Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
identifier
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
assigner		0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
basedOn		0..*	Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1)	Fulfills plan, proposal or order
status		1..1	code	registered | preliminary | final | amended + Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation.
code		1..1	CodeableConcept	Type of observation (code / type) Binding: http://snomed.info/sct (required): A code from SNOMED Clinical Terminology UK
coding		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1104441000000107
display		1..1	string	Representation defined by the system Fixed Value: ACVPU (Alert Confusion Voice Pain Unresponsive) scale score
subject		0..1	Reference(Group | CareConnectPatient1)	Who and/or what this is about
context		0..1	Reference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)	Healthcare event during which this observation is made.
performer		0..*	Reference(CareConnect-RelatedPerson-1 | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	Who is responsible for the observation
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	Actual result Binding: Care Connect ACVPU (required): A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.
coding		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
bodySite
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT		0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (preferred): A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|).
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
method
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT		0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
specimen		0..1	Reference(CareConnect-Specimen-1)	Specimen used for this observation
related
target		1..1	Reference(QuestionnaireResponse | Sequence | CareConnect-Observation-1)	Resource that is related to this one
component
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:snomedCT		0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Type (extensible): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	http://snomed.info/sct
Observation.valueCodeableConcept:valueCodeableConcept	required	Care Connect ACVPU
Observation.bodySite.coding:snomedCT	preferred	Care Connect Body Site
Observation.method.coding:snomedCT	preferred	Care Connect Observation Method
Observation.component.code.coding:snomedCT	extensible	Care Connect Observation Type

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	Σ	0..*	Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation. Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: http://snomed.info/sct (required): A code from SNOMED Clinical Terminology UK
coding	Σ	1..1	Coding	Code defined by a terminology system
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 Fixed Value: 1104441000000107
display	Σ	1..1	string	Representation defined by the system Fixed Value: ACVPU (Alert Confusion Voice Pain Unresponsive) scale score
subject	Σ	0..1	Reference(Group | CareConnectPatient1)	Who and/or what this is about
context		0..1	Reference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)	Healthcare event during which this observation is made.
performer	Σ	0..*	Reference(CareConnect-RelatedPerson-1 | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Care Connect ACVPU (required): A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.
coding	Σ	1..1	Coding	Code defined by a terminology system
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
specimen		0..1	Reference(CareConnect-Specimen-1)	Specimen used for this observation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	Fixed Value: final
Observation.category	preferred	Observation Category Codes
Observation.code	required	http://snomed.info/sct
Observation.value[x]:valueCodeableConcept	required	Care Connect ACVPU

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
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 code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
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: Common Languages (extensible): 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
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..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(CareConnect-Organization-1)	Organization that issued id (may be just text)
basedOn	Σ	0..*	Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation. Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: http://snomed.info/sct (required): A code from SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
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 Fixed Value: 1104441000000107
display	Σ	1..1	string	Representation defined by the system Fixed Value: ACVPU (Alert Confusion Voice Pain Unresponsive) scale score
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	Σ	0..1	Reference(Group | CareConnectPatient1)	Who and/or what this is about
context		0..1	Reference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)	Healthcare event during which this observation is made.
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this was made available
performer	Σ	0..*	Reference(CareConnect-RelatedPerson-1 | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Care Connect ACVPU (required): A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
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
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment		0..1	string	Comments about result
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (preferred): A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|).
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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
specimen		0..1	Reference(CareConnect-Specimen-1)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
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: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (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
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(QuestionnaireResponse | Sequence | CareConnect-Observation-1)	Resource that is related to this one
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Type (extensible): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueAttachment			Attachment
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Observation.identifier.use	required	IdentifierUse
Observation.identifier.type	extensible	Identifier Type Codes
Observation.status	required	Fixed Value: final
Observation.category	preferred	Observation Category Codes
Observation.code	required	http://snomed.info/sct
Observation.value[x]:valueCodeableConcept	required	Care Connect ACVPU
Observation.dataAbsentReason	extensible	Observation Value Absent Reason
Observation.interpretation	extensible	Observation Interpretation Codes
Observation.bodySite	example	SNOMED CT Body Structures
Observation.bodySite.coding:snomedCT	preferred	Care Connect Body Site
Observation.method	example	Observation Methods
Observation.method.coding:snomedCT	preferred	Care Connect Observation Method
Observation.referenceRange.type	extensible	Observation Reference Range Meaning Codes
Observation.referenceRange.appliesTo	example	Observation Reference Range Applies To Codes
Observation.related.type	required	ObservationRelationshipType
Observation.component.code	example	LOINC Codes (a valid code from LOINC)
Observation.component.code.coding:snomedCT	extensible	Care Connect Observation Type
Observation.component.dataAbsentReason	extensible	Observation Value Absent Reason
Observation.component.interpretation	extensible	Observation Interpretation Codes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()

Summary

Mandatory: 4 elements (15 nested mandatory elements)
Fixed Value: 8 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

• CareConnect-Organization-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)
• CareConnect-CarePlan-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-CarePlan-1)
• CareConnect-ReferralRequest-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ReferralRequest-1)
• CareConnect-MedicationRequest-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-MedicationRequest-1)
• CareConnect-ProcedureRequest-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ProcedureRequest-1)
• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
• CareConnect-EpisodeOfCare-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-EpisodeOfCare-1)
• CareConnect-Encounter-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)
• CareConnect-RelatedPerson-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-RelatedPerson-1)
• CareConnect-Practitioner-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1)
• CareConnect-Specimen-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Specimen-1)
• CareConnect-Observation-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1)

Extensions

This structure refers to these extensions:

• https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Slices

This structure defines the following Slices:

• The element Observation.bodySite.coding is sliced based on the value of value:system
• The element Observation.method.coding is sliced based on the value of value:system
• The element Observation.component.code.coding is sliced based on the value of value:code

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
identifier
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
assigner		0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
basedOn		0..*	Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1)	Fulfills plan, proposal or order
status		1..1	code	registered | preliminary | final | amended + Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation.
code		1..1	CodeableConcept	Type of observation (code / type) Binding: http://snomed.info/sct (required): A code from SNOMED Clinical Terminology UK
coding		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1104441000000107
display		1..1	string	Representation defined by the system Fixed Value: ACVPU (Alert Confusion Voice Pain Unresponsive) scale score
subject		0..1	Reference(Group | CareConnectPatient1)	Who and/or what this is about
context		0..1	Reference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)	Healthcare event during which this observation is made.
performer		0..*	Reference(CareConnect-RelatedPerson-1 | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	Who is responsible for the observation
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	Actual result Binding: Care Connect ACVPU (required): A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.
coding		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
bodySite
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT		0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (preferred): A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|).
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
method
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT		0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
specimen		0..1	Reference(CareConnect-Specimen-1)	Specimen used for this observation
related
target		1..1	Reference(QuestionnaireResponse | Sequence | CareConnect-Observation-1)	Resource that is related to this one
component
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:snomedCT		0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Type (extensible): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..0
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	required	http://snomed.info/sct
Observation.valueCodeableConcept:valueCodeableConcept	required	Care Connect ACVPU
Observation.bodySite.coding:snomedCT	preferred	Care Connect Body Site
Observation.method.coding:snomedCT	preferred	Care Connect Observation Method
Observation.component.code.coding:snomedCT	extensible	Care Connect Observation Type

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	Σ	0..*	Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation. Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: http://snomed.info/sct (required): A code from SNOMED Clinical Terminology UK
coding	Σ	1..1	Coding	Code defined by a terminology system
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 Fixed Value: 1104441000000107
display	Σ	1..1	string	Representation defined by the system Fixed Value: ACVPU (Alert Confusion Voice Pain Unresponsive) scale score
subject	Σ	0..1	Reference(Group | CareConnectPatient1)	Who and/or what this is about
context		0..1	Reference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)	Healthcare event during which this observation is made.
performer	Σ	0..*	Reference(CareConnect-RelatedPerson-1 | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Care Connect ACVPU (required): A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.
coding	Σ	1..1	Coding	Code defined by a terminology system
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
specimen		0..1	Reference(CareConnect-Specimen-1)	Specimen used for this observation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.status	required	Fixed Value: final
Observation.category	preferred	Observation Category Codes
Observation.code	required	http://snomed.info/sct
Observation.value[x]:valueCodeableConcept	required	Care Connect ACVPU

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
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 code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions
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: Common Languages (extensible): 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
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..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(CareConnect-Organization-1)	Organization that issued id (may be just text)
basedOn	Σ	0..*	Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Fixed Value: final
category		0..*	CodeableConcept	Classification of type of observation. Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: http://snomed.info/sct (required): A code from SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
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 Fixed Value: 1104441000000107
display	Σ	1..1	string	Representation defined by the system Fixed Value: ACVPU (Alert Confusion Voice Pain Unresponsive) scale score
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	Σ	0..1	Reference(Group | CareConnectPatient1)	Who and/or what this is about
context		0..1	Reference(CareConnect-EpisodeOfCare-1 | CareConnect-Encounter-1)	Healthcare event during which this observation is made.
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this was made available
performer	Σ	0..*	Reference(CareConnect-RelatedPerson-1 | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	Who is responsible for the observation
Slices for value[x]	ΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Care Connect ACVPU (required): A code from the SNOMED Clinical Terminology UK coding system which describes whether a patient is mentally alert, unresponsive, responds to voice, responds to pain or is acutely confused.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
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
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment		0..1	string	Comments about result
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Body Site (preferred): A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|).
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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
specimen		0..1	Reference(CareConnect-Specimen-1)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
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: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (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
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(QuestionnaireResponse | Sequence | CareConnect-Observation-1)	Resource that is related to this one
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Observation Type (extensible): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
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
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueAttachment			Attachment
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Observation.identifier.use	required	IdentifierUse
Observation.identifier.type	extensible	Identifier Type Codes
Observation.status	required	Fixed Value: final
Observation.category	preferred	Observation Category Codes
Observation.code	required	http://snomed.info/sct
Observation.value[x]:valueCodeableConcept	required	Care Connect ACVPU
Observation.dataAbsentReason	extensible	Observation Value Absent Reason
Observation.interpretation	extensible	Observation Interpretation Codes
Observation.bodySite	example	SNOMED CT Body Structures
Observation.bodySite.coding:snomedCT	preferred	Care Connect Body Site
Observation.method	example	Observation Methods
Observation.method.coding:snomedCT	preferred	Care Connect Observation Method
Observation.referenceRange.type	extensible	Observation Reference Range Meaning Codes
Observation.referenceRange.appliesTo	example	Observation Reference Range Applies To Codes
Observation.related.type	required	ObservationRelationshipType
Observation.component.code	example	LOINC Codes (a valid code from LOINC)
Observation.component.code.coding:snomedCT	extensible	Care Connect Observation Type
Observation.component.dataAbsentReason	extensible	Observation Value Absent Reason
Observation.component.interpretation	extensible	Observation Interpretation Codes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()

Summary

Mandatory: 4 elements (15 nested mandatory elements)
Fixed Value: 8 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

• CareConnect-Organization-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)
• CareConnect-CarePlan-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-CarePlan-1)
• CareConnect-ReferralRequest-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ReferralRequest-1)
• CareConnect-MedicationRequest-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-MedicationRequest-1)
• CareConnect-ProcedureRequest-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ProcedureRequest-1)
• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
• CareConnect-EpisodeOfCare-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-EpisodeOfCare-1)
• CareConnect-Encounter-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)
• CareConnect-RelatedPerson-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-RelatedPerson-1)
• CareConnect-Practitioner-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1)
• CareConnect-Specimen-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Specimen-1)
• CareConnect-Observation-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1)

Extensions

This structure refers to these extensions:

• https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Slices

This structure defines the following Slices:

• The element Observation.bodySite.coding is sliced based on the value of value:system
• The element Observation.method.coding is sliced based on the value of value:system
• The element Observation.component.code.coding is sliced based on the value of value:code