Dit profiel is het resultaat van de vergelijking tussen de zib2017 STU3 en zibs2020 R4 FHIR Profiel, relevante informatiestandarden en de implementaties in de ontsloten systemen en instellingen. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

Zorginformatiebouwstenen

De volgende zibs vallen min of meer onder het thema vitale gegevens.

View Definition

ViewDefinition voor Vitale Gegevens

UI Wireframe

Vitale gegevens

Kolomdefinities

Zoeken naar codes

• LOINC - system=http://loinc.org
• NHG Tabel 45 Diagnostische Bepalingen Diagnostisch system=https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen
• SNOMED CT waarneembare entiteiten - system=http://snomed.info/sct

Request

N.B. Eerste request is optimaal en wordt ondersteund door Epic, Sanday en CGM. De andere requests zijn de "officiele" BgZ requests en zijn nodig voor uitvragen van Zorgplatform.

CGM: Ondersteunt de generieke query (category=vital-signs). CGM gebruikt NHG Tabel 45 codes voor vitale gegevens.

1. Opvragen (search) vitale gegevens

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&category=vital-signs

2. Opvragen (search) bloeddruk (BgZ)

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&code=http://loinc.org|85354-9

3. Opvragen (search) gewicht (BgZ)

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&code=http://loinc.org|29463-7

4. Opvragen (search) lengte (BgZ)

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&code=http://loinc.org|8302-2,http://loinc.org|8306-3,http://loinc.org|8308-9

5. Opvragen (search) vital signs (NUTS HA-VVT UC1²)

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&_profile=http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure&_sort=-date&_count=5

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&_profile=http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight&_sort=-date&_count=5

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&_profile=http://nictiz.nl/fhir/StructureDefinition/zib-BodyTemperature&_sort=-date&_count=5

   GET <ontsluiten-bronsysteem-base>/Observation?patient=<fhir_patient_id>&_profile=http://nictiz.nl/fhir/StructureDefinition/zib-Respiration&_sort=-date&_count=5

Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

"meta": {
    "extension": [ {
        "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
        "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
    } ]
}

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (<resource>.subject|patient). Elke patient heeft een Patient.managingOrganization en in de gerefereerde Organization.identifier staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

Changes since version 1.24.0:

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-7, obs-6
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
coding	SΣ	0..*	Coding	Code defined by a terminology system
text	SΣ	0..1	string	Plain text representation of the concept
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
performer	SΣ	0..*	Reference(Practitioner | Organization | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
comment	S	0..1	string	Comments about result
bodySite	S	0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
component	Σ	0..*	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	SΣ	0..1	Quantity S	Actual component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍3.0.2	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍3.0.2	FHIR Std.
Observation.method	Base	example	Observation Methods	📍3.0.2	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
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 code is the same as a component code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
code	S	1..1	CodeableConcept	Type of observation (code / type)
coding	S	0..*	Coding	Code defined by a terminology system
text	S	0..1	string	Plain text representation of the concept
effective[x]	S	0..1	dateTime, Period	Clinically relevant time/time-period for observation
performer	S	0..*	Reference(Practitioner | Organization | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	S	0..1		Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
comment	S	0..1	string	Comments about result
bodySite	S	0..1	CodeableConcept	Observed body part
method	S	0..1	CodeableConcept	How it was done
component
value[x]	S	0..1	Quantity S	Actual component result
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-7, obs-6
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
text	SΣ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(Patient | Group | Device | Location)	Who and/or what this is about
context		0..1	Reference(Encounter | EpisodeOfCare)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this was made available
performer	SΣ	0..*	Reference(Practitioner | Organization | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment	S	0..1	string	Comments about result
bodySite	S	0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(Observation | QuestionnaireResponse | Sequence)	Resource that is related to this one
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	SΣ	0..1	Quantity S	Actual component result
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
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	extensible	Common Languages	📍3.0.2	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍3.0.2	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍3.0.2	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.
Observation.dataAbsentReason	Base	extensible	Observation Value Absent Reason	📍3.0.2	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍3.0.2	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍3.0.2	FHIR Std.
Observation.method	Base	example	Observation Methods	📍3.0.2	FHIR Std.
Observation.referenceRange.​type	Base	extensible	Observation Reference Range Meaning Codes	📍3.0.2	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍3.0.2	FHIR Std.
Observation.related.​type	Base	required	ObservationRelationshipType	📍3.0.2	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	Observation Value Absent Reason	📍3.0.2	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
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 code is the same as a component code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-7, obs-6
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
coding	SΣ	0..*	Coding	Code defined by a terminology system
text	SΣ	0..1	string	Plain text representation of the concept
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
performer	SΣ	0..*	Reference(Practitioner | Organization | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
comment	S	0..1	string	Comments about result
bodySite	S	0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
component	Σ	0..*	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	SΣ	0..1	Quantity S	Actual component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍3.0.2	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍3.0.2	FHIR Std.
Observation.method	Base	example	Observation Methods	📍3.0.2	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
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 code is the same as a component code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
code	S	1..1	CodeableConcept	Type of observation (code / type)
coding	S	0..*	Coding	Code defined by a terminology system
text	S	0..1	string	Plain text representation of the concept
effective[x]	S	0..1	dateTime, Period	Clinically relevant time/time-period for observation
performer	S	0..*	Reference(Practitioner | Organization | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	S	0..1		Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
comment	S	0..1	string	Comments about result
bodySite	S	0..1	CodeableConcept	Observed body part
method	S	0..1	CodeableConcept	How it was done
component
value[x]	S	0..1	Quantity S	Actual component result
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-7, obs-6
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
text	SΣ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(Patient | Group | Device | Location)	Who and/or what this is about
context		0..1	Reference(Encounter | EpisodeOfCare)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this was made available
performer	SΣ	0..*	Reference(Practitioner | Organization | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity S
valueCodeableConcept			CodeableConcept S
valueString			string S
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment	S	0..1	string	Comments about result
bodySite	S	0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(Observation | QuestionnaireResponse | Sequence)	Resource that is related to this one
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	SΣ	0..1	Quantity S	Actual component result
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
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	extensible	Common Languages	📍3.0.2	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍3.0.2	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍3.0.2	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.
Observation.dataAbsentReason	Base	extensible	Observation Value Absent Reason	📍3.0.2	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍3.0.2	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍3.0.2	FHIR Std.
Observation.method	Base	example	Observation Methods	📍3.0.2	FHIR Std.
Observation.referenceRange.​type	Base	extensible	Observation Reference Range Meaning Codes	📍3.0.2	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍3.0.2	FHIR Std.
Observation.related.​type	Base	required	ObservationRelationshipType	📍3.0.2	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍3.0.2	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	Observation Value Absent Reason	📍3.0.2	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
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 code is the same as a component code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from Observation

Summary

Must-Support: 10 elements