Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: InterweaveObservationVitalSignsOxygenSaturation

Official URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Observation-VitalSigns-OxygenSaturation Version: 0.0.1
Draft as of 2024-07-15 Computable Name: InterweaveObservationVitalSignsOxygenSaturation

Interweave Observation Vital Signs Blood Oxygen Saturation resource profile - DRAFT.

Status: DRAFT: For Review

Introduction

This profile sets out the expectations for the interweave blood oxygen saturation observation resource. The base for this profile is the UK Core Observation Vital Signs Oxygen Saturation.

We stipulate the use of SNOMED concept codes where possible, and the result should be provided as a Quantity within the valueQuantity field.

Mandatory fields

The following mandatory fields are defined:

  1. status – Fixed value of ‘final’. Only finalised observations should be shared.

  2. category – Fixed value of ‘vital-signs’.

  3. code – Fixed value of A LOINC "magic code" describing the type of observation SHALL be present. (LOINC: 2708-6(Oxygen saturation in Arterial blood)). There is also a mandated set of SNOMED CT codes defined in UK Core OxygenSaturation with required binding.

  4. subject – Reference to the patient who is the subject of this measurement.

  5. effective – An important field to provide details of the time/time period during which the observation was taken.

  6. valueQuantity – The actual result recorded.

Must Support fields

In addition the following fields are "Must Support" - ie they must be populated if relevant and known.

  1. identifier – A Local Id should be provided, such that could be quoted if manually getting in touch to find out more.

  2. encounter – his will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). For some observations it may be important to know the link between an observation and a particular encounter.

  3. performer – We limit this field to reference practitioner / practitionerRole/ CareTeam resources only. The organization responsible for the observation can be obtained via the provenance tag.

  4. referenceRange – To aid the interpretation of a result, it is important to include the reference range.

  5. note – Comments in addition to the result are often recorded for observations, it is therefore important to provide this field when available to give the consumer the full result information.

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Points of note include:

  • method – Option to provide the mechanism used to perform the observation

  • device – Opportunity to provide a link to a device resource from which was used to obtain the observation.

  • bodyStructureR5 (extension) - Indicates the body structure on the subject's body where the observation was made (i.e. the target site). This is a R5 backport.

  • bodyPosition (extension) - The position of the body when the observation was done, e.g. standing, sitting. To be used only when the body position in not precoordinated in the observation code.

  • recordingSetting (extension) - This extension allows the recording of the care setting in which an observation was performed in a clinical or non clinical setting.

Discouraged or Removed fields

  • Component – Removed to aid the data consumer, we ask that the result is provided in the valueQuantity field and not as a component.

  • basedOn – This field is discouraged as it does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.

  • partOf – This field is discouraged as it does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.

  • issued – This field has been removed as this information can be taken from the mandatory meta.lastUpdated field, and to also avoid any confusion with the other date fields.

  • dataAbsentReason - Removed.
  • interpretation - Removed.
  • specimen – Removed.
  • bodysite - Removed.
  • focus - Removed.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from UKCoreObservationVitalSignsOxygenSaturation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* UKCoreObservationVitalSignsOxygenSaturation Measurements and simple assertions
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... versionId S 0..1 id Version specific identifier
.... lastUpdated S 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... code S 1..1 code The Data Provider Id of the system supplying the data
...... display S 1..1 string Name of the system supplying the data
..... tag:Provenance S 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... code S 1..1 code The ODS Code of the organisation responsible for the data
...... display S 1..1 string Name of the organisation supplying the data
... implicitRules 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... language 0..1 code English is assumed (not currently a multi-lingual implementation)
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... extension:triggeredByR5 0..0
... identifier S 0..* Identifier Business Identifier for observation
.... assigner 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... category 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.

.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
Fixed Value: Vital Signs
... code
.... id 0..0
.... coding 2..* Coding Code defined by a terminology system
..... id 0..0
.... Slices for coding Content/Rules for all slices
..... coding:loinc 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
...... id 0..0
...... version 0..0
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
Fixed Value: Oxygen saturation in Arterial blood
.... Slices for coding Content/Rules for all slices
..... coding:snomedCT 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core OxygenSaturation (required)
...... id 0..0
...... version 0..0
...... display 1..1 string Representation defined by the system
... subject 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... id 0..0
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... focus 0..0
... encounter S 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... issued 0..0
... performer 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... dataAbsentReason 0..0
... interpretation S 0..* CodeableConcept High, low, normal, etc.
.... coding
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... note S 0..1 Annotation Comments about the observation
... bodySite 0..0
... method
.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... specimen 0..0
... device 0..1 Reference(Device) (Measurement) Device
... referenceRange S 0..* BackboneElement Provides guide for interpretation
.... id 0..0
... hasMember 0..0
... derivedFrom 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... component 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.code.coding:snomedCTrequiredUKCoreOxygenSaturation
https://fhir.hl7.org.uk/ValueSet/UKCore-OxygenSaturation
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsOxygenSaturation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 2708-6
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Oxygen saturation in Arterial blood
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core OxygenSaturation (required)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... value[x] SΣC 1..1 Quantity The actual observed result.
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... unit Σ 1..1 string Unit representation
Fixed Value: percent
.... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code Σ 1..1 code Coded form of the unit
Fixed Value: %
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note S 0..1 Annotation Comments about the observation
... device 0..1 Reference(Device) (Measurement) Device
... referenceRange SC 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
... derivedFrom Σ 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]requiredhttp://hl7.org/fhir/ValueSet/observation-triggeredbytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.extension:bodyPosition.value[x]preferredUKCoreBodyPosition
https://fhir.hl7.org.uk/ValueSet/UKCore-BodyPosition
from this IG
Observation.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.code.coding:loincextensibleFixed Value: LOINC Code 2708-6
http://hl7.org/fhir/ValueSet/observation-vitalsignresult
from the FHIR Standard
Observation.code.coding:snomedCTrequiredUKCoreOxygenSaturation
https://fhir.hl7.org.uk/ValueSet/UKCore-OxygenSaturation
from this IG
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.component.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ukcore-obs-vs-001errorObservation`code.coding` SHALL include a LOINC "magic code"
: code.coding.where(system='http://loinc.org').exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsOxygenSaturation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ 1..1 string Representation defined by the system
Fixed Value: Vital Signs
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 2708-6
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Oxygen saturation in Arterial blood
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core OxygenSaturation (required)
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... value[x] SΣC 1..1 Quantity The actual observed result.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... unit Σ 1..1 string Unit representation
Fixed Value: percent
.... system ΣC 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code Σ 1..1 code Coded form of the unit
Fixed Value: %
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... note S 0..1 Annotation Comments about the observation
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (preferred): Methods for simple observations.

.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... device 0..1 Reference(Device) (Measurement) Device
... referenceRange SC 0..* BackboneElement Provides guide for interpretation
obs-3: Must have at least a low or a high or text
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity Low Range, if relevant
.... high C 0..1 SimpleQuantity High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... derivedFrom Σ 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Observation.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]requiredhttp://hl7.org/fhir/ValueSet/observation-triggeredbytype
http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.extension:bodyPosition.value[x]preferredUKCoreBodyPosition
https://fhir.hl7.org.uk/ValueSet/UKCore-BodyPosition
from this IG
Observation.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Observation.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Observation.statusrequiredFixed Value: final
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.code.coding:loincextensibleFixed Value: LOINC Code 2708-6
http://hl7.org/fhir/ValueSet/observation-vitalsignresult
from the FHIR Standard
Observation.code.coding:snomedCTrequiredUKCoreOxygenSaturation
https://fhir.hl7.org.uk/ValueSet/UKCore-OxygenSaturation
from this IG
Observation.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Observation.performer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard
Observation.methodpreferredObservationMethods
http://hl7.org/fhir/ValueSet/observation-methods
from the FHIR Standard
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
http://hl7.org/fhir/ValueSet/referencerange-meaning
from the FHIR Standard
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
http://hl7.org/fhir/ValueSet/referencerange-appliesto
from the FHIR Standard
Observation.component.codepreferredUKCoreObservationType
https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
from this IG
Observation.component.dataAbsentReasonextensibleDataAbsentReason
http://hl7.org/fhir/ValueSet/data-absent-reason
from the FHIR Standard
Observation.component.interpretationextensibleObservationInterpretationCodes
http://hl7.org/fhir/ValueSet/observation-interpretation
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorObservationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorObservationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceObservationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
ukcore-obs-vs-001errorObservation`code.coding` SHALL include a LOINC "magic code"
: code.coding.where(system='http://loinc.org').exists()

Differential View

This structure is derived from UKCoreObservationVitalSignsOxygenSaturation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..* UKCoreObservationVitalSignsOxygenSaturation Measurements and simple assertions
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... versionId S 0..1 id Version specific identifier
.... lastUpdated S 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... code S 1..1 code The Data Provider Id of the system supplying the data
...... display S 1..1 string Name of the system supplying the data
..... tag:Provenance S 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... code S 1..1 code The ODS Code of the organisation responsible for the data
...... display S 1..1 string Name of the organisation supplying the data
... implicitRules 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... language 0..1 code English is assumed (not currently a multi-lingual implementation)
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... extension:triggeredByR5 0..0
... identifier S 0..* Identifier Business Identifier for observation
.... assigner 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... category 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.

.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
Fixed Value: Vital Signs
... code
.... id 0..0
.... coding 2..* Coding Code defined by a terminology system
..... id 0..0
.... Slices for coding Content/Rules for all slices
..... coding:loinc 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
...... id 0..0
...... version 0..0
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
Fixed Value: Oxygen saturation in Arterial blood
.... Slices for coding Content/Rules for all slices
..... coding:snomedCT 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core OxygenSaturation (required)
...... id 0..0
...... version 0..0
...... display 1..1 string Representation defined by the system
... subject 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... id 0..0
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... focus 0..0
... encounter S 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... issued 0..0
... performer 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... dataAbsentReason 0..0
... interpretation S 0..* CodeableConcept High, low, normal, etc.
.... coding
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... note S 0..1 Annotation Comments about the observation
... bodySite 0..0
... method
.... id 0..0
.... coding
..... id 0..0
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... specimen 0..0
... device 0..1 Reference(Device) (Measurement) Device
... referenceRange S 0..* BackboneElement Provides guide for interpretation
.... id 0..0
... hasMember 0..0
... derivedFrom 0..* Reference(InterweaveObservation | InterweaveQuestionnaireResponse) Related measurements the observation is made from
... component 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.categoryrequiredObservationCategoryCodes
http://hl7.org/fhir/ValueSet/observation-category
from the FHIR Standard
Observation.code.coding:snomedCTrequiredUKCoreOxygenSaturation
https://fhir.hl7.org.uk/ValueSet/UKCore-OxygenSaturation
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* UKCoreObservationVitalSignsOxygenSaturation Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
ukcore-obs-vs-001: `code.coding` SHALL include a LOINC "magic code"
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... bodyStructureR5 0..1 Reference(BodyStructure) Observed body structure. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
.... bodyPosition 0..1 (Complex) The patients body position when the vital signs observation was recorded.
URL: http://hl7.org/fhir/StructureDefinition/observation-bodyPosition
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/observation-bodyPosition"
..... value[x] 1..1 CodeableConcept Value of extension
Binding: UK Core Body Position (preferred)
.... recordingSetting 0..* CodeableConcept Records whether the vital signs observation was performed in a clinical or non clinical setting.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-RecordingSetting
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Business Identifier for observation
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) DISCOURAGED - This field does not appear to provide information which would be beneficial in a shared care record. It also allows references to a raft of request/order resources which introduces a lot of complexity for a data consumer.
... status ?!SΣ 1..1 code A status of `final` SHALL be present.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S 1..1 CodeableConcept A category of `vital-signs` SHALL be present.
Binding: ObservationCategoryCodes (required): Codes for high level observation categories.


... code SΣ 1..1 CodeableConcept The type of vital signs observation (code / type).
Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation

.... Slices for coding Σ 2..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
..... coding:loinc Σ 1..1 Coding A LOINC "magic code" describing the type of observation SHALL be present.
Binding: VitalSigns (extensible)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code Σ 1..1 code Symbol in syntax defined by the system
Fixed Value: 2708-6
...... display Σ 1..1 string Representation defined by the system
Fixed Value: Oxygen saturation in Arterial blood
..... coding:snomedCT Σ 1..* Coding A SNOMED CT concept describing the type of observation SHALL be present.
Binding: UK Core OxygenSaturation (required)
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(InterweavePatient) Who or what the observation relates to SHALL be present.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Healthcare event during which this observation is made
... effective[x] SΣ 1..1 This is the time/time period during which the observation was taken.
.... effectiveDateTime dateTime
.... effectiveInstant instant
... performer SΣ 0..* Reference(Practitioner | PractitionerRole | CareTeam) Who is responsible for the observation.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... value[x] SΣC 1..1 Quantity The actual observed result.
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

.... unit Σ 1..1 string Unit representation
Fixed Value: percent
.... system ΣC 1..1 uri