CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
3.0.0 - Release 3 - draft United States of America flag

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v3.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ACH Monthly Event Observation

Official URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-observation Version: 3.0.0
Standards status: Trial-use Maturity Level: 2 Computable Name: AcuteCareHospitalMonthlyReportingObservation
Other Identifiers: OID:2.16.840.1.113883.4.642.40.1002.42.24

This profile contains Required and Must Support data elements for reporting observation information to the NHSN Acute Care Hospital (ACH) Monthly 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.

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation C 0..* QICoreSimpleObservationSubstitute assessment observation
    Constraints: obs-6, obs-7
    Observation.id This element must be supported. This element is included in summaries. 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    Observation.partOf This element must be supported. This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
    (NHSN-MS)
    Part of referenced event
    Observation.partOf.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code
    (NHSN-MS)
    (QI-Core)(USCDI) registered | preliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    Observation.Slices for category This element must be supported. 1..* CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    Observation.Slices for category.category:us-core This element must be supported. 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
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(Cross-Measure Patient Profile) {b}
    (NHSN-MS)
    (QI-Core)(USCDI) Who and/or what the observation is about
    Observation.subject.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(Encounter) {b}
    (NHSN-MS)
    Healthcare event during which this observation is made
    Observation.encounter.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.effective[x] This element must be supported. This element is included in summaries. 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Observation.effective[x].effectiveDateTime dateTime This target must be supported.
    Observation.effective[x].effectivePeriod Period
    Observation.effective[x].effectiveTiming Timing
    Observation.effective[x].effectiveInstant instant
    Observation.issued This element must be supported. This element is included in summaries. 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    Observation.value[x] This element must be supported. This element is included in summaries. C 0..1
    (NHSN-MS)
    (QI-Core)(USCDI) Actual result
    Observation.value[x].valueQuantity Quantity This type must be supported.
    Observation.value[x].valueCodeableConcept CodeableConcept This type must be supported.
    Observation.value[x].valueString string This target must be supported.
    Observation.value[x].valueBoolean boolean This target must be supported.
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueSampledData SampledData
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible)
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.referenceRange This element must be supported. C 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Constraints: obs-3
    Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.referenceRange.low This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.high This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) {b}
    (NHSN-MS)
    Related resource that belongs to the Observation group
    Observation.hasMember.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.component This element must be supported. This element is included in summaries. 0..* BackboneElement
    (NHSN-MS)
    Component results
    Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.component.value[x] This element must be supported. This element is included in summaries. 0..1
    (NHSN-MS)
    Actual component result
    Observation.component.value[x].valueQuantity Quantity
    Observation.component.value[x].valueCodeableConcept CodeableConcept
    Observation.component.value[x].valueString string
    Observation.component.value[x].valueBoolean boolean
    Observation.component.value[x].valueInteger integer
    Observation.component.value[x].valueRange Range
    Observation.component.value[x].valueRatio Ratio
    Observation.component.value[x].valueSampledData SampledData
    Observation.component.value[x].valueTime time
    Observation.component.value[x].valueDateTime dateTime
    Observation.component.value[x].valuePeriod Period
    Observation.component.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    Observation.component.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    Observation.component.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.referenceRange.low This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.high This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.age This element must be supported. 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 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.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.​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()
    sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high, Observation.component.referenceRange.low, Observation.component.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()

    This structure is derived from QICoreSimpleObservationSubstitute

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation 0..* QICoreSimpleObservationSubstitute assessment observation
    Observation.id This element must be supported. 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    Observation.meta
    Observation.meta.Slices for extension Content/Rules for all slices
    Observation.meta.Slices for extension.extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    Observation.partOf This element must be supported. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
    (NHSN-MS)
    Part of referenced event
    Observation.partOf.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.category 1..* CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Classification of type of observation
    Observation.code 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.subject 1..1 Reference(Cross-Measure Patient Profile) {b} (NHSN-MS)(QI-Core)(USCDI) Who and/or what the observation is about
    Observation.subject.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.encounter This element must be supported. 0..1 Reference(Encounter) {b}
    (NHSN-MS)
    Healthcare event during which this observation is made
    Observation.encounter.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.effective[x] 1..1 dateTime, Period, Timing, instant (NHSN-MS)(QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Observation.issued This element must be supported. 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    Observation.value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period (NHSN-MS)(QI-Core)(USCDI) Actual result
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Observation.referenceRange.low This element must be supported. 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    Observation.referenceRange.high This element must be supported. 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    Observation.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.hasMember This element must be supported. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) {b}
    (NHSN-MS)
    Related resource that belongs to the Observation group
    Observation.hasMember.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.component This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Component results
    Observation.component.code This element must be supported. 1..1 CodeableConcept
    (NHSN-MS)
    Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.component.value[x] This element must be supported. 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    (NHSN-MS)
    Actual component result
    Observation.component.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Observation.component.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    Observation.component.referenceRange.low This element must be supported. 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    Observation.component.referenceRange.high This element must be supported. 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    Observation.component.referenceRange.age This element must be supported. 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.code Base extensible LOINC 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.
    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation C 0..* QICoreSimpleObservationSubstitute assessment observation
    Constraints: obs-6, obs-7
    Observation.id This element must be supported. This element is included in summaries. 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    Observation.meta This element is included in summaries. 0..1 Meta Metadata about the resource
    Observation.meta.id 0..1 string Unique id for inter-element referencing
    Observation.meta.Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.meta.Slices for extension.extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    Observation.meta.versionId This element is included in summaries. 0..1 id Version specific identifier
    Observation.meta.lastUpdated This element is included in summaries. 0..1 instant When the resource version last changed
    Observation.meta.source This element is included in summaries. 0..1 uri Identifies where the resource comes from
    Observation.meta.profile This element is included in summaries. 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    Observation.meta.security This element is included in summaries. 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    Observation.meta.tag This element is included in summaries. 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".
    Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    Observation.language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional Bindings Purpose
    AllLanguages Max Binding
    Observation.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
    Observation.contained 0..* Resource Contained, inline Resources
    Observation.extension 0..* Extension Additional content defined by implementations
    Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    Observation.identifier This element is included in summaries. 0..* Identifier Business Identifier for observation
    Observation.basedOn This element is included in summaries. 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    Observation.partOf This element must be supported. This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
    (NHSN-MS)
    Part of referenced event
    Observation.partOf.id 0..1 string Unique id for inter-element referencing
    Observation.partOf.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.partOf.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.partOf.type This element is included in summaries. 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).
    Observation.partOf.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.partOf.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code
    (NHSN-MS)
    (QI-Core)(USCDI) registered | preliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    Observation.Slices for category This element must be supported. 1..* CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    Observation.Slices for category.category:us-core This element must be supported. 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
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(Cross-Measure Patient Profile) {b}
    (NHSN-MS)
    (QI-Core)(USCDI) Who and/or what the observation is about
    Observation.subject.id 0..1 string Unique id for inter-element referencing
    Observation.subject.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.subject.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.subject.type This element is included in summaries. 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).
    Observation.subject.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.subject.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.focus This element is included in summaries. 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(Encounter) {b}
    (NHSN-MS)
    Healthcare event during which this observation is made
    Observation.encounter.id 0..1 string Unique id for inter-element referencing
    Observation.encounter.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.encounter.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.encounter.type This element is included in summaries. 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).
    Observation.encounter.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.encounter.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.effective[x] This element must be supported. This element is included in summaries. 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Observation.effective[x].effectiveDateTime dateTime This target must be supported.
    Observation.effective[x].effectivePeriod Period
    Observation.effective[x].effectiveTiming Timing
    Observation.effective[x].effectiveInstant instant
    Observation.issued This element must be supported. This element is included in summaries. 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    Observation.value[x] This element must be supported. This element is included in summaries. C 0..1
    (NHSN-MS)
    (QI-Core)(USCDI) Actual result
    Observation.value[x].valueQuantity Quantity This type must be supported.
    Observation.value[x].valueCodeableConcept CodeableConcept This type must be supported.
    Observation.value[x].valueString string This target must be supported.
    Observation.value[x].valueBoolean boolean This target must be supported.
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueSampledData SampledData
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible)
    Observation.note 0..* Annotation Comments about the observation
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen 0..1 Reference(Specimen) Specimen used for this observation
    Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    Observation.referenceRange This element must be supported. C 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Constraints: obs-3
    Observation.referenceRange.id 0..1 string Unique id for inter-element referencing
    Observation.referenceRange.extension 0..* Extension Additional content defined by implementations
    Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.referenceRange.low This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.high This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
    Observation.referenceRange.appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
    Observation.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.referenceRange.text 0..1 string Text based reference range in an observation
    Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) {b}
    (NHSN-MS)
    Related resource that belongs to the Observation group
    Observation.hasMember.id 0..1 string Unique id for inter-element referencing
    Observation.hasMember.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.hasMember.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.hasMember.type This element is included in summaries. 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).
    Observation.hasMember.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.hasMember.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.derivedFrom This element is included in summaries. 0..* Reference(QICore Simple Observation (Substitute) | 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
    Observation.component This element must be supported. This element is included in summaries. 0..* BackboneElement
    (NHSN-MS)
    Component results
    Observation.component.id 0..1 string Unique id for inter-element referencing
    Observation.component.extension 0..* Extension Additional content defined by implementations
    Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.component.value[x] This element must be supported. This element is included in summaries. 0..1
    (NHSN-MS)
    Actual component result
    Observation.component.value[x].valueQuantity Quantity
    Observation.component.value[x].valueCodeableConcept CodeableConcept
    Observation.component.value[x].valueString string
    Observation.component.value[x].valueBoolean boolean
    Observation.component.value[x].valueInteger integer
    Observation.component.value[x].valueRange Range
    Observation.component.value[x].valueRatio Ratio
    Observation.component.value[x].valueSampledData SampledData
    Observation.component.value[x].valueTime time
    Observation.component.value[x].valueDateTime dateTime
    Observation.component.value[x].valuePeriod Period
    Observation.component.dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    Observation.component.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    Observation.component.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    Observation.component.referenceRange.id 0..1 string Unique id for inter-element referencing
    Observation.component.referenceRange.extension 0..* Extension Additional content defined by implementations
    Observation.component.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.referenceRange.low This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.high This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
    Observation.component.referenceRange.appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
    Observation.component.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.component.referenceRange.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 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.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.​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()
    sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high, Observation.component.referenceRange.low, Observation.component.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()

    This structure is derived from QICoreSimpleObservationSubstitute

    Summary

    Mandatory: 3 elements(3 nested mandatory elements)
    Must-Support: 24 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Maturity: 2

    Key Elements View

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation C 0..* QICoreSimpleObservationSubstitute assessment observation
    Constraints: obs-6, obs-7
    Observation.id This element must be supported. This element is included in summaries. 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    Observation.partOf This element must be supported. This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
    (NHSN-MS)
    Part of referenced event
    Observation.partOf.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code
    (NHSN-MS)
    (QI-Core)(USCDI) registered | preliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    Observation.Slices for category This element must be supported. 1..* CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    Observation.Slices for category.category:us-core This element must be supported. 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
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(Cross-Measure Patient Profile) {b}
    (NHSN-MS)
    (QI-Core)(USCDI) Who and/or what the observation is about
    Observation.subject.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(Encounter) {b}
    (NHSN-MS)
    Healthcare event during which this observation is made
    Observation.encounter.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.effective[x] This element must be supported. This element is included in summaries. 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Observation.effective[x].effectiveDateTime dateTime This target must be supported.
    Observation.effective[x].effectivePeriod Period
    Observation.effective[x].effectiveTiming Timing
    Observation.effective[x].effectiveInstant instant
    Observation.issued This element must be supported. This element is included in summaries. 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    Observation.value[x] This element must be supported. This element is included in summaries. C 0..1
    (NHSN-MS)
    (QI-Core)(USCDI) Actual result
    Observation.value[x].valueQuantity Quantity This type must be supported.
    Observation.value[x].valueCodeableConcept CodeableConcept This type must be supported.
    Observation.value[x].valueString string This target must be supported.
    Observation.value[x].valueBoolean boolean This target must be supported.
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueSampledData SampledData
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible)
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.referenceRange This element must be supported. C 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Constraints: obs-3
    Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.referenceRange.low This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.high This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) {b}
    (NHSN-MS)
    Related resource that belongs to the Observation group
    Observation.hasMember.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.component This element must be supported. This element is included in summaries. 0..* BackboneElement
    (NHSN-MS)
    Component results
    Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.component.value[x] This element must be supported. This element is included in summaries. 0..1
    (NHSN-MS)
    Actual component result
    Observation.component.value[x].valueQuantity Quantity
    Observation.component.value[x].valueCodeableConcept CodeableConcept
    Observation.component.value[x].valueString string
    Observation.component.value[x].valueBoolean boolean
    Observation.component.value[x].valueInteger integer
    Observation.component.value[x].valueRange Range
    Observation.component.value[x].valueRatio Ratio
    Observation.component.value[x].valueSampledData SampledData
    Observation.component.value[x].valueTime time
    Observation.component.value[x].valueDateTime dateTime
    Observation.component.value[x].valuePeriod Period
    Observation.component.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    Observation.component.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    Observation.component.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.referenceRange.low This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.high This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.age This element must be supported. 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 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.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.​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()
    sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high, Observation.component.referenceRange.low, Observation.component.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()

    Differential View

    This structure is derived from QICoreSimpleObservationSubstitute

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation 0..* QICoreSimpleObservationSubstitute assessment observation
    Observation.id This element must be supported. 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    Observation.meta
    Observation.meta.Slices for extension Content/Rules for all slices
    Observation.meta.Slices for extension.extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    Observation.partOf This element must be supported. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
    (NHSN-MS)
    Part of referenced event
    Observation.partOf.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.status 1..1 code (NHSN-MS)(QI-Core)(USCDI) registered | preliminary | final | amended | corrected | entered-in-error | unknown
    Observation.category 1..* CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Classification of type of observation
    Observation.code 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.subject 1..1 Reference(Cross-Measure Patient Profile) {b} (NHSN-MS)(QI-Core)(USCDI) Who and/or what the observation is about
    Observation.subject.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.encounter This element must be supported. 0..1 Reference(Encounter) {b}
    (NHSN-MS)
    Healthcare event during which this observation is made
    Observation.encounter.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.effective[x] 1..1 dateTime, Period, Timing, instant (NHSN-MS)(QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Observation.issued This element must be supported. 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    Observation.value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period (NHSN-MS)(QI-Core)(USCDI) Actual result
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Observation.referenceRange.low This element must be supported. 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    Observation.referenceRange.high This element must be supported. 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    Observation.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.hasMember This element must be supported. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) {b}
    (NHSN-MS)
    Related resource that belongs to the Observation group
    Observation.hasMember.reference This element must be supported. 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.component This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Component results
    Observation.component.code This element must be supported. 1..1 CodeableConcept
    (NHSN-MS)
    Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.component.value[x] This element must be supported. 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    (NHSN-MS)
    Actual component result
    Observation.component.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Observation.component.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    Observation.component.referenceRange.low This element must be supported. 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    Observation.component.referenceRange.high This element must be supported. 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    Observation.component.referenceRange.age This element must be supported. 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.code Base extensible LOINC 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.

    Snapshot View

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation C 0..* QICoreSimpleObservationSubstitute assessment observation
    Constraints: obs-6, obs-7
    Observation.id This element must be supported. This element is included in summaries. 1..1 id
    (NHSN-MS)
    Logical id of this artifact
    Observation.meta This element is included in summaries. 0..1 Meta Metadata about the resource
    Observation.meta.id 0..1 string Unique id for inter-element referencing
    Observation.meta.Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.meta.Slices for extension.extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    Observation.meta.versionId This element is included in summaries. 0..1 id Version specific identifier
    Observation.meta.lastUpdated This element is included in summaries. 0..1 instant When the resource version last changed
    Observation.meta.source This element is included in summaries. 0..1 uri Identifies where the resource comes from
    Observation.meta.profile This element is included in summaries. 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    Observation.meta.security This element is included in summaries. 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    Observation.meta.tag This element is included in summaries. 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".
    Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
    Observation.language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional Bindings Purpose
    AllLanguages Max Binding
    Observation.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
    Observation.contained 0..* Resource Contained, inline Resources
    Observation.extension 0..* Extension Additional content defined by implementations
    Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
    Observation.identifier This element is included in summaries. 0..* Identifier Business Identifier for observation
    Observation.basedOn This element is included in summaries. 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
    Observation.partOf This element must be supported. This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) {b}
    (NHSN-MS)
    Part of referenced event
    Observation.partOf.id 0..1 string Unique id for inter-element referencing
    Observation.partOf.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.partOf.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.partOf.type This element is included in summaries. 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).
    Observation.partOf.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.partOf.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code
    (NHSN-MS)
    (QI-Core)(USCDI) registered | preliminary | final | amended | corrected | entered-in-error | unknown
    Binding: Non-Negative Observation Status (required)
    Observation.Slices for category This element must be supported. 1..* CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

    Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
    Observation.Slices for category.category:us-core This element must be supported. 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
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(Cross-Measure Patient Profile) {b}
    (NHSN-MS)
    (QI-Core)(USCDI) Who and/or what the observation is about
    Observation.subject.id 0..1 string Unique id for inter-element referencing
    Observation.subject.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.subject.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.subject.type This element is included in summaries. 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).
    Observation.subject.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.subject.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.focus This element is included in summaries. 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(Encounter) {b}
    (NHSN-MS)
    Healthcare event during which this observation is made
    Observation.encounter.id 0..1 string Unique id for inter-element referencing
    Observation.encounter.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.encounter.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.encounter.type This element is included in summaries. 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).
    Observation.encounter.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.encounter.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.effective[x] This element must be supported. This element is included in summaries. 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Observation.effective[x].effectiveDateTime dateTime This target must be supported.
    Observation.effective[x].effectivePeriod Period
    Observation.effective[x].effectiveTiming Timing
    Observation.effective[x].effectiveInstant instant
    Observation.issued This element must be supported. This element is included in summaries. 0..1 instant
    (NHSN-MS)
    Date/Time this version was made available
    Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore PractitionerRole | QICore CareTeam | QICore RelatedPerson) (QI-Core)(USCDI) Who is responsible for the observation
    Observation.value[x] This element must be supported. This element is included in summaries. C 0..1
    (NHSN-MS)
    (QI-Core)(USCDI) Actual result
    Observation.value[x].valueQuantity Quantity This type must be supported.
    Observation.value[x].valueCodeableConcept CodeableConcept This type must be supported.
    Observation.value[x].valueString string This target must be supported.
    Observation.value[x].valueBoolean boolean This target must be supported.
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueSampledData SampledData
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    (QI-Core) High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible)
    Observation.note 0..* Annotation Comments about the observation
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (extensible)
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen 0..1 Reference(Specimen) Specimen used for this observation
    Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    Observation.referenceRange This element must be supported. C 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation
    Constraints: obs-3
    Observation.referenceRange.id 0..1 string Unique id for inter-element referencing
    Observation.referenceRange.extension 0..* Extension Additional content defined by implementations
    Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.referenceRange.low This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.high This element must be supported. C 0..1 SimpleQuantity
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
    Observation.referenceRange.appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
    Observation.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.referenceRange.text 0..1 string Text based reference range in an observation
    Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) {b}
    (NHSN-MS)
    Related resource that belongs to the Observation group
    Observation.hasMember.id 0..1 string Unique id for inter-element referencing
    Observation.hasMember.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.hasMember.reference This element must be supported. This element is included in summaries. C 1..1 string
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.hasMember.type This element is included in summaries. 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).
    Observation.hasMember.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.hasMember.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.derivedFrom This element is included in summaries. 0..* Reference(QICore Simple Observation (Substitute) | 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
    Observation.component This element must be supported. This element is included in summaries. 0..* BackboneElement
    (NHSN-MS)
    Component results
    Observation.component.id 0..1 string Unique id for inter-element referencing
    Observation.component.extension 0..* Extension Additional content defined by implementations
    Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    Type of observation (code / type)
    Binding: LOINCCodes (extensible)
    Observation.component.value[x] This element must be supported. This element is included in summaries. 0..1
    (NHSN-MS)
    Actual component result
    Observation.component.value[x].valueQuantity Quantity
    Observation.component.value[x].valueCodeableConcept CodeableConcept
    Observation.component.value[x].valueString string
    Observation.component.value[x].valueBoolean boolean
    Observation.component.value[x].valueInteger integer
    Observation.component.value[x].valueRange Range
    Observation.component.value[x].valueRatio Ratio
    Observation.component.value[x].valueSampledData SampledData
    Observation.component.value[x].valueTime time
    Observation.component.value[x].valueDateTime dateTime
    Observation.component.value[x].valuePeriod Period
    Observation.component.dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
    Observation.component.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    Observation.component.referenceRange This element must be supported. 0..* BackboneElement
    (NHSN-MS)
    Provides guide for interpretation of component result
    Observation.component.referenceRange.id 0..1 string Unique id for inter-element referencing
    Observation.component.referenceRange.extension 0..* Extension Additional content defined by implementations
    Observation.component.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
    Observation.component.referenceRange.low This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    Low Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.high This element must be supported. C 0..1 SimpleQuantity(4.0.1)
    (NHSN-MS)
    High Range, if relevant
    Constraints: sqty-1
    Observation.component.referenceRange.type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
    Observation.component.referenceRange.appliesTo 0..* CodeableConcept Reference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
    Observation.component.referenceRange.age This element must be supported. 0..1 Range
    (NHSN-MS)
    Applicable age range, if relevant
    Observation.component.referenceRange.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 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.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.​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()
    sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high, Observation.component.referenceRange.low, Observation.component.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()

    This structure is derived from QICoreSimpleObservationSubstitute

    Summary

    Mandatory: 3 elements(3 nested mandatory elements)
    Must-Support: 24 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Maturity: 2

     

    Other representations of profile: CSV, Excel, Schematron