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{
"resourceType": "StructureDefinition",
"id": "il-core-observation",
"url": "http://fhir.health.gov.il/StructureDefinition/il-core-observation",
"version": "0.12.1",
"name": "ILCoreObservation",
"title": "ILCore Observation Profile",
"status": "draft",
"date": "2021-05-02",
"publisher": "Israel Core Team",
"contact": [
{
"telecom": [
{
"system": "email",
"value": "ido.levin@moh.gov.il"
}
]
}
],
"description": "Israel Core proposed constraints and extensions on the Observation Resource",
"fhirVersion": "4.0.1",
"mapping": [
{
"identity": "workflow",
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern"
},
{
"identity": "sct-concept",
"uri": "http://snomed.info/conceptdomain",
"name": "SNOMED CT Concept Domain Binding"
},
{
"identity": "v2",
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping"
},
{
"identity": "sct-attr",
"uri": "http://snomed.org/attributebinding",
"name": "SNOMED CT Attribute Binding"
}
],
"kind": "resource",
"abstract": false,
"type": "Observation",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Observation",
"path": "Observation",
"short": "ILCore Observation Profile",
"definition": "Definitions for the profile-Observation resource profile."
},
{
"id": "Observation.basedOn",
"path": "Observation.basedOn",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/DeviceRequest",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://fhir.health.gov.il/StructureDefinition/il-core-medication-request",
"http://hl7.org/fhir/StructureDefinition/NutritionOrder",
"http://fhir.health.gov.il/StructureDefinition/il-core-service-request"
]
}
]
},
{
"id": "Observation.partOf",
"path": "Observation.partOf",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
"http://hl7.org/fhir/StructureDefinition/MedicationDispense",
"http://fhir.health.gov.il/StructureDefinition/il-core-procedure",
"http://fhir.health.gov.il/StructureDefinition/il-core-immunization",
"http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study"
]
}
]
},
{
"id": "Observation.status",
"path": "Observation.status",
"mustSupport": true
},
{
"id": "Observation.category",
"path": "Observation.category",
"mustSupport": true
},
{
"id": "Observation.code",
"path": "Observation.code",
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-code"
}
},
{
"id": "Observation.subject",
"path": "Observation.subject",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-patient",
"http://fhir.health.gov.il/StructureDefinition/il-core-group",
"http://fhir.health.gov.il/StructureDefinition/il-core-device",
"http://fhir.health.gov.il/StructureDefinition/il-core-location"
]
}
],
"mustSupport": true
},
{
"id": "Observation.encounter",
"path": "Observation.encounter",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-encounter"
]
}
]
},
{
"id": "Observation.performer",
"path": "Observation.performer",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-practitioner",
"http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role",
"http://fhir.health.gov.il/StructureDefinition/il-core-organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam",
"http://fhir.health.gov.il/StructureDefinition/il-core-patient",
"http://fhir.health.gov.il/StructureDefinition/il-core-related-person"
]
}
]
},
{
"id": "Observation.value[x]",
"path": "Observation.value[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"mustSupport": true
},
{
"id": "Observation.value[x]:valueQuantity",
"path": "Observation.value[x]",
"sliceName": "valueQuantity",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
}
],
"constraint": [
{
"key": "il-obs-ucum",
"severity": "warning",
"human": "SHOULD use UCUM for coded quantity units",
"expression": "system.empty() or system = 'http://unitsofmeasure.org'",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.value[x]:valueCodeableConcept",
"path": "Observation.value[x]",
"sliceName": "valueCodeableConcept",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "il-obs-value-cc",
"severity": "warning",
"human": "SHOULD use SNOMED-CT or LOINC Answers for coded results",
"expression": "coding.where(system='http://snomed.info/sct' and code.exists()).exists() OR coding.where(system='http://loinc.org' and code.startsWith('LA')).exists()",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
],
"binding": {
"strength": "preferred",
"valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-value"
}
},
{
"id": "Observation.dataAbsentReason",
"path": "Observation.dataAbsentReason",
"constraint": [
{
"key": "il-obs-not-performed",
"severity": "error",
"human": "dataAbsentReason - if an IL-Core 'not-performed-reason' code is supplied, 'not performed' code MUST be supplied as well",
"expression": "coding.where(system='http://fhir.health.gov.il/cs/il-core-not-performed-reason').exists() implies coding.where(system='http://terminology.hl7.org/CodeSystem/data-absent-reason' and code='not-performed').exists()",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.dataAbsentReason.coding",
"path": "Observation.dataAbsentReason.coding",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "system"
}
],
"rules": "open"
}
},
{
"id": "Observation.dataAbsentReason.coding:not-performed-reason",
"path": "Observation.dataAbsentReason.coding",
"sliceName": "not-performed-reason",
"min": 0,
"max": "1"
},
{
"id": "Observation.dataAbsentReason.coding:not-performed-reason.system",
"path": "Observation.dataAbsentReason.coding.system",
"min": 1,
"patternUri": "http://fhir.health.gov.il/cs/il-core-not-performed-reason"
},
{
"id": "Observation.dataAbsentReason.coding:not-performed-reason.code",
"path": "Observation.dataAbsentReason.coding.code",
"min": 1
},
{
"id": "Observation.bodySite",
"path": "Observation.bodySite",
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
}
],
"strength": "preferred",
"description": "Codes describing anatomical locations. May include laterality.",
"valueSet": "http://hl7.org/fhir/ValueSet/body-site"
}
},
{
"id": "Observation.method",
"path": "Observation.method",
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ObservationMethod"
}
],
"strength": "preferred",
"description": "Methods for simple observations.",
"valueSet": "http://hl7.org/fhir/ValueSet/observation-methods"
}
},
{
"id": "Observation.specimen",
"path": "Observation.specimen",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-specimen"
]
}
]
},
{
"id": "Observation.device",
"path": "Observation.device",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-device",
"http://hl7.org/fhir/StructureDefinition/DeviceMetric"
]
}
]
},
{
"id": "Observation.referenceRange.low",
"path": "Observation.referenceRange.low",
"constraint": [
{
"key": "il-obs-ucum",
"severity": "warning",
"human": "SHOULD use UCUM for coded quantity units",
"expression": "system.empty() or system = 'http://unitsofmeasure.org'",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.referenceRange.high",
"path": "Observation.referenceRange.high",
"constraint": [
{
"key": "il-obs-ucum",
"severity": "warning",
"human": "SHOULD use UCUM for coded quantity units",
"expression": "system.empty() or system = 'http://unitsofmeasure.org'",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.referenceRange.age.low",
"path": "Observation.referenceRange.age.low",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/age-units"
}
},
{
"id": "Observation.referenceRange.age.high",
"path": "Observation.referenceRange.age.high",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/age-units"
}
},
{
"id": "Observation.hasMember",
"path": "Observation.hasMember",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-observation",
"http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response",
"http://hl7.org/fhir/StructureDefinition/MolecularSequence"
]
}
]
},
{
"id": "Observation.derivedFrom",
"path": "Observation.derivedFrom",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.health.gov.il/StructureDefinition/il-core-document-reference",
"http://fhir.health.gov.il/StructureDefinition/il-core-imaging-study",
"http://fhir.health.gov.il/StructureDefinition/il-core-media",
"http://fhir.health.gov.il/StructureDefinition/il-core-questionnaire-response",
"http://fhir.health.gov.il/StructureDefinition/il-core-observation",
"http://hl7.org/fhir/StructureDefinition/MolecularSequence"
]
}
]
},
{
"id": "Observation.component.code",
"path": "Observation.component.code",
"binding": {
"strength": "preferred",
"valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-code"
}
},
{
"id": "Observation.component.value[x]",
"path": "Observation.component.value[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "Observation.component.value[x]:valueQuantity",
"path": "Observation.component.value[x]",
"sliceName": "valueQuantity",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
}
],
"constraint": [
{
"key": "il-obs-ucum",
"severity": "warning",
"human": "SHOULD use UCUM for coded quantity units",
"expression": "system.empty() or system = 'http://unitsofmeasure.org'",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.component.value[x]:valueCodeableConcept",
"path": "Observation.component.value[x]",
"sliceName": "valueCodeableConcept",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "il-obs-value-cc",
"severity": "warning",
"human": "SHOULD use SNOMED-CT or LOINC Answers for coded results",
"expression": "coding.where(system='http://snomed.info/sct' and code.exists()).exists() OR coding.where(system='http://loinc.org' and code.startsWith('LA')).exists()",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
],
"binding": {
"strength": "preferred",
"valueSet": "http://fhir.health.gov.il/ValueSet/il-core-observation-value"
}
},
{
"id": "Observation.component.referenceRange",
"path": "Observation.component.referenceRange",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "Observation.component.referenceRange.low",
"path": "Observation.component.referenceRange.low",
"constraint": [
{
"key": "il-obs-ucum",
"severity": "warning",
"human": "SHOULD use UCUM for coded quantity units",
"expression": "system.empty() or system = 'http://unitsofmeasure.org'",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.component.referenceRange.high",
"path": "Observation.component.referenceRange.high",
"constraint": [
{
"key": "il-obs-ucum",
"severity": "warning",
"human": "SHOULD use UCUM for coded quantity units",
"expression": "system.empty() or system = 'http://unitsofmeasure.org'",
"source": "http://fhir.health.gov.il/StructureDefinition/il-core-observation"
}
]
},
{
"id": "Observation.component.referenceRange.age.low",
"path": "Observation.component.referenceRange.age.low",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/age-units"
}
},
{
"id": "Observation.component.referenceRange.age.high",
"path": "Observation.component.referenceRange.age.high",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/age-units"
}
}
]
}
}