CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
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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 Monthly Event Observation - Vital Signs

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

This profile contains Required and Must Support data elements for reporting observation-vital signs information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile inherits from the US Core 6.1.0 Vital Signs

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.

    Name Flags Card. Type Description & Constraints    Filter: Filtersdoco
    .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
    Constraints: obs-6, obs-7, vs-2
    ... id SΣ 1..1 id
    (NHSN-MS)
    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
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... status ?!SΣ 1..1 code
    (NHSN-MS)
    (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S 1..* CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:VSCat S 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    ..... coding SΣ 1..* Coding (USCDI) Code defined by a terminology system
    ...... system SΣ 1..1 uri (USCDI) Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code SΣ 1..1 code (USCDI) Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Coded Responses from C-CDA Vital Sign Results
    Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile)
    (NHSN-MS)
    (USCDI) Who and/or what the observation is about
    .... reference SΣC 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... encounter SΣ 0..1 Reference(Encounter)
    (NHSN-MS)
    Healthcare event during which this observation is made
    .... reference SΣC 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... effective[x] SΣC 1..1
    (NHSN-MS)
    (USCDI) Often just a dateTime for Vital Signs
    Constraints: vs-1
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    ... issued SΣ 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    ... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept
    .... valueString string
    .... valueBoolean boolean
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    ... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... bodySite S 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    ... method S 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    ... referenceRange SC 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Constraints: obs-3
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low SC 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    .... high SC 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    .... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
    (NHSN-MS)
    Used when reporting vital signs panel components
    .... reference SΣC 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... component SΣC 0..* BackboneElement
    (NHSN-MS)
    (USCDI) Component observations
    Constraints: vs-3
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    ..... valueQuantity Quantity S
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... low SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    ..... high SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    ..... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:VSCat Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.code Base extensible US Core Vital Signs ValueSet 📦6.1.0 US Core v6.1
    Observation.value[x] Base extensible Vital Signs Units 📍4.0.1 FHIR Std.
    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 extensible SNOMED CT Body Structures 📦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.​value[x] Base extensible Vital Signs Units 📍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()
    vs-1 error Observation.effective[x] if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day $this is dateTime implies $this.toString().length() >= 10
    vs-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3 error Observation.component If there is no a value a data absent reason must be present value.exists() or dataAbsentReason.exists()

    This structure is derived from USCoreVitalSignsProfile

    Name Flags Card. Type Description & Constraints    Filter: Filtersdoco
    .. Observation 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
    ... id S 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    ... meta
    .... Slices for extension Content/Rules for all slices
    ..... extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    ... partOf S 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)
    (NHSN-MS)
    Part of referenced event
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... category 1..* CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    ... Slices for category Content/Rules for all slices
    .... category:VSCat 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    ... code 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Coded Responses from C-CDA Vital Sign Results
    ... subject 1..1 Reference(Cross-Measure Patient Profile)
    (NHSN-MS)
    (USCDI) Who and/or what the observation is about
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... encounter S 0..1 Reference(Encounter)
    (NHSN-MS)
    Healthcare event during which this observation is made
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... effective[x] 1..1 dateTime, Period
    (NHSN-MS)
    (USCDI) Often just a dateTime for Vital Signs
    ... issued S 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    ... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    (NHSN-MS)
    (USCDI) Vital Signs Value
    ... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    ... bodySite S 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    ... method S 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    ... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    .... low S 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    .... high S 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    .... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    ... hasMember S 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
    (NHSN-MS)
    Used when reporting vital signs panel components
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... component 0..* BackboneElement
    (NHSN-MS)
    (USCDI) Component observations
    .... code 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    (NHSN-MS)
    (USCDI) Vital Sign Component Value
    .... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    .... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    ..... low S 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    ..... high S 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    ..... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Observation.bodySite Base extensible SNOMED CT Body Structures 📦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.
    Name Flags Card. Type Description & Constraints    Filter: Filtersdoco
    .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
    Constraints: obs-6, obs-7, vs-2
    ... id SΣ 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    .... versionId Σ 0..1 id Version specific identifier
    .... lastUpdated Σ 0..1 instant When the resource version last changed
    .... source Σ 0..1 uri Identifies where the resource comes from
    .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    .... security Σ 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    .... tag Σ 0..* Coding Tags applied to this resource
    Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
    ... 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 Bindings Purpose
    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 Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)
    (NHSN-MS)
    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
    (NHSN-MS)
    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
    (NHSN-MS)
    (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S 1..* CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:VSCat S 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... coding SΣ 1..* Coding (USCDI) Code defined by a terminology system
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... system SΣ 1..1 uri (USCDI) Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... version Σ 0..1 string Version of the system - if relevant
    ...... code SΣ 1..1 code (USCDI) Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ...... display Σ 0..1 string Representation defined by the system
    ...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ..... text Σ 0..1 string Plain text representation of the concept
    ... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Coded Responses from C-CDA Vital Sign Results
    Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile)
    (NHSN-MS)
    (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
    (NHSN-MS)
    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)
    (NHSN-MS)
    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
    (NHSN-MS)
    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] SΣC 1..1
    (NHSN-MS)
    (USCDI) Often just a dateTime for Vital Signs
    Constraints: vs-1
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    ... issued SΣ 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
    ... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept
    .... valueString string
    .... valueBoolean boolean
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    ... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... note 0..* Annotation Comments about the observation
    ... bodySite S 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    ... method S 0..1 CodeableConcept
    (NHSN-MS)
    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 SC 0..* BackboneElement
    (NHSN-MS)
    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 SC 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    .... high SC 0..1 SimpleQuantity
    (NHSN-MS)
    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 S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
    (NHSN-MS)
    Used when reporting vital signs panel components
    .... 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
    (NHSN-MS)
    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(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) Related measurements the observation is made from
    ... component SΣC 0..* BackboneElement
    (NHSN-MS)
    (USCDI) Component observations
    Constraints: vs-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
    .... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    ..... valueQuantity Quantity S
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    ..... 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 SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    ..... high SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    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 S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    ..... text 0..1 string Text based reference range in an observation

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
    Observation.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
    Observation.language Base preferred Common Languages 📦4.0.1 FHIR Std.
    Observation.partOf.type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:VSCat Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.code Base extensible US Core Vital Signs ValueSet 📦6.1.0 US Core v6.1
    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] Base extensible Vital Signs Units 📍4.0.1 FHIR Std.
    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 extensible 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.​value[x] Base extensible Vital Signs Units 📍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.
    Observation.component.​referenceRange.type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
    Observation.component.​referenceRange.appliesTo Base example Observation Reference Range Applies To 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()
    vs-1 error Observation.effective[x] if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day $this is dateTime implies $this.toString().length() >= 10
    vs-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3 error Observation.component If there is no a value a data absent reason must be present value.exists() or dataAbsentReason.exists()

    This structure is derived from USCoreVitalSignsProfile

    Summary

    Mandatory: 2 elements(3 nested mandatory elements)
    Must-Support: 21 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Maturity: 1

    Key Elements View

    Name Flags Card. Type Description & Constraints    Filter: Filtersdoco
    .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
    Constraints: obs-6, obs-7, vs-2
    ... id SΣ 1..1 id
    (NHSN-MS)
    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
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... status ?!SΣ 1..1 code
    (NHSN-MS)
    (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S 1..* CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:VSCat S 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    ..... coding SΣ 1..* Coding (USCDI) Code defined by a terminology system
    ...... system SΣ 1..1 uri (USCDI) Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... code SΣ 1..1 code (USCDI) Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Coded Responses from C-CDA Vital Sign Results
    Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile)
    (NHSN-MS)
    (USCDI) Who and/or what the observation is about
    .... reference SΣC 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... encounter SΣ 0..1 Reference(Encounter)
    (NHSN-MS)
    Healthcare event during which this observation is made
    .... reference SΣC 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... effective[x] SΣC 1..1
    (NHSN-MS)
    (USCDI) Often just a dateTime for Vital Signs
    Constraints: vs-1
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    ... issued SΣ 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    ... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept
    .... valueString string
    .... valueBoolean boolean
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    ... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... bodySite S 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    ... method S 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    ... referenceRange SC 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Constraints: obs-3
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low SC 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    .... high SC 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    .... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
    (NHSN-MS)
    Used when reporting vital signs panel components
    .... reference SΣC 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... component SΣC 0..* BackboneElement
    (NHSN-MS)
    (USCDI) Component observations
    Constraints: vs-3
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    ..... valueQuantity Quantity S
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... low SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    ..... high SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    ..... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:VSCat Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.code Base extensible US Core Vital Signs ValueSet 📦6.1.0 US Core v6.1
    Observation.value[x] Base extensible Vital Signs Units 📍4.0.1 FHIR Std.
    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 extensible SNOMED CT Body Structures 📦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.​value[x] Base extensible Vital Signs Units 📍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()
    vs-1 error Observation.effective[x] if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day $this is dateTime implies $this.toString().length() >= 10
    vs-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3 error Observation.component If there is no a value a data absent reason must be present value.exists() or dataAbsentReason.exists()

    Differential View

    This structure is derived from USCoreVitalSignsProfile

    Name Flags Card. Type Description & Constraints    Filter: Filtersdoco
    .. Observation 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
    ... id S 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    ... meta
    .... Slices for extension Content/Rules for all slices
    ..... extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    ... partOf S 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)
    (NHSN-MS)
    Part of referenced event
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... category 1..* CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    ... Slices for category Content/Rules for all slices
    .... category:VSCat 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    ... code 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Coded Responses from C-CDA Vital Sign Results
    ... subject 1..1 Reference(Cross-Measure Patient Profile)
    (NHSN-MS)
    (USCDI) Who and/or what the observation is about
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... encounter S 0..1 Reference(Encounter)
    (NHSN-MS)
    Healthcare event during which this observation is made
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... effective[x] 1..1 dateTime, Period
    (NHSN-MS)
    (USCDI) Often just a dateTime for Vital Signs
    ... issued S 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    ... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    (NHSN-MS)
    (USCDI) Vital Signs Value
    ... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    ... bodySite S 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    ... method S 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    ... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    .... low S 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    .... high S 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    .... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    ... hasMember S 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
    (NHSN-MS)
    Used when reporting vital signs panel components
    .... reference S 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    ... component 0..* BackboneElement
    (NHSN-MS)
    (USCDI) Component observations
    .... code 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    (NHSN-MS)
    (USCDI) Vital Sign Component Value
    .... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    .... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    ..... low S 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    ..... high S 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    ..... age S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Observation.bodySite Base extensible SNOMED CT Body Structures 📦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

    Name Flags Card. Type Description & Constraints    Filter: Filtersdoco
    .. Observation C 0..* USCoreVitalSignsProfile(6.1.0) US Core Vital Signs Profile
    Constraints: obs-6, obs-7, vs-2
    ... id SΣ 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    .... versionId Σ 0..1 id Version specific identifier
    .... lastUpdated Σ 0..1 instant When the resource version last changed
    .... source Σ 0..1 uri Identifies where the resource comes from
    .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    .... security Σ 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    .... tag Σ 0..* Coding Tags applied to this resource
    Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
    ... 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 Bindings Purpose
    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 Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    ... partOf SΣ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)
    (NHSN-MS)
    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
    (NHSN-MS)
    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
    (NHSN-MS)
    (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required)
    ... Slices for category S 1..* CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Slice: Unordered, Open by value:coding.code, value:coding.system
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    .... category:VSCat S 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Classification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... coding SΣ 1..* Coding (USCDI) Code defined by a terminology system
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... system SΣ 1..1 uri (USCDI) Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    ...... version Σ 0..1 string Version of the system - if relevant
    ...... code SΣ 1..1 code (USCDI) Symbol in syntax defined by the system
    Fixed Value: vital-signs
    ...... display Σ 0..1 string Representation defined by the system
    ...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ..... text Σ 0..1 string Plain text representation of the concept
    ... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Coded Responses from C-CDA Vital Sign Results
    Binding: US Core Vital Signs ValueSet (extensible): The vital sign codes from the base FHIR and US Core Vital Signs.
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile)
    (NHSN-MS)
    (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
    (NHSN-MS)
    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)
    (NHSN-MS)
    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
    (NHSN-MS)
    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] SΣC 1..1
    (NHSN-MS)
    (USCDI) Often just a dateTime for Vital Signs
    Constraints: vs-1
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    ... issued SΣ 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
    ... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Signs Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    .... valueQuantity Quantity S
    .... valueCodeableConcept CodeableConcept
    .... valueString string
    .... valueBoolean boolean
    .... valueInteger integer
    .... valueRange Range
    .... valueRatio Ratio
    .... valueSampledData SampledData
    .... valueTime time
    .... valueDateTime dateTime
    .... valuePeriod Period
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    ... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    ... note 0..* Annotation Comments about the observation
    ... bodySite S 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    ... method S 0..1 CodeableConcept
    (NHSN-MS)
    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 SC 0..* BackboneElement
    (NHSN-MS)
    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 SC 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    .... high SC 0..1 SimpleQuantity
    (NHSN-MS)
    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 S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember SΣ 0..* Reference(QuestionnaireResponse | MolecularSequence | Vital Signs Profile)
    (NHSN-MS)
    Used when reporting vital signs panel components
    .... 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
    (NHSN-MS)
    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(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | Vital Signs Profile) Related measurements the observation is made from
    ... component SΣC 0..* BackboneElement
    (NHSN-MS)
    (USCDI) Component observations
    Constraints: vs-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
    .... code SΣ 1..1 CodeableConcept
    (NHSN-MS)
    (USCDI) Type of component observation (code / type)
    Binding: LOINCCodes (extensible)
    .... value[x] SΣC 0..1
    (NHSN-MS)
    (USCDI) Vital Sign Component Value
    Binding: VitalSignsUnits (extensible): Common UCUM units for recording Vital Signs.
    ..... valueQuantity Quantity S
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    .... interpretation S 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    .... referenceRange S 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    ..... 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 SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    ..... high SC 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    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 S 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    ..... text 0..1 string Text based reference range in an observation

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
    Observation.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
    Observation.language Base preferred Common Languages 📦4.0.1 FHIR Std.
    Observation.partOf.type Base extensible ResourceType 📍4.0.1 FHIR Std.
    Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
    Observation.category Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.category:VSCat Base preferred Observation Category Codes 📦4.0.1 FHIR Std.
    Observation.code Base extensible US Core Vital Signs ValueSet 📦6.1.0 US Core v6.1
    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] Base extensible Vital Signs Units 📍4.0.1 FHIR Std.
    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 extensible 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.​value[x] Base extensible Vital Signs Units 📍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.
    Observation.component.​referenceRange.type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
    Observation.component.​referenceRange.appliesTo Base example Observation Reference Range Applies To 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()
    vs-1 error Observation.effective[x] if Observation.effective[x] is dateTime and has a value then that value shall be precise to the day $this is dateTime implies $this.toString().length() >= 10
    vs-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
    vs-3 error Observation.component If there is no a value a data absent reason must be present value.exists() or dataAbsentReason.exists()

    This structure is derived from USCoreVitalSignsProfile

    Summary

    Mandatory: 2 elements(3 nested mandatory elements)
    Must-Support: 21 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Maturity: 1

     

    Other representations of profile: CSV, Excel, Schematron