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

• Content
• Detailed Descriptions
• Mappings
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Resource Profile: UK Core Observation ACVPU

Defines the additional constraints and extensions on the UK Core Observation profile, to record clinical observations about a patients level of consciousness.

To provide implementers with additional support when implementing gathering of a patients ACVPU (level of consciousness) status, and to provide a consistent structure to how the data is presented.

Usage:

• Derived from this Resource Profile: InterweaveObservationACVPU

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from UKCoreObservation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	UKCoreObservation	Measurements and simple assertions
status		1..1	code	The status of the result value. Fixed Value: final
category		1..1	CodeableConcept	A code that classifies the general type of observation being made.
code
coding
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 1104441000000107
subject		1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
effective[x]		1..1	dateTime, Period, Timing, instant	A clinically relevant time / time-period for observation.
value[x]		0..1	CodeableConcept	The actual observed result. Binding: UK Core ACVPU (preferred)
component		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.value[x]	preferred	UKCoreACVPU https://fhir.hl7.org.uk/ValueSet/UKCore-ACVPU from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	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
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
triggeredByR5		0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:observation		1..1	Extension	Extension
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation.
extension:type		1..1	Extension	Extension
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	​The type of trigger. Reflex | Repeat | Re-run Binding: observation-triggeredbytype (required)
extension:reason		0..1	Extension	Extension
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
bodyStructureR5		0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	The status of the result value. Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category	S	1..1	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
subject	SΣ	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
effective[x]	SΣ	1..1		A clinically relevant time / time-period for observation.
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation.
value[x]	SΣC	0..1	CodeableConcept	The actual observed result. Binding: UK Core ACVPU (preferred)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.extension:triggeredByR5.extension:type.value[x]	required	http://hl7.org/fhir/ValueSet/observation-triggeredbytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG
Observation.value[x]	preferred	UKCoreACVPU https://fhir.hl7.org.uk/ValueSet/UKCore-ACVPU from this IG
Observation.component.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : 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-4	error	Observation	If 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-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If 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()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	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
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
triggeredByR5		0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:observation		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation.
extension:type		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	​The type of trigger. Reflex | Repeat | Re-run Binding: observation-triggeredbytype (required)
extension:reason		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
bodyStructureR5		0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	The status of the result value. Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category	S	1..1	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of 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
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	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 Fixed Value: 1104441000000107
display	Σ	0..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(Patient | Group | Device | Location)	Who and / or what the observation is about.
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	1..1		A clinically relevant time / time-period for observation.
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation.
value[x]	SΣC	0..1	CodeableConcept	The actual observed result. Binding: UK Core ACVPU (preferred)
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (preferred): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
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
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]	required	http://hl7.org/fhir/ValueSet/observation-triggeredbytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG
Observation.value[x]	preferred	UKCoreACVPU https://fhir.hl7.org.uk/ValueSet/UKCore-ACVPU from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	preferred	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : 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-4	error	Observation	If 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-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If 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()

This structure is derived from UKCoreObservation

Summary

Mandatory: 3 elements
Fixed: 2 elements
Prohibited: 1 element

Differential View

This structure is derived from UKCoreObservation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	UKCoreObservation	Measurements and simple assertions
status		1..1	code	The status of the result value. Fixed Value: final
category		1..1	CodeableConcept	A code that classifies the general type of observation being made.
code
coding
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 1104441000000107
subject		1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
effective[x]		1..1	dateTime, Period, Timing, instant	A clinically relevant time / time-period for observation.
value[x]		0..1	CodeableConcept	The actual observed result. Binding: UK Core ACVPU (preferred)
component		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.value[x]	preferred	UKCoreACVPU https://fhir.hl7.org.uk/ValueSet/UKCore-ACVPU from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	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
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
triggeredByR5		0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:observation		1..1	Extension	Extension
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation.
extension:type		1..1	Extension	Extension
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	​The type of trigger. Reflex | Repeat | Re-run Binding: observation-triggeredbytype (required)
extension:reason		0..1	Extension	Extension
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
bodyStructureR5		0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	The status of the result value. Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category	S	1..1	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
subject	SΣ	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
effective[x]	SΣ	1..1		A clinically relevant time / time-period for observation.
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation.
value[x]	SΣC	0..1	CodeableConcept	The actual observed result. Binding: UK Core ACVPU (preferred)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.extension:triggeredByR5.extension:type.value[x]	required	http://hl7.org/fhir/ValueSet/observation-triggeredbytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG
Observation.value[x]	preferred	UKCoreACVPU https://fhir.hl7.org.uk/ValueSet/UKCore-ACVPU from this IG
Observation.component.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : 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-4	error	Observation	If 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-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If 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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	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
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
triggeredByR5		0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:observation		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation.
extension:type		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"type"
value[x]		1..1	code	​The type of trigger. Reflex | Repeat | Re-run Binding: observation-triggeredbytype (required)
extension:reason		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
bodyStructureR5		0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	The status of the result value. Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category	S	1..1	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of 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
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	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 Fixed Value: 1104441000000107
display	Σ	0..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(Patient | Group | Device | Location)	Who and / or what the observation is about.
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	1..1		A clinically relevant time / time-period for observation.
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation.
value[x]	SΣC	0..1	CodeableConcept	The actual observed result. Binding: UK Core ACVPU (preferred)
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (preferred): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
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
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.extension:triggeredByR5.extension:type.value[x]	required	http://hl7.org/fhir/ValueSet/observation-triggeredbytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.status	required	Fixed Value: final http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG
Observation.value[x]	preferred	UKCoreACVPU https://fhir.hl7.org.uk/ValueSet/UKCore-ACVPU from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	preferred	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	preferred	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType from this IG
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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 : 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-4	error	Observation	If 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-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If 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()

This structure is derived from UKCoreObservation

Summary

Mandatory: 3 elements
Fixed: 2 elements
Prohibited: 1 element

Other representations of profile: CSV, Excel, Schematron