Interweave Implementation Guide
0.1.0 - ci-build

Interweave Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions

Resource Profile: InterweaveObservationNEWS2Score

Official URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-Observation-NEWS2Score Version: 0.1.0
Active as of 2024-06-10 Computable Name: InterweaveObservationNEWS2Score

Interweave NEWS2 Score Observation resource profile.

  Status: Active: Approved (STU)

Introduction

This profile sets out the expectations for the interweave NEWS2 score observation resource. Care connect do not have a profile for this observation, and therefore the base for this profile is the Interweave-Observation-AssessmentScore. We stipulate the use of SNOMED concept codes where possible, and the score should be provided within the valueQuantity field.

Mandatory fields

The following mandatory fields are defined:

  1. status – Fixed value of ‘final’.

  2. category – Fixed value of ‘survey’.

  3. code – Fixed value of SCT: 1104051000000101 (“Royal College of Physicians NEWS2 (National Early Warning Score 2) total score”).

  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.

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

  3. interpretation – This is also known as the ‘abnormal flag’ and is regularly recorded alongside the actual result. It is used to signal the meaning of the result.

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

  5. comment – 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.

  6. related – It is often important for a clinician to see the observations from which a score has been derived. This field should be used to reference any such observations.

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:

  • reasonCondition (care connect extension) – An optional care connect extension that allows the reason for an observation being performed/recorded to be specified. This can be a reference to a condition resource or a coded entity.

  • context – Optional link to an encounter resource.

  • 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.

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.

  • dataAbsentReason – Removed as a score should always be available.

  • bodySite – Removed as not required for a score observation.

  • specimen – Removed as not required for a score observation.

  • 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.

  • 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.

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 InterweaveObservationAssessmentScore

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*InterweaveObservationAssessmentScoreMeasurements and simple assertions
... code
.... coding:snomedCT 0..1CodingCode defined by a terminology system
..... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 1104051000000101
..... display 1..1stringRepresentation defined by the system
Fixed Value: Royal College of Physicians NEWS2 (National Early Warning Score 2) total score

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*InterweaveObservationAssessmentScoreMeasurements and simple assertions
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierBusiness Identifier for observation
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ1..1stringThe value that is unique
Example General: 123456
... status ?!SΣ1..1codeOnly finalised observations should be shared. We do also allow for amendments and corrections to the final observation to take place. We therefore limit the list of statuses which can be used to the following - final | amended | corrected
Binding: ObservationStatus (required)
Fixed Value: final
... Slices for category S1..1CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.system
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


.... category:observationCategory 1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (required): Codes for high level observation categories.


..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:All Slices Content/Rules for all slices
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
....... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: survey
....... display Σ1..1stringRepresentation defined by the system
Fixed Value: Survey
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Care Connect Observation Type (preferred)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT SΣ0..1CodingCode defined by a terminology system
Binding: Care Connect Observation Type (preferred)
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 1104051000000101
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Royal College of Physicians NEWS2 (National Early Warning Score 2) total score
... subject SΣ1..1Reference(CareConnectPatient1)The patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... display Σ1..1stringDescription of the referenced resource
... effective[x] SΣ1..1This is the time/time period during which the observation was taken.
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer SΣ0..*Reference(CareConnect-Practitioner-1)Who is responsible for the observation.
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... display Σ1..1stringDescription of the referenced resource
... value[x] SΣC0..1Actual result
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
... comment S0..1stringComments about the result
... referenceRange SC0..*BackboneElementProvides guide for interpretation
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... related SΣ0..*BackboneElementResources related to this observation
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: derived-from
.... target S1..1Reference(CareConnect-Observation-1)we limit the related field’s usage to only allow links to observation resources, from which the primary observation’s value was derived. E.g. An observation may have a value which is a score, and that score may have been derived from several other observations.

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.meta.tagexampleCommon Tags
Observation.meta.tag:SourceexampleCommon Tags
Observation.meta.tag:ProvenanceexampleCommon Tags
Observation.identifier.userequiredIdentifierUse
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservation Category Codes
Observation.category:observationCategoryrequiredObservation Category Codes
Observation.codepreferredCare Connect Observation Type
Observation.code.coding:snomedCTpreferredFixed Value: SNOMED CT code 1104051000000101
Observation.interpretationrequiredObservation Interpretation Codes
Observation.related.typerequiredFixed Value: derived-from
Observation.component.codepreferredCare Connect Observation Type
Observation.component.code.coding:snomedCTpreferredCare Connect Observation Type

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
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
: contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1errorObservation.extension:reason, Observation.referenceRange, Observation.related, Observation.component.extension:valuePrecisionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1errorObservation.extension:reason, Observation.component.extension:valuePrecisionMust 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 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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*InterweaveObservationAssessmentScoreMeasurements and simple assertions
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - 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 Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... reason 0..*CodeableConcept, Reference(CareConnect-Condition-1)Reason resource added/performed/given
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ReasonCondition-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierBusiness Identifier for observation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ0..1CodeableConceptDescription 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 Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ1..1stringThe value that is unique
Example General: 123456
.... period Σ0..1PeriodTime period when id is/was valid for use
.... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)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 ?!SΣ1..1codeOnly finalised observations should be shared. We do also allow for amendments and corrections to the final observation to take place. We therefore limit the list of statuses which can be used to the following - final | amended | corrected
Binding: ObservationStatus (required)
Fixed Value: final
... Slices for category S1..1CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.system
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


.... category:observationCategory 1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (required): Codes for high level observation categories.


..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:All Slices Content/Rules for all slices
....... id 0..1stringxml:id (or equivalent in JSON)
....... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
....... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: survey
....... display Σ1..1stringRepresentation defined by the system
Fixed Value: Survey
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Care Connect Observation Type (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT SΣ0..1CodingCode defined by a terminology system
Binding: Care Connect Observation Type (preferred)
...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
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 Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 1104051000000101
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Royal College of Physicians NEWS2 (National Early Warning Score 2) total score
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(CareConnectPatient1)The patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context 0..1Reference(CareConnect-Encounter-1)The encounter during which this observation is made.
... effective[x] SΣ1..1This is the time/time period during which the observation was taken.
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer SΣ0..*Reference(CareConnect-Practitioner-1)Who is responsible for the observation.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... value[x] SΣC0..1Actual result
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ1..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... comment S0..1stringComments about the result
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:snomedCT Σ0..1CodingCode defined by a terminology system
...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
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 Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... device 0..1Reference(Device)Measurement device.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
... referenceRange SC0..*BackboneElementProvides guide for interpretation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... related SΣ0..*BackboneElementResources related to this observation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: derived-from
.... target S1..1Reference(CareConnect-Observation-1)we limit the related field’s usage to only allow links to observation resources, from which the primary observation’s value was derived. E.g. An observation may have a value which is a score, and that score may have been derived from several other observations.

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.meta.securityextensibleAll Security Labels
Observation.meta.tagexampleCommon Tags
Observation.meta.tag:SourceexampleCommon Tags
Observation.meta.tag:ProvenanceexampleCommon Tags
Observation.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.identifier.userequiredIdentifierUse
Observation.identifier.typeextensibleIdentifier Type Codes
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservation Category Codes
Observation.category:observationCategoryrequiredObservation Category Codes
Observation.codepreferredCare Connect Observation Type
Observation.code.coding:snomedCTpreferredFixed Value: SNOMED CT code 1104051000000101
Observation.interpretationrequiredObservation Interpretation Codes
Observation.methodpreferredObservation Methods
Observation.referenceRange.typeextensibleObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToexampleObservation Reference Range Applies To Codes
Observation.related.typerequiredFixed Value: derived-from
Observation.component.codepreferredCare Connect Observation Type
Observation.component.code.coding:snomedCTpreferredCare Connect Observation Type
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason
Observation.component.interpretationextensibleObservation Interpretation Codes

Constraints

IdGradePath(s)DetailsRequirements
ele-1errorObservation.extension:reason, Observation.referenceRange, Observation.related, Observation.component.extension:valuePrecisionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1errorObservation.extension:reason, Observation.component.extension:valuePrecisionMust 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()

This structure is derived from InterweaveObservationAssessmentScore

Summary

Fixed Value: 2 elements

Differential View

This structure is derived from InterweaveObservationAssessmentScore

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*InterweaveObservationAssessmentScoreMeasurements and simple assertions
... code
.... coding:snomedCT 0..1CodingCode defined by a terminology system
..... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 1104051000000101
..... display 1..1stringRepresentation defined by the system
Fixed Value: Royal College of Physicians NEWS2 (National Early Warning Score 2) total score

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*InterweaveObservationAssessmentScoreMeasurements and simple assertions
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierBusiness Identifier for observation
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ1..1stringThe value that is unique
Example General: 123456
... status ?!SΣ1..1codeOnly finalised observations should be shared. We do also allow for amendments and corrections to the final observation to take place. We therefore limit the list of statuses which can be used to the following - final | amended | corrected
Binding: ObservationStatus (required)
Fixed Value: final
... Slices for category S1..1CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.system
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


.... category:observationCategory 1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (required): Codes for high level observation categories.


..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:All Slices Content/Rules for all slices
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
....... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: survey
....... display Σ1..1stringRepresentation defined by the system
Fixed Value: Survey
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Care Connect Observation Type (preferred)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT SΣ0..1CodingCode defined by a terminology system
Binding: Care Connect Observation Type (preferred)
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 1104051000000101
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Royal College of Physicians NEWS2 (National Early Warning Score 2) total score
... subject SΣ1..1Reference(CareConnectPatient1)The patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... display Σ1..1stringDescription of the referenced resource
... effective[x] SΣ1..1This is the time/time period during which the observation was taken.
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer SΣ0..*Reference(CareConnect-Practitioner-1)Who is responsible for the observation.
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... display Σ1..1stringDescription of the referenced resource
... value[x] SΣC0..1Actual result
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
... comment S0..1stringComments about the result
... referenceRange SC0..*BackboneElementProvides guide for interpretation
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... related SΣ0..*BackboneElementResources related to this observation
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: derived-from
.... target S1..1Reference(CareConnect-Observation-1)we limit the related field’s usage to only allow links to observation resources, from which the primary observation’s value was derived. E.g. An observation may have a value which is a score, and that score may have been derived from several other observations.

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.meta.tagexampleCommon Tags
Observation.meta.tag:SourceexampleCommon Tags
Observation.meta.tag:ProvenanceexampleCommon Tags
Observation.identifier.userequiredIdentifierUse
Observation.statusrequiredFixed Value: final
Observation.categorypreferredObservation Category Codes
Observation.category:observationCategoryrequiredObservation Category Codes
Observation.codepreferredCare Connect Observation Type
Observation.code.coding:snomedCTpreferredFixed Value: SNOMED CT code 1104051000000101
Observation.interpretationrequiredObservation Interpretation Codes
Observation.related.typerequiredFixed Value: derived-from
Observation.component.codepreferredCare Connect Observation Type
Observation.component.code.coding:snomedCTpreferredCare Connect Observation Type

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
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
: contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1errorObservation.extension:reason, Observation.referenceRange, Observation.related, Observation.component.extension:valuePrecisionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1errorObservation.extension:reason, Observation.component.extension:valuePrecisionMust 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 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()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*InterweaveObservationAssessmentScoreMeasurements and simple assertions
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - 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 Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... reason 0..*CodeableConcept, Reference(CareConnect-Condition-1)Reason resource added/performed/given
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ReasonCondition-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierBusiness Identifier for observation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ0..1CodeableConceptDescription 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 Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ1..1stringThe value that is unique
Example General: 123456
.... period Σ0..1PeriodTime period when id is/was valid for use
.... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)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 ?!SΣ1..1codeOnly finalised observations should be shared. We do also allow for amendments and corrections to the final observation to take place. We therefore limit the list of statuses which can be used to the following - final | amended | corrected
Binding: ObservationStatus (required)
Fixed Value: final
... Slices for category S1..1CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding.system
Binding: Observation Category Codes (preferred): Codes for high level observation categories.


.... category:observationCategory 1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (required): Codes for high level observation categories.


..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:All Slices Content/Rules for all slices
....... id 0..1stringxml:id (or equivalent in JSON)
....... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
....... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: survey
....... display Σ1..1stringRepresentation defined by the system
Fixed Value: Survey
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Care Connect Observation Type (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT SΣ0..1CodingCode defined by a terminology system
Binding: Care Connect Observation Type (preferred)
...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
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 Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 1104051000000101
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Royal College of Physicians NEWS2 (National Early Warning Score 2) total score
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(CareConnectPatient1)The patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context 0..1Reference(CareConnect-Encounter-1)The encounter during which this observation is made.
... effective[x] SΣ1..1This is the time/time period during which the observation was taken.
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer SΣ0..*Reference(CareConnect-Practitioner-1)Who is responsible for the observation.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... value[x] SΣC0..1Actual result
.... valueQuantityQuantity
.... valueCodeableConceptCodeableConcept
.... valueStringstring
.... valueBooleanboolean
.... valueRangeRange
.... valueRatioRatio
.... valueSampledDataSampledData
.... valueTimetime
.... valueDateTimedateTime
.... valuePeriodPeriod
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ1..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... comment S0..1stringComments about the result
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:snomedCT Σ0..1CodingCode defined by a terminology system
...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
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 Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... device 0..1Reference(Device)Measurement device.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
... referenceRange SC0..*BackboneElementProvides guide for interpretation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... related SΣ0..*BackboneElementResources related to this observation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type S1..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: derived-from
.... target