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Source1

{
  "resourceType": "StructureDefinition",
  "id": "mii-pr-icu-score-rass",
  "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-rass",
  "version": "2026.0.0",
  "name": "MII_PR_ICU_Score_RASS",
  "title": "MII PR ICU Score RASS",
  "status": "draft",
  "experimental": true,
  "date": "2025-12-15",
  "publisher": "Medizininformatik Initiative",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://www.medizininformatik-initiative.de"
        }
      ]
    }
  ],
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "RASS score (SNOMED observation type; LOINC answers)"
      },
      {
        "id": "Observation.category",
        "path": "Observation.category",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "survey",
              "system": "http://terminology.hl7.org/CodeSystem/observation-category"
            }
          ]
        }
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "comment": "Instrument/Observation type is represented using SNOMED CT observable entity. Answer options are represented using LOINC Answer List LL6536-8.",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "1345050000",
              "system": "http://snomed.info/sct",
              "display": "Richmond Agitation Sedation Scale score (observable entity)"
            }
          ]
        }
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept",
        "path": "Observation.value[x]",
        "sliceName": "valueCodeableConcept",
        "comment": "Answer is a LOINC LA-code from the RASS Answer List (LL6536-8).",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "http://loinc.org/vs/LL6536-8"
        }
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.extension",
        "path": "Observation.value[x].extension",
        "min": 1
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.extension:ordinalValue",
        "path": "Observation.value[x].extension",
        "sliceName": "ordinalValue",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/ordinalValue"
            ]
          }
        ],
        "constraint": [
          {
            "key": "rass-ordinal-range",
            "human": "RASS ordinal score must be between -5 and +4.",
            "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-rass",
            "severity": "error",
            "expression": "%resource.valueCodeableConcept.extension('http://hl7.org/fhir/StructureDefinition/ordinalValue').value.as(Decimal) >= -5 and %resource.valueCodeableConcept.extension('http://hl7.org/fhir/StructureDefinition/ordinalValue').value.as(Decimal) <= 4"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding",
        "path": "Observation.value[x].coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "system"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept.coding:loinc",
        "path": "Observation.value[x].coding",
        "sliceName": "loinc",
        "min": 1,
        "max": "1",
        "patternCoding": {
          "system": "http://loinc.org"
        }
      }
    ]
  }
}