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: LTC Monthly Event Lab Result Observation

Official URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ltc-monthly-observation-lab Version: 3.0.0
Standards status: Trial-use Maturity Level: 2 Computable Name: LongTermCareMonthlyEventLabObservation
Other Identifiers: OID:2.16.840.1.113883.4.642.40.1002.42.40

This profile contains Required and Must Support data elements for reporting laboratory result information to the NHSN Long-term Care Monthly Digital Quality Measure. This profile inherits from the QI Core 6.0.0 Laboratory Result Observation profile, which inherits from the US Core 6.1.0 Laboratory Result 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..* QICoreLaboratoryResultObservation(6.0.0) Measurements and simple assertions
    Constraints: obs-6, obs-7, us-core-2
    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.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. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

    Required Pattern: At least the following
    Observation.Slices for category.category:us-core.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding 1..* Coding Code defined by a terminology system
    Fixed Value: (Complex)
    Observation.Slices for category.category:us-core.coding.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.coding.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding.system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    Observation.Slices for category.category:us-core.coding.version 0..1 string Version of the system - if relevant
    Observation.Slices for category.category:us-core.coding.code 1..1 code Symbol in syntax defined by the system
    Fixed Value: laboratory
    Observation.Slices for category.category:us-core.coding.display 0..1 string Representation defined by the system
    Observation.Slices for category.category:us-core.coding.userSelected 0..1 boolean If this coding was chosen directly by the user
    Observation.Slices for category.category:us-core.text 0..1 string Plain text representation of the concept
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Laboratory Test Name
    Binding: US Core Laboratory Test Codes (extensible): Laboratory LOINC Codes
    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. C 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Constraints: us-core-1
    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.value[x] This element must be supported. This element is included in summaries. C 0..1
    (NHSN-MS)
    (QI-Core)(USCDI) Result Value
    Constraints: us-core-3, us-core-4
    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
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) 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)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen This element must be supported. 0..1 Reference(LTC Monthly Event Specimen) {b}
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.specimen.reference This element must be supported. This element is included in summaries. C 1..1 string 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)
    (QI-Core)(USCDI) Component Observation 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.

    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 Clinical Result Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible US Core Laboratory Test Codes 📦6.1.0 US Core v6.1
    Observation.dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
    us-core-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())
    us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'
    us-core-4 best practice Observation.value[x] SHOULD use Snomed CT for coded Results value.ofType(CodeableConcept).coding.system.empty() or value.ofType(CodeableConcept).coding.system = 'http://snomed.info/sct'

    This structure is derived from QICoreLaboratoryResultObservation

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation 0..* QICoreLaboratoryResultObservation(6.0.0) Measurements and simple assertions
    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.status 1..1 code (NHSN-MS)(QI-Core)(USCDI) registered | preliminary | final | amended | corrected | entered-in-error | unknown
    Observation.Slices for category Content/Rules for all slices
    Observation.Slices for category.category:us-core 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Classification of type of observation
    Observation.code 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Laboratory Test Name
    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, time, dateTime, Period (NHSN-MS)(QI-Core)(USCDI) Result Value
    Observation.dataAbsentReason 0..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Why the result is missing
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen 0..1 Reference(LTC Monthly Event Specimen) {b} (NHSN-MS) Literal reference, Relative, internal or absolute URL
    Observation.specimen.reference This element must be supported. 1..1 string 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)
    (QI-Core)(USCDI) Component Observation 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.

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    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..* QICoreLaboratoryResultObservation(6.0.0) Measurements and simple assertions
    Constraints: obs-6, obs-7, us-core-2
    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 is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    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. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

    Required Pattern: At least the following
    Observation.Slices for category.category:us-core.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding 1..* Coding Code defined by a terminology system
    Fixed Value: (Complex)
    Observation.Slices for category.category:us-core.coding.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.coding.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding.system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    Observation.Slices for category.category:us-core.coding.version 0..1 string Version of the system - if relevant
    Observation.Slices for category.category:us-core.coding.code 1..1 code Symbol in syntax defined by the system
    Fixed Value: laboratory
    Observation.Slices for category.category:us-core.coding.display 0..1 string Representation defined by the system
    Observation.Slices for category.category:us-core.coding.userSelected 0..1 boolean If this coding was chosen directly by the user
    Observation.Slices for category.category:us-core.text 0..1 string Plain text representation of the concept
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Laboratory Test Name
    Binding: US Core Laboratory Test Codes (extensible): Laboratory LOINC Codes
    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. C 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Constraints: us-core-1
    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 is included in summaries. 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) 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) Result Value
    Constraints: us-core-3, us-core-4
    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
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) 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)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    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 (example): Codes describing anatomical locations. May include laterality.
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen This element must be supported. 0..1 Reference(LTC Monthly Event Specimen) {b}
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.specimen.id 0..1 string Unique id for inter-element referencing
    Observation.specimen.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.specimen.reference This element must be supported. This element is included in summaries. C 1..1 string Literal reference, Relative, internal or absolute URL
    Observation.specimen.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.specimen.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.specimen.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    Observation.referenceRange C 0..* BackboneElement 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 C 0..1 SimpleQuantity Low Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.high C 0..1 SimpleQuantity 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 0..1 Range Applicable age range, if relevant
    Observation.referenceRange.text 0..1 string Text based reference range in an observation
    Observation.hasMember This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    Observation.derivedFrom This element is included in summaries. 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements 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)
    (QI-Core)(USCDI) Component Observation 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 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.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.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 Clinical Result Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible US Core Laboratory Test Codes 📦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.dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.specimen.​type Base extensible ResourceType 📍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.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()
    us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
    us-core-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())
    us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'
    us-core-4 best practice Observation.value[x] SHOULD use Snomed CT for coded Results value.ofType(CodeableConcept).coding.system.empty() or value.ofType(CodeableConcept).coding.system = 'http://snomed.info/sct'

    Key Elements View

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation C 0..* QICoreLaboratoryResultObservation(6.0.0) Measurements and simple assertions
    Constraints: obs-6, obs-7, us-core-2
    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.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. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

    Required Pattern: At least the following
    Observation.Slices for category.category:us-core.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding 1..* Coding Code defined by a terminology system
    Fixed Value: (Complex)
    Observation.Slices for category.category:us-core.coding.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.coding.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding.system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    Observation.Slices for category.category:us-core.coding.version 0..1 string Version of the system - if relevant
    Observation.Slices for category.category:us-core.coding.code 1..1 code Symbol in syntax defined by the system
    Fixed Value: laboratory
    Observation.Slices for category.category:us-core.coding.display 0..1 string Representation defined by the system
    Observation.Slices for category.category:us-core.coding.userSelected 0..1 boolean If this coding was chosen directly by the user
    Observation.Slices for category.category:us-core.text 0..1 string Plain text representation of the concept
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Laboratory Test Name
    Binding: US Core Laboratory Test Codes (extensible): Laboratory LOINC Codes
    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. C 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Constraints: us-core-1
    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.value[x] This element must be supported. This element is included in summaries. C 0..1
    (NHSN-MS)
    (QI-Core)(USCDI) Result Value
    Constraints: us-core-3, us-core-4
    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
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) 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)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen This element must be supported. 0..1 Reference(LTC Monthly Event Specimen) {b}
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.specimen.reference This element must be supported. This element is included in summaries. C 1..1 string 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)
    (QI-Core)(USCDI) Component Observation 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.

    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 Clinical Result Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible US Core Laboratory Test Codes 📦6.1.0 US Core v6.1
    Observation.dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
    us-core-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())
    us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'
    us-core-4 best practice Observation.value[x] SHOULD use Snomed CT for coded Results value.ofType(CodeableConcept).coding.system.empty() or value.ofType(CodeableConcept).coding.system = 'http://snomed.info/sct'

    Differential View

    This structure is derived from QICoreLaboratoryResultObservation

    Name Flags Card. Type Description & Constraints    Filter: doco
    Observation 0..* QICoreLaboratoryResultObservation(6.0.0) Measurements and simple assertions
    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.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.Slices for category Content/Rules for all slices
    Observation.Slices for category.category:us-core 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Classification of type of observation
    Observation.code 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Laboratory Test Name
    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, time, dateTime, Period (NHSN-MS)(QI-Core)(USCDI) Result Value
    Observation.dataAbsentReason 0..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Why the result is missing
    Observation.interpretation This element must be supported. 0..* CodeableConcept
    (NHSN-MS)
    High, low, normal, etc.
    Observation.bodySite This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    Observed body part
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen 0..1 Reference(LTC Monthly Event Specimen) {b} (NHSN-MS) Literal reference, Relative, internal or absolute URL
    Observation.specimen.reference This element must be supported. 1..1 string 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)
    (QI-Core)(USCDI) Component Observation 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.

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    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..* QICoreLaboratoryResultObservation(6.0.0) Measurements and simple assertions
    Constraints: obs-6, obs-7, us-core-2
    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 is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
    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. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

    Required Pattern: At least the following
    Observation.Slices for category.category:us-core.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding 1..* Coding Code defined by a terminology system
    Fixed Value: (Complex)
    Observation.Slices for category.category:us-core.coding.id 0..1 string Unique id for inter-element referencing
    Observation.Slices for category.category:us-core.coding.extension 0..* Extension Additional content defined by implementations
    Observation.Slices for category.category:us-core.coding.system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
    Observation.Slices for category.category:us-core.coding.version 0..1 string Version of the system - if relevant
    Observation.Slices for category.category:us-core.coding.code 1..1 code Symbol in syntax defined by the system
    Fixed Value: laboratory
    Observation.Slices for category.category:us-core.coding.display 0..1 string Representation defined by the system
    Observation.Slices for category.category:us-core.coding.userSelected 0..1 boolean If this coding was chosen directly by the user
    Observation.Slices for category.category:us-core.text 0..1 string Plain text representation of the concept
    Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) Laboratory Test Name
    Binding: US Core Laboratory Test Codes (extensible): Laboratory LOINC Codes
    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. C 1..1
    (NHSN-MS)
    (QI-Core)(USCDI) Clinically relevant time/time-period for observation
    Constraints: us-core-1
    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 is included in summaries. 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) 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) Result Value
    Constraints: us-core-3, us-core-4
    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
    Observation.value[x].valueInteger integer
    Observation.value[x].valueRange Range
    Observation.value[x].valueRatio Ratio
    Observation.value[x].valueTime time
    Observation.value[x].valueDateTime dateTime
    Observation.value[x].valuePeriod Period
    Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConcept
    (NHSN-MS)
    (QI-Core)(USCDI) 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)
    High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
    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 (example): Codes describing anatomical locations. May include laterality.
    Observation.method This element must be supported. 0..1 CodeableConcept
    (NHSN-MS)
    How it was done
    Binding: ObservationMethods (extensible)
    Observation.specimen This element must be supported. 0..1 Reference(LTC Monthly Event Specimen) {b}
    (NHSN-MS)
    Literal reference, Relative, internal or absolute URL
    Observation.specimen.id 0..1 string Unique id for inter-element referencing
    Observation.specimen.extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    Observation.specimen.reference This element must be supported. This element is included in summaries. C 1..1 string Literal reference, Relative, internal or absolute URL
    Observation.specimen.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.specimen.identifier This element is included in summaries. 0..1 Identifier Logical reference, when literal reference is not known
    Observation.specimen.display This element is included in summaries. 0..1 string Text alternative for the resource
    Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
    Observation.referenceRange C 0..* BackboneElement 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 C 0..1 SimpleQuantity Low Range, if relevant
    Constraints: sqty-1
    Observation.referenceRange.high C 0..1 SimpleQuantity 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 0..1 Range Applicable age range, if relevant
    Observation.referenceRange.text 0..1 string Text based reference range in an observation
    Observation.hasMember This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
    Observation.derivedFrom This element is included in summaries. 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements 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)
    (QI-Core)(USCDI) Component Observation 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 0..* See referenceRange (Observation) Provides guide for interpretation of component result

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Observation.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.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 Clinical Result Observation Category 📦6.1.0 US Core v6.1
    Observation.code Base extensible US Core Laboratory Test Codes 📦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.dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.
    Observation.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.
    Observation.method Base extensible Observation Methods 📦4.0.1 FHIR Std.
    Observation.specimen.​type Base extensible ResourceType 📍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.component.​code Base extensible LOINC Codes 📦4.0.1 FHIR Std.
    Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📦4.0.1 FHIR Std.
    Observation.component.​interpretation Base extensible Observation Interpretation Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
    obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
    obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
    sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()
    us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
    us-core-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())
    us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'
    us-core-4 best practice Observation.value[x] SHOULD use Snomed CT for coded Results value.ofType(CodeableConcept).coding.system.empty() or value.ofType(CodeableConcept).coding.system = 'http://snomed.info/sct'

     

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