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{
  "resourceType": "StructureDefinition",
  "id": "cdr-observation",
  "url": "http://example.org/fhir/ImplementationGuide/hl7.fhir.cdr/StructureDefinition/cdr-observation",
  "version": "1.0.0",
  "name": "CDRObservation",
  "title": "CDR Observation Profile",
  "status": "draft",
  "experimental": true,
  "publisher": "CDR Team",
  "contact": [
    {
      "name": "CDR Team",
      "telecom": [
        {
          "system": "email",
          "value": "cdr-team@example.com"
        }
      ]
    }
  ],
  "description": "Observation profile for CDR (Clinical Data Repository) with additional extensions and constraints",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation.extension",
        "path": "Observation.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation.extension:confidence",
        "path": "Observation.extension",
        "sliceName": "confidence",
        "short": "Observation confidence level",
        "definition": "Indicates the confidence level in the accuracy of this observation",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://example.org/fhir/ImplementationGuide/hl7.fhir.cdr/StructureDefinition/cdr-observation-confidence"
            ]
          }
        ]
      },
      {
        "id": "Observation.extension:source",
        "path": "Observation.extension",
        "sliceName": "source",
        "short": "Observation source",
        "definition": "Indicates the source system that provided this observation",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://example.org/fhir/ImplementationGuide/hl7.fhir.cdr/StructureDefinition/cdr-observation-source"
            ]
          }
        ]
      },
      {
        "id": "Observation.status",
        "path": "Observation.status",
        "short": "Observation status",
        "definition": "The status of the result value"
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "short": "Observation code",
        "definition": "Describes what was observed",
        "constraint": [
          {
            "key": "cdr-observation-code-invariant",
            "severity": "error",
            "human": "Observation code must have a coding with a system and code",
            "expression": "code.coding.all(system.exists() and code.exists())",
            "source": "http://example.org/fhir/ImplementationGuide/hl7.fhir.cdr/StructureDefinition/cdr-observation"
          }
        ]
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "short": "Observation subject",
        "definition": "The patient, or group of patients, location, or device this observation is about",
        "min": 1
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "short": "Observation effective date/time",
        "definition": "The time or time-period the observed value is asserted as being true",
        "min": 1,
        "constraint": [
          {
            "key": "cdr-observation-effective-invariant",
            "severity": "warning",
            "human": "Observation effective date/time must not be in the future",
            "expression": "effective.ofType(dateTime) <= now() or effective.ofType(Period).start <= now()",
            "source": "http://example.org/fhir/ImplementationGuide/hl7.fhir.cdr/StructureDefinition/cdr-observation"
          }
        ]
      },
      {
        "id": "Observation.issued",
        "path": "Observation.issued",
        "short": "Observation issued date/time",
        "definition": "The date and time this version of the observation was made available to providers"
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "short": "Observation performer",
        "definition": "Who was responsible for asserting the observed value"
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "short": "Observation value",
        "definition": "The information determined as a result of making the observation"
      },
      {
        "id": "Observation.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "short": "Data absent reason",
        "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing"
      },
      {
        "id": "Observation.referenceRange",
        "path": "Observation.referenceRange",
        "short": "Observation reference range",
        "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range"
      }
    ]
  }
}