| Package | ca.ab.fhir.psab |
| Type | StructureDefinition |
| Id | Id |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=ca.ab.fhir.psab@1.1.0&canonical=https://www.alberta.ca/fhir/psab/StructureDefinition/ObservationSocialHistoryPSAB |
| Url | https://www.alberta.ca/fhir/psab/StructureDefinition/ObservationSocialHistoryPSAB |
| Version | 1.1.0 |
| Status | draft |
| Name | ObservationSocialHistoryPSAB |
| Title | Social History Observation (PS-AB) |
| Experimental | False |
| Realm | ca |
| Description | This profile defines a set of constraints to the FHIR Observation (Social History) resource for use in Alberta Patient Summaries (PS-AB). It re-profiles the PS-CA Social History (General) profile and refines constraints applied to the Observation (Social History) resource when used in the PS-AB Composition profile. |
| Type | Observation |
| Kind | resource |
| StructureDefinition | |
https://www.alberta.ca/fhir/psab/StructureDefinition/CompositionPSAB  | Composition (PS-AB) |
| StructureDefinition | |
| http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps | SHx Observation: Social History (PS-CA) |
| https://www.alberta.ca/fhir/psab/StructureDefinition/PatientPSAB | Patient (PS-AB) |
| https://www.alberta.ca/fhir/psab/StructureDefinition/PractitionerPSAB | Practitioner (PS-AB) |
| https://www.alberta.ca/fhir/psab/StructureDefinition/PractitionerRolePSAB | PractitionerRole (PS-AB) |
FHIR{
"resourceType" : "StructureDefinition",
"id" : "ObservationSocialHistoryPSAB",
"url" : "https://www.alberta.ca/fhir/psab/StructureDefinition/ObservationSocialHistoryPSAB",
"version" : "1.1.0",
"name" : "ObservationSocialHistoryPSAB",
"title" : "Social History Observation (PS-AB)",
"status" : "draft",
"description" : "This profile defines a set of constraints to the FHIR Observation (Social History) resource for use in Alberta Patient Summaries (PS-AB). It re-profiles the PS-CA Social History (General) profile and refines constraints applied to the Observation (Social History) resource when used in the PS-AB Composition profile.",
"fhirVersion" : "4.0.1",
"kind" : "resource",
"abstract" : false,
"type" : "Observation",
"baseDefinition" : "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps",
"derivation" : "constraint",
"snapshot" : {
"element" : [
{
"id" : "Observation",
"path" : "Observation",
"short" : "Measurements and simple assertions",
"definition" : "Measurements and simple assertions made about a patient, device or other subject.",
"comment" : "Observation (Social History) resources included in Alberta Patient Summary Document Bundles have rules that certain attributes are not to be contained in Observation (Social History) resource. These are mechanically enforced through invariants at the PS-AB Bundle level.",
"alias" : [
"Vital Signs",
"Measurement",
"Results",
"Tests"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation",
"min" : 0,
"max" : "*"
},
"constraint" : [
{
"key" : "dom-2",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression" : "contained.contained.empty()",
"xpath" : "not(parent::f:contained and f:contained)",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "dom-4",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "dom-3",
"severity" : "error",
"human" : "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",
"expression" : "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()",
"xpath" : "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean" : true
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown" : "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key" : "dom-6",
"severity" : "warning",
"human" : "A resource should have narrative for robust management",
"expression" : "text.`div`.exists()",
"xpath" : "exists(f:text/h:div)",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "dom-5",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression" : "contained.meta.security.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:security))",
"source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key" : "obs-7",
"severity" : "error",
"human" : "If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present",
"expression" : "value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()",
"xpath" : "not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@value]))",
"source" : "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"key" : "obs-6",
"severity" : "error",
"human" : "dataAbsentReason SHALL only be present if Observation.value[x] is not present",
"expression" : "dataAbsentReason.empty() or value.empty()",
"xpath" : "not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))",
"source" : "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"key" : "psca-obs-sh-1",
"severity" : "error",
"human" : "This profile is being used for conformance requirements on generic social history (instances that aren't intended for tobacco or alcohol use profiles). If instance asserts conformance of instance to generic social history profile, observation.code SHALL NOT be 74013-4 or 72166-2 LOINC codes. This is done to prevent the instance matching multiple slices on composition.section",
"expression" : "category.coding.where(system='http://terminology.hl7.org/CodeSystem/observation-category' and (code='social-history')).exists() implies code.coding.where(system='http://loinc.org' and (code='74013-4' or code='72166-2')).exists().not()",
"source" : "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/observation-socialhistory-ca-ps"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "Entity. Role, or Act"
},
{
"identity" : "workflow",
"map" : "Event"
},
{
"identity" : "sct-concept",
"map" : "< 363787002 |Observable entity|"
},
{
"identity" : "v2",
"map" : "OBX"
},
{
"identity" : "rim",
"map" : "Observation[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id" : "Observation.id",
"path" : "Observation.id",
"short" : "Logical id of this artifact",
"definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"isSummary" : true
},
{
"id" : "Observation.meta",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.meta",
"short" : "Metadata about the resource",
"definition" : "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.meta",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Meta"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.implicitRules",
"path" : "Observation.implicitRules",
"short" : "A set of rules under which this content was created",
"definition" : "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment" : "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.implicitRules",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "uri"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier" : true,
"isModifierReason" : "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.language",
"path" : "Observation.language",
"short" : "Language of the resource content",
"definition" : "The base language in which the resource is written.",
"comment" : "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.language",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "code"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "Language"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean" : true
}
],
"strength" : "preferred",
"description" : "A human language.",
"valueSet" : "http://hl7.org/fhir/ValueSet/languages"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.text",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.text",
"short" : "Text summary of the resource, for human interpretation",
"definition" : "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment" : "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias" : [
"narrative",
"html",
"xhtml",
"display"
],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DomainResource.text",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Narrative"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "Act.text?"
}
]
},
{
"id" : "Observation.contained",
"path" : "Observation.contained",
"short" : "Contained, inline Resources",
"definition" : "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment" : "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias" : [
"inline resources",
"anonymous resources",
"contained resources"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.contained",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Resource"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "Entity. Role, or Act"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.modifierExtension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.modifierExtension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Extensions that cannot be ignored",
"definition" : "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.identifier",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.identifier",
"short" : "Business Identifier for observation",
"definition" : "A unique identifier assigned to this observation.",
"requirements" : "Allows observations to be distinguished and referenced.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.identifier",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Identifier"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity" : "rim",
"map" : "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity" : "servd",
"map" : "Identifier"
},
{
"identity" : "workflow",
"map" : "Event.identifier"
},
{
"identity" : "w5",
"map" : "FiveWs.identifier"
},
{
"identity" : "v2",
"map" : "OBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
},
{
"identity" : "rim",
"map" : "id"
}
]
},
{
"id" : "Observation.basedOn",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.basedOn",
"short" : "Fulfills plan, proposal or order",
"definition" : "A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.",
"comment" : "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"requirements" : "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
"alias" : [
"Fulfills"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.basedOn",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/DeviceRequest",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"http://hl7.org/fhir/StructureDefinition/NutritionOrder",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "workflow",
"map" : "Event.basedOn"
},
{
"identity" : "v2",
"map" : "ORC"
},
{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"
}
]
},
{
"id" : "Observation.partOf",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.partOf",
"short" : "Part of referenced event",
"definition" : "A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.",
"comment" : "To link an Observation to an Encounter use `encounter`. See the [Notes](observation.html#obsgrouping) below for guidance on referencing another Observation.",
"alias" : [
"Container"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.partOf",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
"http://hl7.org/fhir/StructureDefinition/MedicationDispense",
"http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"http://hl7.org/fhir/StructureDefinition/Procedure",
"http://hl7.org/fhir/StructureDefinition/Immunization",
"http://hl7.org/fhir/StructureDefinition/ImagingStudy"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "workflow",
"map" : "Event.partOf"
},
{
"identity" : "v2",
"map" : "Varies by domain"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=FLFS].target"
}
]
},
{
"id" : "Observation.status",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
"valueString" : "default: final"
}
],
"path" : "Observation.status",
"short" : "registered | preliminary | final | amended +",
"definition" : "The status of the result value.",
"comment" : "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"requirements" : "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Observation.status",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "code"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isModifier" : true,
"isModifierReason" : "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationStatus"
}
],
"strength" : "required",
"description" : "Codes providing the status of an observation.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-status|4.0.1"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "workflow",
"map" : "Event.status"
},
{
"identity" : "w5",
"map" : "FiveWs.status"
},
{
"identity" : "sct-concept",
"map" : "< 445584004 |Report by finality status|"
},
{
"identity" : "v2",
"map" : "OBX-11"
},
{
"identity" : "rim",
"map" : "status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of \"revise\""
}
]
},
{
"id" : "Observation.category",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.category",
"slicing" : {
"discriminator" : [
{
"type" : "pattern",
"path" : "$this"
}
],
"rules" : "open"
},
"short" : "Classification of type of observation",
"definition" : "A code that classifies the general type of observation being made.",
"comment" : "As this is an initial draft profile, it contains open slicing to maximize the ability to reuse for the full breadth of social history profiles that may contain further categorization (e.g., another optional category slice for SDOH)",
"requirements" : "Used for filtering what observations are retrieved and displayed.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.category",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationCategory"
}
],
"strength" : "preferred",
"description" : "Codes for high level observation categories.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-category"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "w5",
"map" : "FiveWs.class"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
}
]
},
{
"id" : "Observation.category:social-history",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.category",
"sliceName" : "social-history",
"sliceIsConstraining" : true,
"short" : "Classification of type of observation",
"definition" : "A code that classifies the general type of observation being made.",
"comment" : "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.",
"requirements" : "Used for filtering what observations are retrieved and displayed.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Observation.category",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"patternCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "social-history"
}
]
},
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationCategory"
}
],
"strength" : "preferred",
"description" : "Codes for high level observation categories.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-category"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "w5",
"map" : "FiveWs.class"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
}
]
},
{
"id" : "Observation.category:social-history.id",
"path" : "Observation.category.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.category:social-history.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.category.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.category:social-history.coding",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.category.coding",
"short" : "Code defined by a terminology system",
"definition" : "A reference to a code defined by a terminology system.",
"comment" : "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements" : "Allows for alternative encodings within a code system, and translations to other code systems.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "CodeableConcept.coding",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Coding"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity" : "rim",
"map" : "CV"
},
{
"identity" : "orim",
"map" : "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity" : "v2",
"map" : "C*E.1-8, C*E.10-22"
},
{
"identity" : "rim",
"map" : "union(., ./translation)"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id" : "Observation.category:social-history.coding.id",
"path" : "Observation.category.coding.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.category:social-history.coding.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.category.coding.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.category:social-history.coding.system",
"path" : "Observation.category.coding.system",
"short" : "Identity of the terminology system",
"definition" : "The identification of the code system that defines the meaning of the symbol in the code.",
"comment" : "Fixed system value of 'http://terminology.hl7.org/CodeSystem/observation-category'",
"requirements" : "Need to be unambiguous about the source of the definition of the symbol.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Coding.system",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "uri"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "C*E.3"
},
{
"identity" : "rim",
"map" : "./codeSystem"
},
{
"identity" : "orim",
"map" : "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id" : "Observation.category:social-history.coding.version",
"path" : "Observation.category.coding.version",
"short" : "Version of the system - if relevant",
"definition" : "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment" : "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Coding.version",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "C*E.7"
},
{
"identity" : "rim",
"map" : "./codeSystemVersion"
},
{
"identity" : "orim",
"map" : "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id" : "Observation.category:social-history.coding.code",
"path" : "Observation.category.coding.code",
"short" : "Symbol in syntax defined by the system",
"definition" : "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment" : "Fixed code value of 'social-history'",
"requirements" : "Need to refer to a particular code in the system.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Coding.code",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "code"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "C*E.1"
},
{
"identity" : "rim",
"map" : "./code"
},
{
"identity" : "orim",
"map" : "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id" : "Observation.category:social-history.coding.display",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean" : true
}
],
"path" : "Observation.category.coding.display",
"short" : "Representation defined by the system",
"definition" : "A representation of the meaning of the code in the system, following the rules of the system.",
"comment" : "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements" : "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Coding.display",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "C*E.2 - but note this is not well followed"
},
{
"identity" : "rim",
"map" : "CV.displayName"
},
{
"identity" : "orim",
"map" : "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id" : "Observation.category:social-history.coding.userSelected",
"path" : "Observation.category.coding.userSelected",
"short" : "If this coding was chosen directly by the user",
"definition" : "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment" : "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"requirements" : "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Coding.userSelected",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "Sometimes implied by being first"
},
{
"identity" : "rim",
"map" : "CD.codingRationale"
},
{
"identity" : "orim",
"map" : "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
"id" : "Observation.category:social-history.text",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean" : true
}
],
"path" : "Observation.category.text",
"short" : "Plain text representation of the concept",
"definition" : "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment" : "Very often the text is the same as a displayName of one of the codings.",
"requirements" : "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CodeableConcept.text",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity" : "rim",
"map" : "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id" : "Observation.code",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.code",
"short" : "Concept - reference to a terminology or just text",
"definition" : "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment" : "One challenge with a generic social history profile is that there is uneven terminology coverage for broad social history concepts (e.g., lifestyle risk factors, Social Determinants of Health factors) and specific social history concepts (e.g., tobacco use assessment) across both LOINC and SNOMED CT terminologies, as well as a lack of consistency in implementation across international implementation guides & vendors. In places where the International Patient Summary guide has defined terminology for a specific social history concept (e.g., tobacco use) via a specific profile, that terminology is governed by the specialized profile. However, in broader profiles where the terminology is not defined by external requirements and not well known, the terminology options will be expressed as examples rather than bindings or sliced value sets until further use is known regarding use & harmonization in the Canadian and International patient summary space. \r\n At minimum text is expected to be supplied for this element given that code is mandatory in FHIR and codings may not be supported by every implementation.",
"requirements" : "Knowing what kind of observation is being made is essential to understanding the observation.",
"alias" : [
"Name"
],
"min" : 1,
"max" : "1",
"base" : {
"path" : "Observation.code",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept",
"profile" : [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps"
]
}
],
"example" : [
{
"label" : "LifestyleRiskFactors",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "80943009",
"display" : "Risk Factor"
}
],
"text" : "Risk Factor"
}
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isSummary" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationCode"
}
],
"strength" : "example",
"description" : "Codes identifying names of simple observations.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-codes"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "workflow",
"map" : "Event.code"
},
{
"identity" : "w5",
"map" : "FiveWs.what[x]"
},
{
"identity" : "sct-concept",
"map" : "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
},
{
"identity" : "v2",
"map" : "OBX-3"
},
{
"identity" : "rim",
"map" : "code"
},
{
"identity" : "sct-attr",
"map" : "116680003 |Is a|"
}
]
},
{
"id" : "Observation.code.id",
"path" : "Observation.code.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.code.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.code.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.code.coding",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.code.coding",
"short" : "A reference to a code defined by a terminology system",
"definition" : "A reference to a code defined by a terminology system.",
"comment" : "While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance.\r\n\r\nImplementers that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR).\r\n\r\nAdditionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content",
"requirements" : "Allows for alternative encodings within a code system, and translations to other code systems.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "CodeableConcept.coding",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Coding",
"profile" : [
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Coding-ca-ps"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity" : "rim",
"map" : "CV"
},
{
"identity" : "orim",
"map" : "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity" : "v2",
"map" : "C*E.1-8, C*E.10-22"
},
{
"identity" : "rim",
"map" : "union(., ./translation)"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id" : "Observation.code.text",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean" : true
}
],
"path" : "Observation.code.text",
"short" : "Plain text representation of the concept",
"definition" : "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment" : "Text string describing the risk factor or type of observation",
"requirements" : "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "CodeableConcept.text",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity" : "rim",
"map" : "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id" : "Observation.subject",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.subject",
"short" : "Who and/or what the observation is about",
"definition" : "The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.",
"comment" : "One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.",
"requirements" : "Observations have no value if you don't know who or what they're about.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Observation.subject",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"https://www.alberta.ca/fhir/psab/StructureDefinition/PatientPSAB"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "workflow",
"map" : "Event.subject"
},
{
"identity" : "w5",
"map" : "FiveWs.subject[x]"
},
{
"identity" : "v2",
"map" : "PID-3"
},
{
"identity" : "rim",
"map" : "participation[typeCode=RTGT]"
},
{
"identity" : "w5",
"map" : "FiveWs.subject"
}
]
},
{
"id" : "Observation.subject.id",
"path" : "Observation.subject.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.subject.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.subject.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.subject.reference",
"path" : "Observation.subject.reference",
"short" : "Literal reference, Relative, internal or absolute URL",
"definition" : "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment" : "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Reference.reference",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"condition" : [
"ele-1",
"ref-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
&nb " : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationValueAbsentReason"
}
],
"strength" : "extensible",
"description" : "Codes specifying why the result (`Observation.value[x]`) is missing.",
"valueSet" : "http://hl7.org/fhir/ValueSet/data-absent-reason"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "v2",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "value.nullFlavor"
}
]
},
{
"id" : "Observation.interpretation",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.interpretation",
"short" : "High, low, normal, etc.",
"definition" : "A categorical assessment of an observation value. For example, high, low, normal.",
"comment" : "Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.",
"requirements" : "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
"alias" : [
"Abnormal Flag"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.interpretation",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationInterpretation"
}
],
"strength" : "extensible",
"description" : "Codes identifying interpretations of observations.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-interpretation"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "sct-concept",
"map" : "< 260245000 |Findings values|"
},
{
"identity" : "v2",
"map" : "OBX-8"
},
{
"identity" : "rim",
"map" : "interpretationCode"
},
{
"identity" : "sct-attr",
"map" : "363713009 |Has interpretation|"
}
]
},
{
"id" : "Observation.note",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.note",
"short" : "Lifestyle Risk Factor Notes",
"definition" : "Comments about the observation or the results.",
"comment" : "May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.",
"requirements" : "Need to be able to provide free text additional information.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.note",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Annotation"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "Act"
},
{
"identity" : "v2",
"map" : "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
},
{
"identity" : "rim",
"map" : "subjectOf.observationEvent[code=\"annotation\"].value"
}
]
},
{
"id" : "Observation.note.id",
"path" : "Observation.note.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.note.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.note.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.note.author[x]",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.note.author[x]",
"short" : "Individual responsible for the annotation",
"definition" : "The individual responsible for making the annotation.",
"comment" : "Organization is used when there's no need for specific attribution as to who made the comment.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Annotation.author[x]",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
},
{
"code" : "string"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "Act.participant[typeCode=AUT].role"
}
]
},
{
"id" : "Observation.note.time",
"path" : "Observation.note.time",
"short" : "When the annotation was made",
"definition" : "Indicates when this particular annotation was made.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Annotation.time",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "dateTime"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "Act.effectiveTime"
}
]
},
{
"id" : "Observation.note.text",
"path" : "Observation.note.text",
"short" : "The annotation - text content (as markdown)",
"definition" : "The text of the annotation in markdown format.",
"comment" : "Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Annotation.text",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "markdown"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport" : true,
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "Act.text"
}
]
},
{
"id" : "Observation.bodySite",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.bodySite",
"short" : "Observed body part",
"definition" : "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
"comment" : "Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. \n\nIf the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](extension-bodysite.html).",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.bodySite",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "BodySite"
}
],
"strength" : "example",
"description" : "Codes describing anatomical locations. May include laterality.",
"valueSet" : "http://hl7.org/fhir/ValueSet/body-site"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "sct-concept",
"map" : "< 123037004 |Body structure|"
},
{
"identity" : "v2",
"map" : "OBX-20"
},
{
"identity" : "rim",
"map" : "targetSiteCode"
},
{
"identity" : "sct-attr",
"map" : "718497002 |Inherent location|"
}
]
},
{
"id" : "Observation.method",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.method",
"short" : "How it was done",
"definition" : "Indicates the mechanism used to perform the observation.",
"comment" : "Only used if not implicit in code for Observation.code.",
"requirements" : "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.method",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationMethod"
}
],
"strength" : "example",
"description" : "Methods for simple observations.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-methods"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "v2",
"map" : "OBX-17"
},
{
"identity" : "rim",
"map" : "methodCode"
}
]
},
{
"id" : "Observation.specimen",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.specimen",
"short" : "Specimen used for this observation",
"definition" : "The specimen that was used when this observation was made.",
"comment" : "Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.specimen",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Specimen"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "sct-concept",
"map" : "< 123038009 |Specimen|"
},
{
"identity" : "v2",
"map" : "SPM segment"
},
{
"identity" : "rim",
"map" : "participation[typeCode=SPC].specimen"
},
{
"identity" : "sct-attr",
"map" : "704319004 |Inherent in|"
}
]
},
{
"id" : "Observation.device",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.device",
"short" : "(Measurement) Device",
"definition" : "The device used to generate the observation data.",
"comment" : "Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.device",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/DeviceMetric"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "sct-concept",
"map" : "< 49062001 |Device|"
},
{
"identity" : "v2",
"map" : "OBX-17 / PRT -10"
},
{
"identity" : "rim",
"map" : "participation[typeCode=DEV]"
},
{
"identity" : "sct-attr",
"map" : "424226004 |Using device|"
}
]
},
{
"id" : "Observation.referenceRange",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange",
"short" : "Provides guide for interpretation",
"definition" : "Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an \"OR\". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.",
"comment" : "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
"requirements" : "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.referenceRange",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "BackboneElement"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "obs-3",
"severity" : "error",
"human" : "Must have at least a low or a high or text",
"expression" : "low.exists() or high.exists() or text.exists()",
"xpath" : "(exists(f:low) or exists(f:high)or exists(f:text))",
"source" : "http://hl7.org/fhir/StructureDefinition/Observation"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "OBX.7"
},
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id" : "Observation.referenceRange.id",
"path" : "Observation.referenceRange.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.referenceRange.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.referenceRange.modifierExtension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.modifierExtension",
"short" : "Extensions that cannot be ignored even if unrecognized",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias" : [
"extensions",
"user content",
"modifiers"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "BackboneElement.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.referenceRange.low",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.low",
"short" : "Low Range, if relevant",
"definition" : "The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).",
"comment" : "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.referenceRange.low",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Quantity",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"condition" : [
"ele-1",
"obs-3"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "qty-3",
"severity" : "error",
"human" : "If a code for the unit is present, the system SHALL also be present",
"expression" : "code.empty() or system.exists()",
"xpath" : "not(exists(f:code)) or exists(f:system)",
"source" : "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key" : "sqty-1",
"severity" : "error",
"human" : "The comparator is not used on a SimpleQuantity",
"expression" : "comparator.empty()",
"xpath" : "not(exists(f:comparator))",
"source" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "SN (see also Range) or CQ"
},
{
"identity" : "rim",
"map" : "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity" : "v2",
"map" : "OBX-7"
},
{
"identity" : "rim",
"map" : "value:IVL_PQ.low"
}
]
},
{
"id" : "Observation.referenceRange.high",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.high",
"short" : "High Range, if relevant",
"definition" : "The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).",
"comment" : "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.referenceRange.high",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Quantity",
"profile" : [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"condition" : [
"ele-1",
"obs-3"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "qty-3",
"severity" : "error",
"human" : "If a code for the unit is present, the system SHALL also be present",
"expression" : "code.empty() or system.exists()",
"xpath" : "not(exists(f:code)) or exists(f:system)",
"source" : "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key" : "sqty-1",
"severity" : "error",
"human" : "The comparator is not used on a SimpleQuantity",
"expression" : "comparator.empty()",
"xpath" : "not(exists(f:comparator))",
"source" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier" : false,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "SN (see also Range) or CQ"
},
{
"identity" : "rim",
"map" : "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity" : "v2",
"map" : "OBX-7"
},
{
"identity" : "rim",
"map" : "value:IVL_PQ.high"
}
]
},
{
"id" : "Observation.referenceRange.type",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.type",
"short" : "Reference range qualifier",
"definition" : "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
"comment" : "This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.",
"requirements" : "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.referenceRange.type",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationRangeMeaning"
}
],
"strength" : "preferred",
"description" : "Code for the meaning of a reference range.",
"valueSet" : "http://hl7.org/fhir/ValueSet/referencerange-meaning"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "sct-concept",
"map" : "< 260245000 |Findings values| OR \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
},
{
"identity" : "v2",
"map" : "OBX-10"
},
{
"identity" : "rim",
"map" : "interpretationCode"
}
]
},
{
"id" : "Observation.referenceRange.appliesTo",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.appliesTo",
"short" : "Reference range population",
"definition" : "Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple `appliesTo` are interpreted as an \"AND\" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.",
"comment" : "This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.",
"requirements" : "Need to be able to identify the target population for proper interpretation.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.referenceRange.appliesTo",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationRangeType"
}
],
"strength" : "example",
"description" : "Codes identifying the population the reference range applies to.",
"valueSet" : "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "sct-concept",
"map" : "< 260245000 |Findings values| OR \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
},
{
"identity" : "v2",
"map" : "OBX-10"
},
{
"identity" : "rim",
"map" : "interpretationCode"
}
]
},
{
"id" : "Observation.referenceRange.age",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.referenceRange.age",
"short" : "Applicable age range, if relevant",
"definition" : "The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.",
"comment" : "The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.",
"requirements" : "Some analytes vary greatly over age.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.referenceRange.age",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Range"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "rng-2",
"severity" : "error",
"human" : "If present, low SHALL have a lower value than high",
"expression" : "low.empty() or high.empty() or (low <= high)",
"xpath" : "not(exists(f:low/f:value/@value)) or not(exists(f:high/f:value/@value)) or (number(f:low/f:value/@value) <= number(f:high/f:value/@value))",
"source" : "http://hl7.org/fhir/StructureDefinition/Range"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "NR and also possibly SN (but see also quantity)"
},
{
"identity" : "rim",
"map" : "IVL<QTY[not(type=\"TS\")]> [lowClosed=\"true\" and highClosed=\"true\"]or URG<QTY[not(type=\"TS\")]>"
},
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=\"age\"].value"
}
]
},
{
"id" : "Observation.referenceRange.text",
"path" : "Observation.referenceRange.text",
"short" : "Text based reference range in an observation",
"definition" : "Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of \"Negative\" or a list or table of \"normals\".",
"comment" : "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.referenceRange.text",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "OBX-7"
},
{
"identity" : "rim",
"map" : "value:ST"
}
]
},
{
"id" : "Observation.hasMember",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.hasMember",
"short" : "Related resource that belongs to the Observation group",
"definition" : "This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.",
"comment" : "When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below. Note that a system may calculate results from [QuestionnaireResponse](questionnaireresponse.html) into a final score and represent the score as an Observation.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.hasMember",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
"http://hl7.org/fhir/StructureDefinition/MolecularSequence"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "v2",
"map" : "Relationships established by OBX-4 usage"
},
{
"identity" : "rim",
"map" : "outBoundRelationship"
}
]
},
{
"id" : "Observation.derivedFrom",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.derivedFrom",
"short" : "Related measurements the observation is made from",
"definition" : "The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.",
"comment" : "All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.derivedFrom",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/DocumentReference",
"http://hl7.org/fhir/StructureDefinition/ImagingStudy",
"http://hl7.org/fhir/StructureDefinition/Media",
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/MolecularSequence"
]
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ref-1",
"severity" : "error",
"human" : "SHALL have a contained resource if a local reference is provided",
"expression" : "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath" : "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity" : "v2",
"map" : "Relationships established by OBX-4 usage"
},
{
"identity" : "rim",
"map" : ".targetObservation"
}
]
},
{
"id" : "Observation.component",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component",
"short" : "Component results",
"definition" : "Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
"comment" : "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
"requirements" : "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.component",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "BackboneElement"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "containment by OBX-4?"
},
{
"identity" : "rim",
"map" : "outBoundRelationship[typeCode=COMP]"
}
]
},
{
"id" : "Observation.component.id",
"path" : "Observation.component.id",
"representation" : [
"xmlAttr"
],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl" : "string"
}
],
"code" : "http://hl7.org/fhirpath/System.String"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
}
]
},
{
"id" : "Observation.component.extension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"description" : "Extensions are always sliced by (at least) url",
"rules" : "open"
},
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias" : [
"extensions",
"user content"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.component.modifierExtension",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component.modifierExtension",
"short" : "Extensions that cannot be ignored even if unrecognized",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias" : [
"extensions",
"user content",
"modifiers"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "BackboneElement.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "Extension"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source" : "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "rim",
"map" : "N/A"
}
]
},
{
"id" : "Observation.component.code",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component.code",
"short" : "Type of component observation (code / type)",
"definition" : "Describes what was observed. Sometimes this is called the observation \"code\".",
"comment" : "*All* code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
"requirements" : "Knowing what kind of observation is being made is essential to understanding the observation.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "Observation.component.code",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationCode"
}
],
"strength" : "example",
"description" : "Codes identifying names of simple observations.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-codes"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "w5",
"map" : "FiveWs.what[x]"
},
{
"identity" : "sct-concept",
"map" : "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
},
{
"identity" : "v2",
"map" : "OBX-3"
},
{
"identity" : "rim",
"map" : "code"
}
]
},
{
"id" : "Observation.component.value[x]",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component.value[x]",
"short" : "Actual component result",
"definition" : "The information determined as a result of making the observation, if the information has a simple value.",
"comment" : "Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section](observation.html#notes) below.",
"requirements" : "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.component.value[x]",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Quantity"
},
{
"code" : "CodeableConcept"
},
{
"code" : "string"
},
{
"code" : "boolean"
},
{
"code" : "integer"
},
{
"code" : "Range"
},
{
"code" : "Ratio"
},
{
"code" : "SampledData"
},
{
"code" : "time"
},
{
"code" : "dateTime"
},
{
"code" : "Period"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary" : true,
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "sct-concept",
"map" : "363714003 |Interprets| < 441742003 |Evaluation finding|"
},
{
"identity" : "v2",
"map" : "OBX.2, OBX.5, OBX.6"
},
{
"identity" : "rim",
"map" : "value"
},
{
"identity" : "sct-attr",
"map" : "363714003 |Interprets|"
}
]
},
{
"id" : "Observation.component.dataAbsentReason",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component.dataAbsentReason",
"short" : "Why the component result is missing",
"definition" : "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
"comment" : "\"Null\" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be \"detected\", \"not detected\", \"inconclusive\", or \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
"requirements" : "For many results it is necessary to handle exceptional values in measurements.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Observation.component.dataAbsentReason",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1",
"obs-6"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationValueAbsentReason"
}
],
"strength" : "extensible",
"description" : "Codes specifying why the result (`Observation.value[x]`) is missing.",
"valueSet" : "http://hl7.org/fhir/ValueSet/data-absent-reason"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "v2",
"map" : "N/A"
},
{
"identity" : "rim",
"map" : "value.nullFlavor"
}
]
},
{
"id" : "Observation.component.interpretation",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "normative"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode" : "4.0.0"
}
],
"path" : "Observation.component.interpretation",
"short" : "High, low, normal, etc.",
"definition" : "A categorical assessment of an observation value. For example, high, low, normal.",
"comment" : "Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.",
"requirements" : "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
"alias" : [
"Abnormal Flag"
],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.component.interpretation",
"min" : 0,
"max" : "*"
},
"type" : [
{
"code" : "CodeableConcept"
}
],
"condition" : [
"ele-1"
],
"constraint" : [
{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "ObservationInterpretation"
}
],
"strength" : "extensible",
"description" : "Codes identifying interpretations of observations.",
"valueSet" : "http://hl7.org/fhir/ValueSet/observation-interpretation"
},
"mapping" : [
{
"identity" : "rim",
"map" : "n/a"
},
{
"identity" : "v2",
"map" : "CE/CNE/CWE"
},
{
"identity" : "rim",
"map" : "CD"
},
{
"identity" : "orim",
"map" : "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity" : "sct-concept",
"map" : "< 260245000 |Findings values|"
},
{
"identity" : "v2",
"map" : "OBX-8"
},
{
"identity" : "rim",
"map" : "interpretationCode"
},
{
"identity" : "sct-attr",
"map" : "363713009 |Has interpretation|"
}
]
},
{
"id" : "Observation.component.referenceRange",
"path" : "Observation.component.referenceRange",
"short" : "Provides guide for interpretation of component result",
"definition" : "Guidance on how to interpret the value by comparison to a normal or recommended range.",
"comment" : "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
"requirements" : "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Observation.component.referenceRange",
"min" : 0,
"max" : "*"
},
"contentReference" : "#Observation.referenceRange",
"mapping" : [
{
"identity" : "v2",
"map" : "OBX.7"
},
{
"identity" : "rim",
"map" : "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"
}
]
}
]
},
"differential" : {
"element" : [
{
"id" : "Observation",
"path" : "Observation",
"comment" : "Observation (Social History) resources included in Alberta Patient Summary Document Bundles have rules that certain attributes are not to be contained in Observation (Social History) resource. These are mechanically enforced through invariants at the PS-AB Bundle level."
},
{
"id" : "Observation.category:social-history",
"path" : "Observation.category",
"sliceName" : "social-history",
"sliceIsConstraining" : true
},
{
"id" : "Observation.category:social-history.coding",
"path" : "Observation.category.coding",
"mustSupport" : true
},
{
"id" : "Observation.category:social-history.coding.system",
"path" : "Observation.category.coding.system",
"comment" : "Fixed system value of 'http://terminology.hl7.org/CodeSystem/observation-category'",
"mustSupport" : true
},
{
"id" : "Observation.category:social-history.coding.code",
"path" : "Observation.category.coding.code",
"comment" : "Fixed code value of 'social-history'",
"mustSupport" : true
},
{
"id" : "Observation.code.text",
"path" : "Observation.code.text",
"comment" : "Text string describing the risk factor or type of observation",
"min" : 1
},
{
"id" : "Observation.subject",
"path" : "Observation.subject",
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"https://www.alberta.ca/fhir/psab/StructureDefinition/PatientPSAB"
]
}
]
},
{
"id" : "Observation.effective[x]",
"path" : "Observation.effective[x]",
"slicing" : {
"discriminator" : [
{
"type" : "type",
"path" : "$this"
}
],
"ordered" : false,
"rules" : "open"
},
"comment" : "Required for each lifestyle factor submitted. YYYY-MM-DD format. Partial dates (YYYY only or YYYY-MM only) are accepted.",
"mustSupport" : true
},
{
"id" : "Observation.effective[x]:effectiveDateTime",
"path" : "Observation.effective[x]",
"sliceName" : "effectiveDateTime",
"comment" : "YYYY-MM-DDThh:mm:ss[+|-]ZZ:ZZ e.g.,: 1980-05-31T12:23:12-05:00",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "dateTime"
}
],
"mustSupport" : true
},
{
"id" : "Observation.performer",
"path" : "Observation.performer",
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"https://www.alberta.ca/fhir/psab/StructureDefinition/PractitionerPSAB",
"https://www.alberta.ca/fhir/psab/StructureDefinition/PractitionerRolePSAB",
"https://www.alberta.ca/fhir/psab/StructureDefinition/PatientPSAB"
]
}
]
},
{
"id" : "Observation.value[x]",
"path" : "Observation.value[x]",
"slicing" : {
"discriminator" : [
{
"type" : "type",
"path" : "$this"
}
],
"ordered" : false,
"rules" : "open"
}
},
{
"id" : "Observation.value[x]:valueString",
"path" : "Observation.value[x]",
"sliceName" : "valueString",
"comment" : "If value is populated (desired over note), it is expected to be populated in string format",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "string"
}
],
"mustSupport" : true
},
{
"id" : "Observation.note",
"path" : "Observation.note",
"short" : "Lifestyle Risk Factor Notes"
}
]
},
"text" : {
}
}
XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.