CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
2.0.0-cibuild - Release 2 ci-build United States of America flag

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v2.0.0-cibuild) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ACH Daily Event Observation

Official URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-daily-observation Version: 2.0.0-cibuild
Standards status: Trial-use Maturity Level: 1 Computable Name: AcuteCareHospitalDailyEventObservation

This profile contains Required and Must Support data elements for reporting observation information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile inherits from the QI Core 6.0.0 Simple Observation profile, which inherits from the US Core 6.1.0 Simple Observation profile.

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 1.0.0:

  • New Content

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* QICoreSimpleObservation(6.0.0) assessment observation
    Constraints: obs-6, obs-7
    ... id Σ 1..1 id Logical id of this artifact
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... partOf SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... status ?!SΣ 1..1 code (QI-Core)(USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    ... Slices for category S 1..* CodeableConcept (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... code SΣ 1..1 CodeableConcept (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who and/or what the observation is about
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... effective[x] SΣ 1..1 (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... issued SΣ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    ... Slices for value[x] SΣC 0..1 (QI-Core)(USCDI) Actual result
    Slice: Unordered, Open by type:$this
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept S
    .... valueString string S
    .... valueBoolean boolean S
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    .... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S (QI-Core) actual | potential
    Binding: USCoreObservationValueCodes (6.1.0) (preferred): SNOMED CT for coded results
    ... interpretation S 0..* CodeableConcept (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... method S 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (extensible)
    ... hasMember SΣ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... component SΣ 0..* BackboneElement Component results
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.status Base required Non-Negative Observation Status 📦6.0.0 QI-Core Implementation Guide v6.0
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📍6.1.0 US Core v6.1
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If 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-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If 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()

    This structure is derived from QICoreSimpleObservation

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation 0..* QICoreSimpleObservation(6.0.0) assessment observation
    ... id 1..1 id Logical id of this artifact
    ... basedOn S 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... partOf S 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... subject 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who and/or what the observation is about
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter S 0..1 Reference(Encounter) Healthcare event during which this observation is made
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... effective[x] 1..1 dateTime, Period, Timing, instant (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    ... issued S 0..1 instant Date/Time this version was made available
    ... interpretation S 0..* CodeableConcept (QI-Core) High, low, normal, etc.
    ... method S 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (extensible)
    ... hasMember S 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... component S 0..* BackboneElement Component results
    .... code 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] S 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period Actual component result
    .... interpretation S 0..* CodeableConcept High, low, normal, etc.

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Observation.code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* QICoreSimpleObservation(6.0.0) assessment observation
    Constraints: obs-6, obs-7
    ... id Σ 1..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn SΣ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... partOf SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... status ?!SΣ 1..1 code (QI-Core)(USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    ... Slices for category S 1..* CodeableConcept (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... code SΣ 1..1 CodeableConcept (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who and/or what the observation is about
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... effective[x] SΣ 1..1 (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... issued SΣ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    ... Slices for value[x] SΣC 0..1 (QI-Core)(USCDI) Actual result
    Slice: Unordered, Open by type:$this
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept S
    .... valueString string S
    .... valueBoolean boolean S
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    .... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S (QI-Core) actual | potential
    Binding: USCoreObservationValueCodes (6.1.0) (preferred): SNOMED CT for coded results
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    ... interpretation S 0..* CodeableConcept (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
    ... method S 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (extensible)
    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    Constraints: obs-3
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
    .... appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember SΣ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... derivedFrom Σ 0..* Reference(QICore Simple Observation | QICore QuestionnaireResponse | QICore ImagingStudy | US Core DocumentReference Profile(6.1.0) | Media | MolecularSequence) (QI-Core)(USCDI) US Core Profiles or other resource the observation is made from
    ... component SΣ 0..* BackboneElement Component results
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.language Base preferred Common Languages 📦4.0.1 FHIR Std.
    Observation.basedOn.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.partOf.type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.status Base required Non-Negative Observation Status 📦6.0.0 QI-Core Implementation Guide v6.0
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📍6.1.0 US Core v6.1
    Observation.dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📦4.0.1 FHIR Std.
    Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📦4.0.1 FHIR Std.
    Observation.hasMember.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If 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-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If 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()

    This structure is derived from QICoreSimpleObservation

    Summary

    Mandatory: 3 elements(4 nested mandatory elements)
    Must-Support: 15 elements

    Structures

    This structure refers to these other structures:

    Maturity: 1

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* QICoreSimpleObservation(6.0.0) assessment observation
    Constraints: obs-6, obs-7
    ... id Σ 1..1 id Logical id of this artifact
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... partOf SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... status ?!SΣ 1..1 code (QI-Core)(USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    ... Slices for category S 1..* CodeableConcept (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... code SΣ 1..1 CodeableConcept (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who and/or what the observation is about
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... effective[x] SΣ 1..1 (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... issued SΣ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    ... Slices for value[x] SΣC 0..1 (QI-Core)(USCDI) Actual result
    Slice: Unordered, Open by type:$this
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept S
    .... valueString string S
    .... valueBoolean boolean S
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    .... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S (QI-Core) actual | potential
    Binding: USCoreObservationValueCodes (6.1.0) (preferred): SNOMED CT for coded results
    ... interpretation S 0..* CodeableConcept (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... method S 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (extensible)
    ... hasMember SΣ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... component SΣ 0..* BackboneElement Component results
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.status Base required Non-Negative Observation Status 📦6.0.0 QI-Core Implementation Guide v6.0
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📍6.1.0 US Core v6.1
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If 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-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If 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()

    Differential View

    This structure is derived from QICoreSimpleObservation

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation 0..* QICoreSimpleObservation(6.0.0) assessment observation
    ... id 1..1 id Logical id of this artifact
    ... basedOn S 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... partOf S 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... subject 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who and/or what the observation is about
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter S 0..1 Reference(Encounter) Healthcare event during which this observation is made
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... effective[x] 1..1 dateTime, Period, Timing, instant (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    ... issued S 0..1 instant Date/Time this version was made available
    ... interpretation S 0..* CodeableConcept (QI-Core) High, low, normal, etc.
    ... method S 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (extensible)
    ... hasMember S 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... component S 0..* BackboneElement Component results
    .... code 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] S 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period Actual component result
    .... interpretation S 0..* CodeableConcept High, low, normal, etc.

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Observation.code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Observation C 0..* QICoreSimpleObservation(6.0.0) assessment observation
    Constraints: obs-6, obs-7
    ... id Σ 1..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn SΣ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... partOf SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... status ?!SΣ 1..1 code (QI-Core)(USCDI) registered | prliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    ... Slices for category S 1..* CodeableConcept (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... code SΣ 1..1 CodeableConcept (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who and/or what the observation is about
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... effective[x] SΣ 1..1 (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... issued SΣ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    ... Slices for value[x] SΣC 0..1 (QI-Core)(USCDI) Actual result
    Slice: Unordered, Open by type:$this
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept S
    .... valueString string S
    .... valueBoolean boolean S
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    .... value[x]:valueCodeableConcept SΣC 0..1 CodeableConcept S (QI-Core) actual | potential
    Binding: USCoreObservationValueCodes (6.1.0) (preferred): SNOMED CT for coded results
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    ... interpretation S 0..* CodeableConcept (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
    ... method S 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (extensible)
    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    Constraints: obs-3
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
    .... appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember SΣ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... derivedFrom Σ 0..* Reference(QICore Simple Observation | QICore QuestionnaireResponse | QICore ImagingStudy | US Core DocumentReference Profile(6.1.0) | Media | MolecularSequence) (QI-Core)(USCDI) US Core Profiles or other resource the observation is made from
    ... component SΣ 0..* BackboneElement Component results
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.language Base preferred Common Languages 📦4.0.1 FHIR Std.
    Observation.basedOn.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.partOf.type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.status Base required Non-Negative Observation Status 📦6.0.0 QI-Core Implementation Guide v6.0
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:us-core Base required US Core Simple Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.value[x]:valueCodeableConcept Base preferred US Core Observation Value Codes (SNOMED-CT) 📍6.1.0 US Core v6.1
    Observation.dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📦4.0.1 FHIR Std.
    Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📦4.0.1 FHIR Std.
    Observation.hasMember.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If 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-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If 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()

    This structure is derived from QICoreSimpleObservation

    Summary

    Mandatory: 3 elements(4 nested mandatory elements)
    Must-Support: 15 elements

    Structures

    This structure refers to these other structures:

    Maturity: 1

     

    Other representations of profile: CSV, Excel, Schematron