΣI1..1stringRepresentation defined by the system
..... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component ΣI0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example)
.... value[x] ΣI0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

This structure is derived from Observation

Summary

Mandatory: 13 elements (4 nested mandatory elements)
Fixed Value: 7 elements
Prohibited: 6 elements

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*ObservationMeasurements and simple assertions
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... Extension-Observation-ExertionalStatus 0..1CodeableConceptThe state of exertion preceding or during the observation.
URL: https://trifolia-fhir-dev.lantanagroup.com/igs/lantana_prod_hapi_r4/MaxMD-AMA-Test-IG/StructureDefinition/Extension-Observation-ExertionalStatus
... status 1..1coderegistered | preliminary | final | amended +
Fixed Value: final
.... coding 1..1CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 65653002
..... display 1..1stringRepresentation defined by the system
Fixed Value: Pulse taking (procedure)
..... userSelected 0..0
... subject 1..1Reference(Patient)Who and/or what the observation is about
... effective[x] 1..1dateTimeClinically relevant time/time-period for observation
... effective[x]:effectiveDateTime 1..1dateTimeClinically relevant time/time-period for observation
... value[x] 1..1QuantityActual result
... value[x]:valueQuantity 1..1QuantityActual result
.... value 1..1decimalNumerical value (with implicit precision)
.... comparator 0..0
.... unit 1..1stringUnit representation
.... system 1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code 1..1codeCoded form of the unit
Fixed Value: /min
... dataAbsentReason 0..0
... interpretation 0..0
... bodySite
.... coding 1..1CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1codeSymbol in syntax defined by the system
Binding: AMA IHMI valueSet body structure 1 instance (required)
..... display 1..1stringRepresentation defined by the system
... method 0..0
... specimen 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*ObservationMeasurements and simple assertions
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... Extension-Observation-ExertionalStatus I0..1CodeableConceptThe state of exertion preceding or during the observation.
URL: https://trifolia-fhir-dev.lantanagroup.com/igs/lantana_prod_hapi_r4/MaxMD-AMA-Test-IG/StructureDefinition/Extension-Observation-ExertionalStatus
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!ΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
Fixed Value: final
... category I0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
... code ΣI1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI1..1CodingCode defined by a terminology system
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version ΣI0..1stringVersion of the system - if relevant
..... code ΣI1..1codeSymbol in syntax defined by the system
Fixed Value: 65653002
..... display ΣI1..1stringRepresentation defined by the system
Fixed Value: Pulse taking (procedure)
.... text ΣI0..1stringPlain text representation of the concept
... subject ΣI1..1Reference(Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Resource)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] ΣI1..1(Slice Definition)Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime ΣI1..1dateTimeClinically relevant time/time-period for observation
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] ΣI1..1(Slice Definition)Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity ΣI1..1QuantityActual result
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... value ΣI1..1decimalNumerical value (with implicit precision)
..... unit ΣI1..1stringUnit representation
..... system ΣI1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code ΣI1..1codeCoded form of the unit
Fixed Value: /min
... note I0..*AnnotationComments about the observation
... bodySite I0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI1..1CodingCode defined by a terminology system
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... system ΣI1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version ΣI0..1stringVersion of the system - if relevant
..... code ΣI1..1codeSymbol in syntax defined by the system
Binding: AMA IHMI valueSet body structure 1 instance (required)
..... display ΣI1..1stringRepresentation defined by the system
..... userSelected ΣI0..1booleanIf this coding was chosen directly by the user
.... text ΣI0..1stringPlain text representation of the concept
... device I0..1Reference(Device | DeviceMetric)(Measurement) Device
... referenceRange I0..*BackboneElementProvides guide for interpretation
obs-3: Must have at least a low or a high or text
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low I0..1SimpleQuantityLow Range, if relevant
.... high I0..1SimpleQuantityHigh Range, if relevant
.... type I0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred)
.... appliesTo I0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example)
.... age I0..1RangeApplicable age range, if relevant
.... text I0..1stringText based reference range in an observation
... hasMember ΣI0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component ΣI0..*BackboneElementComponent results
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example)
.... value[x] ΣI0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible)
.... interpretation I0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
.... referenceRange I0..*Unknown reference to #Observation.referenceRange
Provides guide for interpretation of component result

doco Documentation for this format

 

​Other representations of profile: Schematron

Terminology Bindings

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Max Binding: AllLanguages
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservationCategoryCodes
Observation.codeexampleLOINCCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.bodySite.coding.coderequiredAMA-IHMI-valueSet-body-structure-1-instance
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

Constraints

IdPathDetailsRequirements
dom-2ObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3ObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4ObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5ObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6ObservationA resource should have narrative for robust management
: text.`div`.exists()
obs-6ObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7ObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ele-1Observation.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.extension:myExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.extension:myExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.code.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.code.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.code.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.code.coding.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.code.coding.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.code.coding.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.code.coding.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.code.coding.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.code.coding.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.code.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.focusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.effective[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.effective[x]:effectiveDateTimeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.issuedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.value[x]:valueQuantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.value[x]:valueQuantity.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.value[x]:valueQuantity.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.value[x]:valueQuantity.valueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.value[x]:valueQuantity.unitAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.value[x]:valueQuantity.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.value[x]:valueQuantity.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.bodySite.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.bodySite.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.coding.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.bodySite.coding.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.bodySite.coding.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.coding.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.coding.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.coding.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.coding.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.bodySite.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.deviceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
obs-3Observation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
ele-1Observation.referenceRange.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.referenceRange.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.referenceRange.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.referenceRange.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.referenceRange.lowAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.highAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.appliesToAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.ageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.referenceRange.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.hasMemberAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.derivedFromAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Observation.component.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Observation.component.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.value[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.dataAbsentReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.interpretationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Observation.component.referenceRangeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())