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

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Resource Profile: QICore Simple Observation (Substitute) ( Abstract )

Profile of Simple Observation for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. The profile is a recration of the QICore Simple Observation profile, but without a slice on valueCodeableConcept. This is intended to be used as a substitute for the QICore Simple Observation profile because the slice is causing an error when the Observation needs to include a valueCodeableConcept.

Usages:

• Derived from this Profile: ACH Daily Event Observation and ACH Monthly Event Observation
• Refer to this Profile: ACH Daily Event Medication Request, ACH Monthly Event MedicationRequest and QICore Simple Observation (Substitute)

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	This is an abstract profile. Child profiles: AcuteCareHospitalMonthlyReportingObservation, AcuteCareHospitalDailyEventObservation assessment observation Constraints: obs-6, obs-7
Observation.implicitRules	?! This element is a modifier element. Σ 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. S This element must be supported. Σ This element is included in summaries.	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: Non-Negative Observation Status (required)
Observation.Slices for category	S This element must be supported.	1..*	CodeableConcept	(QI-Core)(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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	S 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	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	(QI-Core)(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who and/or what the observation is about
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		(QI-Core)(USCDI) Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime			dateTime S This target must be supported.
Observation.effective[x].effectivePeriod			Period
Observation.effective[x].effectiveTiming			Timing
Observation.effective[x].effectiveInstant			instant
Observation.performer	S This element must be supported. Σ 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]	S This element must be supported. Σ This element is included in summaries. C	0..1		(QI-Core)(USCDI) Actual result
Observation.value[x].valueQuantity			Quantity S This type must be supported.
Observation.value[x].valueCodeableConcept			CodeableConcept S This type must be supported.
Observation.value[x].valueString			string S This target must be supported.
Observation.value[x].valueBoolean			boolean S 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		0..*	CodeableConcept	(QI-Core) High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
Observation.derivedFrom	Σ 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
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	preferred	LOINC Codes	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from USCoreSimpleObservationProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	USCoreSimpleObservationProfile(6.1.0)	This is an abstract profile. Child profiles: AcuteCareHospitalMonthlyReportingObservation, AcuteCareHospitalDailyEventObservation assessment observation
Observation.status		1..1	code	(USCDI) registered | preliminary | final | amended + Binding: Non-Negative Observation Status (required)
Observation.category		1..*	CodeableConcept	(QI-Core)(USCDI) Classification of type of observation
Observation.code		1..1	CodeableConcept	(QI-Core)(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
Observation.subject		1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who and/or what the observation is about
Observation.effective[x]		0..1		(QI-Core)(USCDI) Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime			dateTime
Observation.effective[x].effectivePeriod			Period
Observation.effective[x].effectiveTiming			Timing
Observation.effective[x].effectiveInstant			instant
Observation.performer		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]		0..1		(QI-Core)(USCDI) Actual result
Observation.value[x].valueQuantity			Quantity
Observation.value[x].valueCodeableConcept			CodeableConcept
Observation.value[x].valueString			string
Observation.value[x].valueBoolean			boolean
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		0..*	CodeableConcept	(QI-Core) High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
Observation.derivedFrom		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
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	Non-Negative Observation Status	📦6.0.0	QI-Core Implementation Guide v6.0
Observation.code	Base	preferred	LOINC Codes	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	This is an abstract profile. Child profiles: AcuteCareHospitalMonthlyReportingObservation, AcuteCareHospitalDailyEventObservation assessment observation Constraints: obs-6, obs-7
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ 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	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for observation
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
Observation.partOf	Σ 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. S This element must be supported. Σ This element is included in summaries.	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: Non-Negative Observation Status (required)
Observation.Slices for category	S This element must be supported.	1..*	CodeableConcept	(QI-Core)(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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	S 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	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	(QI-Core)(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who and/or what the observation is about
Observation.focus	Σ 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	Σ This element is included in summaries.	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		(QI-Core)(USCDI) Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime			dateTime S This target must be supported.
Observation.effective[x].effectivePeriod			Period
Observation.effective[x].effectiveTiming			Timing
Observation.effective[x].effectiveInstant			instant
Observation.issued	Σ This element is included in summaries.	0..1	instant	Date/Time this version was made available
Observation.performer	S This element must be supported. Σ 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]	S This element must be supported. Σ This element is included in summaries. C	0..1		(QI-Core)(USCDI) Actual result
Observation.value[x].valueQuantity			Quantity S This type must be supported.
Observation.value[x].valueCodeableConcept			CodeableConcept S This type must be supported.
Observation.value[x].valueString			string S This target must be supported.
Observation.value[x].valueBoolean			boolean S 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		0..*	CodeableConcept	(QI-Core) High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
Observation.note		0..*	Annotation	Comments about the observation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen		0..1	Reference(Specimen)	Specimen used for this observation
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. Σ 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	Σ This element is included in summaries.	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
Observation.derivedFrom	Σ 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	Σ This element is included in summaries.	0..*	BackboneElement	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. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x]	Σ This element is included in summaries.	0..1		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		0..*	CodeableConcept	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
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
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 Simple Observation Category	📦6.1.0	US Core v6.1
Observation.code	Base	preferred	LOINC Codes	📦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	example	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.component.​code	Base	example	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()

This structure is derived from USCoreSimpleObservationProfile

Summary

Structures

This structure refers to these other structures:

• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
• QICore Organization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
• QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
• QICore CareTeam (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-careteam)
• QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
• QICore Simple Observation (Substitute) (http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/qicore-simple-observation-substitute)
• QICore QuestionnaireResponse (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-questionnaireresponse)
• QICore ImagingStudy (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-imagingstudy)
• US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|6.1.0)

Maturity: 2

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	This is an abstract profile. Child profiles: AcuteCareHospitalMonthlyReportingObservation, AcuteCareHospitalDailyEventObservation assessment observation Constraints: obs-6, obs-7
Observation.implicitRules	?! This element is a modifier element. Σ 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. S This element must be supported. Σ This element is included in summaries.	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: Non-Negative Observation Status (required)
Observation.Slices for category	S This element must be supported.	1..*	CodeableConcept	(QI-Core)(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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	S 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	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	(QI-Core)(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who and/or what the observation is about
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		(QI-Core)(USCDI) Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime			dateTime S This target must be supported.
Observation.effective[x].effectivePeriod			Period
Observation.effective[x].effectiveTiming			Timing
Observation.effective[x].effectiveInstant			instant
Observation.performer	S This element must be supported. Σ 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]	S This element must be supported. Σ This element is included in summaries. C	0..1		(QI-Core)(USCDI) Actual result
Observation.value[x].valueQuantity			Quantity S This type must be supported.
Observation.value[x].valueCodeableConcept			CodeableConcept S This type must be supported.
Observation.value[x].valueString			string S This target must be supported.
Observation.value[x].valueBoolean			boolean S 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		0..*	CodeableConcept	(QI-Core) High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
Observation.derivedFrom	Σ 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
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	preferred	LOINC Codes	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Differential View

This structure is derived from USCoreSimpleObservationProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	USCoreSimpleObservationProfile(6.1.0)	This is an abstract profile. Child profiles: AcuteCareHospitalMonthlyReportingObservation, AcuteCareHospitalDailyEventObservation assessment observation
Observation.status		1..1	code	(USCDI) registered | preliminary | final | amended + Binding: Non-Negative Observation Status (required)
Observation.category		1..*	CodeableConcept	(QI-Core)(USCDI) Classification of type of observation
Observation.code		1..1	CodeableConcept	(QI-Core)(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
Observation.subject		1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who and/or what the observation is about
Observation.effective[x]		0..1		(QI-Core)(USCDI) Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime			dateTime
Observation.effective[x].effectivePeriod			Period
Observation.effective[x].effectiveTiming			Timing
Observation.effective[x].effectiveInstant			instant
Observation.performer		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]		0..1		(QI-Core)(USCDI) Actual result
Observation.value[x].valueQuantity			Quantity
Observation.value[x].valueCodeableConcept			CodeableConcept
Observation.value[x].valueString			string
Observation.value[x].valueBoolean			boolean
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		0..*	CodeableConcept	(QI-Core) High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
Observation.derivedFrom		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
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	Non-Negative Observation Status	📦6.0.0	QI-Core Implementation Guide v6.0
Observation.code	Base	preferred	LOINC Codes	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	This is an abstract profile. Child profiles: AcuteCareHospitalMonthlyReportingObservation, AcuteCareHospitalDailyEventObservation assessment observation Constraints: obs-6, obs-7
Observation.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Observation.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Observation.implicitRules	?! This element is a modifier element. Σ 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	Σ This element is included in summaries.	0..*	Identifier	Business Identifier for observation
Observation.basedOn	Σ This element is included in summaries.	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
Observation.partOf	Σ 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. S This element must be supported. Σ This element is included in summaries.	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: Non-Negative Observation Status (required)
Observation.Slices for category	S This element must be supported.	1..*	CodeableConcept	(QI-Core)(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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	S 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	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	(QI-Core)(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred): This value set specifies the type of observation
Observation.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who and/or what the observation is about
Observation.focus	Σ 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	Σ This element is included in summaries.	0..1	Reference(Encounter)	Healthcare event during which this observation is made
Observation.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		(QI-Core)(USCDI) Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime			dateTime S This target must be supported.
Observation.effective[x].effectivePeriod			Period
Observation.effective[x].effectiveTiming			Timing
Observation.effective[x].effectiveInstant			instant
Observation.issued	Σ This element is included in summaries.	0..1	instant	Date/Time this version was made available
Observation.performer	S This element must be supported. Σ 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]	S This element must be supported. Σ This element is included in summaries. C	0..1		(QI-Core)(USCDI) Actual result
Observation.value[x].valueQuantity			Quantity S This type must be supported.
Observation.value[x].valueCodeableConcept			CodeableConcept S This type must be supported.
Observation.value[x].valueString			string S This target must be supported.
Observation.value[x].valueBoolean			boolean S 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		0..*	CodeableConcept	(QI-Core) High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible)
Observation.note		0..*	Annotation	Comments about the observation
Observation.bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen		0..1	Reference(Specimen)	Specimen used for this observation
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. Σ 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	Σ This element is included in summaries.	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
Observation.derivedFrom	Σ 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	Σ This element is included in summaries.	0..*	BackboneElement	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. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Observation.component.code	Σ This element is included in summaries.	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x]	Σ This element is included in summaries.	0..1		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		0..*	CodeableConcept	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
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
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 Simple Observation Category	📦6.1.0	US Core v6.1
Observation.code	Base	preferred	LOINC Codes	📦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	example	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.component.​code	Base	example	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()

This structure is derived from USCoreSimpleObservationProfile

Summary

Structures

This structure refers to these other structures:

• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
• QICore Organization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
• QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
• QICore CareTeam (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-careteam)
• QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
• QICore Simple Observation (Substitute) (http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/qicore-simple-observation-substitute)
• QICore QuestionnaireResponse (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-questionnaireresponse)
• QICore ImagingStudy (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-imagingstudy)
• US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|6.1.0)

Maturity: 2

Other representations of profile: CSV, Excel, Schematron