Interweave Implementation Guide
0.1.0 - ci-build

Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the R4 profiles here.

Resource Profile: InterweaveObservationVitalSigns

Official URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-Observation-VitalSigns Version: 0.1.0
Active as of 2024-07-17 Computable Name: InterweaveObservationVitalSigns

Interweave Vital Signs Observation resource profile.

  Status: Active: Approved (STU)

Introduction

This profile sets out the expectations for the interweave vital signs observation resource. The base for this profile is the CareConnect-VitalSigns-Observation-1 and we have made little adjustment to this base profile. We have enforced the use of SNOMED codes where possible.

Mandatory fields

The following mandatory fields are defined:

  1. status – Fixed value of ‘final’.

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

  3. code – Fixed value of SCT: 118227000 (Vital Signs).

  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.

Must Support fields

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

  1. valueQuantity – Vital Sign Value recorded with UCUM. We cannot make the field mandatory, as there maybe occasions where a result is missing (see dataAbsentReason below) or the result may be housed within the component field instead. Inline with R4, we have removed the valueAttachment field and pre-adopted the valueInteger field.

  2. Component – The component field is used to house multiple code/value pairs which make up a single result, such as systolic and diastolic measurements which in combination represent blood pressure. If the display order of values held in the component field has importance, then they should be provided in the order in which they should be displayed. As with the value[x] field, we have removed the valueAttachment field and pre-adopted the valueInteger field, to be inline with R4.

  3. dataAbsentReason – The reason why the result is missing, this is valuable if a value has not been obtained for some reason e.g. a patient refused. This field can only be provided when there is no value present.

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

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

  6. 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.

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

  8. 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.

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.

  • bodySite – A long list of SNOMED codes which represent the observed parts of the body.

  • context – Optional link to an encounter resource.

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

  • specimen – Opportunity to provide a link to a specimen resource from which the observation was obtained.

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

  • related – To reduce complexity, 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.

Discouraged or Removed fields

  • 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 CareConnect-VitalSigns-Observation-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*CareConnect-VitalSigns-Observation-1Measurements and simple assertions
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
... 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
... 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
... identifier S0..*IdentifierBusiness Identifier for observation
... basedOn 0..*Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | CareConnect-MedicationRequest-1 | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)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 1..1codeFixed value of ‘final’.
... category 1..1CodeableConceptClassification of type of observation
.... coding
..... display 1..1stringRepresentation defined by the system
... code
.... coding:loinc 1..1CodingCode defined by a terminology system
..... display 1..1stringRepresentation defined by the system
Fixed Value: Vital signs, weight, height, head circumference, oxygen saturation & BMI panel
... subject 1..1Reference(CareConnectPatient1)The patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... context 0..1Reference(CareConnect-Encounter-1)The encounter during which this observation is made.
... effective[x] 1..1dateTime, PeriodThis is the time/time period during which the observation was taken.
... issued 0..0
... performer S0..*Reference(CareConnect-Practitioner-1)Who is responsible for the observation.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... value[x] S0..1QuantityActual result.
... dataAbsentReason 0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (required)
.... coding
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... coding
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... comment S0..1stringComments about the result
... bodySite S0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (required)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (preferred)
.... coding 0..*CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... specimen 0..1Reference(CareConnect-Specimen-1)Specimen used for this observation.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... device 0..1Reference(Device)Measurement device.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... referenceRange S0..*BackboneElementProvides guide for interpretation
... related 0..*BackboneElementResources related to this observation
.... type S1..1codeFixed 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 (Differential)

PathConformanceValueSet
Observation.dataAbsentReasonrequiredObservation Value Absent Reason
Observation.interpretationrequiredObservation Interpretation Codes
Observation.bodySiterequiredSNOMED CT Body Structures
Observation.methodpreferredObservation Methods
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*CareConnect-VitalSigns-Observation-1Measurements 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
.... 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"


...... 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
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... 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
... 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
.... 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
... basedOn Σ0..*Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | CareConnect-MedicationRequest-1 | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)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..1codeFixed value of ‘final’.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories


.... coding SΣ1..1CodingCode defined by a terminology system
..... 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: vital-signs
..... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital Signs
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types.

.... Slices for coding Σ1..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 85353-1
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs, weight, height, head circumference, oxygen saturation & BMI panel
..... coding:snomedCT Σ1..1CodingCode defined by a terminology system
...... 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: 118227000
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs
... 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)
.... 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.
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... Slices for value[x] SΣC0..1QuantityActual result.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣC0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (required)
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
... comment S0..1stringComments about the result
... bodySite S0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (required)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..1CodingCode 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|).


...... 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
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (preferred)
.... 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
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK


...... 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
... specimen 0..1Reference(CareConnect-Specimen-1)Specimen used for this observation.
.... 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
... device 0..1Reference(Device)Measurement device.
.... 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
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... related Σ0..*BackboneElementResources related to this observation
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type S1..1codeFixed value: derived-from
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: has-member
.... 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.
... component SΣ0..*BackboneElementComponent results
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code
...... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code Σ1..1codeSymbol in syntax defined by the system
...... coding:snomedCT Σ1..1CodingCode defined by a terminology system
....... 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
.... Slices for value[x] Σ0..1QuantityActual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ0..1QuantityActual component result
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines the Unified Code for Units of Measure (UCUM).
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

.... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


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.statusrequiredFixed Value: final
Observation.categorypreferredObservation Category Codes
Observation.codeextensibleVital Signs
Observation.code.coding:loincextensibleFixed Value: LOINC code 85353-1
Observation.value[x]:valueQuantityrequiredVital Signs Units
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.dataAbsentReasonrequiredObservation Value Absent Reason
Observation.interpretationrequiredObservation Interpretation Codes
Observation.bodySiterequiredSNOMED CT Body Structures
Observation.bodySite.coding:snomedCTpreferredCare Connect Body Site
Observation.methodpreferredObservation Methods
Observation.method.coding:snomedCTpreferredCare Connect Observation Method
Observation.related.typerequiredFixed Value: has-member
Observation.component.codeextensibleVital Signs
Observation.component.code.coding:loincextensibleVital Signs
Observation.component.value[x]:valueQuantityrequiredVital Signs Units
Observation.component.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.component.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason

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-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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..*CareConnect-VitalSigns-Observation-1Measurements 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
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... 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(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | CareConnect-MedicationRequest-1 | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)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..1codeFixed value of ‘final’.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred): 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
.... coding SΣ1..1CodingCode 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
Fixed Value: http://hl7.org/fhir/observation-category
..... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital Signs
..... 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: Vital Signs (extensible): This value set indicates the allowed vital sign result types.

.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ1..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


...... 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://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 85353-1
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs, weight, height, head circumference, oxygen saturation & BMI panel
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:snomedCT Σ1..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
Fixed Value: 118227000
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs
...... 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
... Slices for value[x] SΣC0..1QuantityActual result.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣC0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (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
... 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
... bodySite S0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (required)
.... 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 Σ0..1CodingCode 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..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
... 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..*CodingCode defined by a terminology system
Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK


...... 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
... specimen 0..1Reference(CareConnect-Specimen-1)Specimen used for this 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 Σ0..1stringIf relevant, description of the referenced resource
... 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 Σ0..*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..1codeFixed value: derived-from
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: has-member
.... 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.
... component SΣ0..*BackboneElementComponent results
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
..... 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:code
...... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


....... 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://loinc.org
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:snomedCT Σ1..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
.... Slices for value[x] Σ0..1QuantityActual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ0..1QuantityActual component result
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines the Unified Code for Units of Measure (UCUM).
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

.... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... 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 Σ0..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... interpretation 0..1CodeableConceptHigh, 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

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.codeextensibleVital Signs
Observation.code.coding:loincextensibleFixed Value: LOINC code 85353-1
Observation.value[x]:valueQuantityrequiredVital Signs Units
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.dataAbsentReasonrequiredObservation Value Absent Reason
Observation.interpretationrequiredObservation Interpretation Codes
Observation.bodySiterequiredSNOMED CT Body Structures
Observation.bodySite.coding:snomedCTpreferredCare Connect Body Site
Observation.methodpreferredObservation Methods
Observation.method.coding:snomedCTpreferredCare Connect Observation Method
Observation.referenceRange.typeextensibleObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToexampleObservation Reference Range Applies To Codes
Observation.related.typerequiredFixed Value: has-member
Observation.component.codeextensibleVital Signs
Observation.component.code.coding:loincextensibleVital Signs
Observation.component.value[x]:valueQuantityrequiredVital Signs Units
Observation.component.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.component.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason
Observation.component.interpretationextensibleObservation Interpretation Codes

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()

This structure is derived from CareConnect-VitalSigns-Observation-1

Summary

Mandatory: 4 elements (21 nested mandatory elements)
Must-Support: 19 elements
Fixed Value: 3 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.meta.tag is sliced based on the value of value:system

Differential View

This structure is derived from CareConnect-VitalSigns-Observation-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*CareConnect-VitalSigns-Observation-1Measurements and simple assertions
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
... 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
... 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
... identifier S0..*IdentifierBusiness Identifier for observation
... basedOn 0..*Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | CareConnect-MedicationRequest-1 | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)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 1..1codeFixed value of ‘final’.
... category 1..1CodeableConceptClassification of type of observation
.... coding
..... display 1..1stringRepresentation defined by the system
... code
.... coding:loinc 1..1CodingCode defined by a terminology system
..... display 1..1stringRepresentation defined by the system
Fixed Value: Vital signs, weight, height, head circumference, oxygen saturation & BMI panel
... subject 1..1Reference(CareConnectPatient1)The patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... context 0..1Reference(CareConnect-Encounter-1)The encounter during which this observation is made.
... effective[x] 1..1dateTime, PeriodThis is the time/time period during which the observation was taken.
... issued 0..0
... performer S0..*Reference(CareConnect-Practitioner-1)Who is responsible for the observation.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... value[x] S0..1QuantityActual result.
... dataAbsentReason 0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (required)
.... coding
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... coding
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... comment S0..1stringComments about the result
... bodySite S0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (required)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (preferred)
.... coding 0..*CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... specimen 0..1Reference(CareConnect-Specimen-1)Specimen used for this observation.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... device 0..1Reference(Device)Measurement device.
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... referenceRange S0..*BackboneElementProvides guide for interpretation
... related 0..*BackboneElementResources related to this observation
.... type S1..1codeFixed 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 (Differential)

PathConformanceValueSet
Observation.dataAbsentReasonrequiredObservation Value Absent Reason
Observation.interpretationrequiredObservation Interpretation Codes
Observation.bodySiterequiredSNOMED CT Body Structures
Observation.methodpreferredObservation Methods

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*CareConnect-VitalSigns-Observation-1Measurements 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
.... 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"


...... 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
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... 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
... 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
.... 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
... basedOn Σ0..*Reference(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | CareConnect-MedicationRequest-1 | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)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..1codeFixed value of ‘final’.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred): Codes for high level observation categories


.... coding SΣ1..1CodingCode defined by a terminology system
..... 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: vital-signs
..... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital Signs
... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types.

.... Slices for coding Σ1..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 85353-1
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs, weight, height, head circumference, oxygen saturation & BMI panel
..... coding:snomedCT Σ1..1CodingCode defined by a terminology system
...... 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: 118227000
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs
... 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)
.... 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.
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... Slices for value[x] SΣC0..1QuantityActual result.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣC0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (required)
... interpretation S0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
... comment S0..1stringComments about the result
... bodySite S0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (required)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..1CodingCode 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|).


...... 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
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (preferred)
.... 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
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK


...... 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
... specimen 0..1Reference(CareConnect-Specimen-1)Specimen used for this observation.
.... 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
... device 0..1Reference(Device)Measurement device.
.... 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
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... related Σ0..*BackboneElementResources related to this observation
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type S1..1codeFixed value: derived-from
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: has-member
.... 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.
... component SΣ0..*BackboneElementComponent results
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code
...... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
....... code Σ1..1codeSymbol in syntax defined by the system
...... coding:snomedCT Σ1..1CodingCode defined by a terminology system
....... 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
.... Slices for value[x] Σ0..1QuantityActual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ0..1QuantityActual component result
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines the Unified Code for Units of Measure (UCUM).
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

.... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


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.statusrequiredFixed Value: final
Observation.categorypreferredObservation Category Codes
Observation.codeextensibleVital Signs
Observation.code.coding:loincextensibleFixed Value: LOINC code 85353-1
Observation.value[x]:valueQuantityrequiredVital Signs Units
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.dataAbsentReasonrequiredObservation Value Absent Reason
Observation.interpretationrequiredObservation Interpretation Codes
Observation.bodySiterequiredSNOMED CT Body Structures
Observation.bodySite.coding:snomedCTpreferredCare Connect Body Site
Observation.methodpreferredObservation Methods
Observation.method.coding:snomedCTpreferredCare Connect Observation Method
Observation.related.typerequiredFixed Value: has-member
Observation.component.codeextensibleVital Signs
Observation.component.code.coding:loincextensibleVital Signs
Observation.component.value[x]:valueQuantityrequiredVital Signs Units
Observation.component.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.component.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason

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-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()
obs-6errorObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
obs-7errorObservationIf 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..*CareConnect-VitalSigns-Observation-1Measurements 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
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... 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(CareConnect-CarePlan-1 | DeviceRequest | ImmunizationRecommendation | CareConnect-MedicationRequest-1 | NutritionOrder | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)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..1codeFixed value of ‘final’.
Binding: ObservationStatus (required): Codes providing the status of an observation.


Fixed Value: final
... category S1..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (preferred): 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
.... coding SΣ1..1CodingCode 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
Fixed Value: http://hl7.org/fhir/observation-category
..... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: vital-signs
..... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital Signs
..... 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: Vital Signs (extensible): This value set indicates the allowed vital sign result types.

.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ1..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


...... 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://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 85353-1
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs, weight, height, head circumference, oxygen saturation & BMI panel
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:snomedCT Σ1..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
Fixed Value: 118227000
...... display Σ1..1stringRepresentation defined by the system
Fixed Value: Vital signs
...... 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
... Slices for value[x] SΣC0..1QuantityActual result.
Slice: Unordered, Closed by type:$this
.... value[x]:valueQuantity SΣC0..1QuantityVital Sign Value recorded with UCUM
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... value SΣ1..1decimalNumerical value (with implicit precision)
..... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

..... unit SΣ1..1stringUnit representation
..... system SΣC1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
..... code SΣ1..1codeCoded form of the unit
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
Binding: Observation Value Absent Reason (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
... 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
... bodySite S0..1CodeableConceptObserved body part
Binding: SNOMED CT Body Structures (required)
.... 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 Σ0..1CodingCode 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..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
... 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..*CodingCode defined by a terminology system
Binding: Care Connect Observation Method (preferred): A code from SNOMED Clinical Terminology UK


...... 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
... specimen 0..1Reference(CareConnect-Specimen-1)Specimen used for this 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 Σ0..1stringIf relevant, description of the referenced resource
... 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 Σ0..*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..1codeFixed value: derived-from
Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.


Fixed Value: has-member
.... 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.
... component SΣ0..*BackboneElementComponent results
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code SΣ1..1CodeableConceptType of component observation (code / type)
Binding: Vital Signs (extensible)
..... 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:code
...... coding:loinc Σ1..1CodingCode defined by a terminology system
Binding: Vital Signs (extensible): This value set indicates the allowed vital sign result types


....... 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://loinc.org
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:snomedCT Σ1..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
.... Slices for value[x] Σ0..1QuantityActual component result
Slice: Unordered, Closed by type:$this
..... value[x]:valueQuantity SΣ0..1QuantityActual component result
Binding: Vital Signs Units (required): A value set describing common UCUM units for recording vital signs

...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... value SΣ1..1decimalNumerical value (with implicit precision)
...... comparator ?!Σ0..1code< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

...... unit SΣ1..1stringUnit representation
...... system SΣC1..1uriSystem that defines the Unified Code for Units of Measure (UCUM).
Fixed Value: http://unitsofmeasure.org
...... code SΣ1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: Vital Signs Units (required): A value set for common UCUM units for recording vital signs

.... dataAbsentReason SC0..1CodeableConceptWhy the component result is missing
Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

..... 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 Σ0..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... interpretation 0..1CodeableConceptHigh, 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

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.codeextensibleVital Signs
Observation.code.coding:loincextensibleFixed Value: LOINC code 85353-1
Observation.value[x]:valueQuantityrequiredVital Signs Units
Observation.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.dataAbsentReasonrequiredObservation Value Absent Reason
Observation.interpretationrequiredObservation Interpretation Codes
Observation.bodySiterequiredSNOMED CT Body Structures
Observation.bodySite.coding:snomedCTpreferredCare Connect Body Site
Observation.methodpreferredObservation Methods
Observation.method.coding:snomedCTpreferredCare Connect Observation Method
Observation.referenceRange.typeextensibleObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToexampleObservation Reference Range Applies To Codes
Observation.related.typerequiredFixed Value: has-member
Observation.component.codeextensibleVital Signs
Observation.component.code.coding:loincextensibleVital Signs
Observation.component.value[x]:valueQuantityrequiredVital Signs Units
Observation.component.value[x]:valueQuantity.comparatorrequiredQuantityComparator
Observation.component.value[x]:valueQuantity.coderequiredVital Signs Units
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason
Observation.component.interpretationextensibleObservation Interpretation Codes

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
obs-3errorObservation.referenceRangeMust have at least a low or a high or text
: low.exists() or high.exists() or text.exists()

This structure is derived from CareConnect-VitalSigns-Observation-1

Summary

Mandatory: 4 elements (21 nested mandatory elements)
Must-Support: 19 elements
Fixed Value: 3 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.meta.tag is sliced based on the value of value:system

 

Other representations of profile: CSV, Excel, Schematron