Amakomaya Nepal FHIR Implementation Guide
2.0.0 - ci-build Nepal

Amakomaya Nepal FHIR Implementation Guide - Local Development build (v2.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AMK Core Observation Profile

Official URL: https://fhir.amakomaya.com/StructureDefinition/amk-observation Version: 2.0.0
Active as of 2026-08-21 Computable Name: AMKCoreObservation

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Observation Profile

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-10, obs-11, obs-12
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... code ΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: Observation ValueSet (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus ?!Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime Σ 1..1 dateTime Clinically relevant time/time-period for observation
... value[x] ΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... valueAttachment Attachment
... dataAbsentReason C 0..1 CodeableConcept Why the result value is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... component ΣC 0..* BackboneElement Component results
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... code ΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCObsOrBoth (example): Codes identifying names of simple observations.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required Observation Status 📍6.0.0-ballot5 FHIR Std.
Observation.code Base required Observation ValueSet 📦2.0.0 This IG
Observation.dataAbsentReason Base extensible Data Absent Reason 📍6.0.0-ballot5 FHIR Std.
Observation.component.​code Base example LOINC codes with Observation or Both 📍6.0.0-ballot5 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
obs-6 error Observation Observation.dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-10 error Observation Observation.component.dataAbsentReason SHALL only be present if Observation.component.value[x] is not present component.empty() or component.where(dataAbsentReason.exists()).all(value.empty())
obs-11 error Observation if organizer exists and organizer = true, then value[x], dataAbsentReason and component SHALL NOT be present (organizer.exists() and organizer.allTrue()) implies (value.empty() and dataAbsentReason.empty() and component.empty())
obs-12 warning Observation All observations SHOULD have a performer performer.exists()

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... status 1..1 code registered | in-process | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
Required Pattern: final
... code 1..1 CodeableConcept Type of observation (code / type)
Binding: Observation ValueSet (required)
... subject S 1..1 Reference(Patient) Who and/or what the observation is about
.... effective[x]:effectiveDateTime 1..1 dateTime Clinically relevant time/time-period for observation
... value[x] 1..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment Actual result

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required Observation ValueSet 📦2.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-10, obs-11, obs-12
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... triggeredBy 0..* BackboneElement Triggering observation(s)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... observation Σ 1..1 Reference(Observation) Triggering observation
.... type Σ 1..1 code reflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
.... reason 0..1 string Reason that the observation was triggered
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | in-process | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... statusReason 0..1 CodeableConcept Reason for current status
Binding: ObservationStatusReason (example): Codes identifying the reason for the current state of an observation.
... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code ΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: Observation ValueSet (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus ?!Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... organizer ΣC 0..1 boolean This observation organizes/groups a set of sub-observations
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime Σ 1..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService | Group) Who is responsible for the observation
... value[x] ΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... valueAttachment Attachment
... dataAbsentReason C 0..1 CodeableConcept Why the result value is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... context 0..* CodeableReference(Resource) Context for understanding the observation
Binding: ObservationContextCodes (example): Codes identifying contextual factors that affect interpretation of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept DEPRECATED: Observed body part
... bodyStructure 0..* CodeableReference(BodyStructure) Observed body structure
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body Structures
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen C 0..1 Reference(Specimen | Group) Specimen used for this observation
Constraints: obs-9
... device 0..1 Reference(Device | DeviceMetric) A reference to the device that generates the measurements or the device settings for the device
... supportingDevice 0..* CodeableReference(Device) Device supporting generation of the measurement
Binding: DeviceType (example): Type of device supporting the generation of the measurement.
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... low C 0..1 Quantity Low Range, if relevant
Constraints: obs-13
.... high C 0..1 Quantity High Range, if relevant
Constraints: obs-14
.... normalValue 0..1 CodeableConcept Normal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (example): Codes identifying the normal value of the observation.
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text C 0..1 markdown Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation) Related resource from which the observation is made
... component ΣC 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... code ΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCObsOrBoth (example): Codes identifying names of simple observations.
.... value[x] ΣC 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
..... valueAttachment Attachment
.... dataAbsentReason C 0..1 CodeableConcept Why the component result value is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result value

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base required All Languages 📍6.0.0-ballot5 FHIR Std.
Observation.triggeredBy.​type Base required triggered Bytype 📍6.0.0-ballot5 FHIR Std.
Observation.status Base required Observation Status 📍6.0.0-ballot5 FHIR Std.
Observation.statusReason Base example Observation Status Reason 📍6.0.0-ballot5 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍6.0.0-ballot5 FHIR Std.
Observation.code Base required Observation ValueSet 📦2.0.0 This IG
Observation.dataAbsentReason Base extensible Data Absent Reason 📍6.0.0-ballot5 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍6.0.0-ballot5 FHIR Std.
Observation.context Base example Observation Context Codes 📍6.0.0-ballot5 FHIR Std.
Observation.bodyStructure Base example SNOMED CT Body Structures 📍6.0.0-ballot5 FHIR Std.
Observation.method Base example Observation Methods 📍6.0.0-ballot5 FHIR Std.
Observation.supportingDevice Base example Device Type 📍6.0.0-ballot5 FHIR Std.
Observation.referenceRange.​normalValue Base example Observation Reference Range Normal Value Codes 📍6.0.0-ballot5 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍6.0.0-ballot5 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍6.0.0-ballot5 FHIR Std.
Observation.component.​code Base example LOINC codes with Observation or Both 📍6.0.0-ballot5 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Data Absent Reason 📍6.0.0-ballot5 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍6.0.0-ballot5 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation Observation.dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-9 error Observation.specimen If Observation.specimen is a reference to Group, the group can only have specimens (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)
obs-10 error Observation Observation.component.dataAbsentReason SHALL only be present if Observation.component.value[x] is not present component.empty() or component.where(dataAbsentReason.exists()).all(value.empty())
obs-11 error Observation if organizer exists and organizer = true, then value[x], dataAbsentReason and component SHALL NOT be present (organizer.exists() and organizer.allTrue()) implies (value.empty() and dataAbsentReason.empty() and component.empty())
obs-12 warning Observation All observations SHOULD have a performer performer.exists()
obs-13 error Observation.referenceRange.low If low.comparator exists, it must be '>=' or '>'. comparator.exists() implies (comparator = '>=' or comparator = '>')
obs-14 error Observation.referenceRange.high If high.comparator exists, it must be '<=' or '<'. comparator.exists() implies (comparator = '<=' or comparator = '<')

This structure is derived from Observation

Summary

Mandatory: 4 elements
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.effective[x]

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-10, obs-11, obs-12
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... code ΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: Observation ValueSet (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus ?!Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime Σ 1..1 dateTime Clinically relevant time/time-period for observation
... value[x] ΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... valueAttachment Attachment
... dataAbsentReason C 0..1 CodeableConcept Why the result value is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... component ΣC 0..* BackboneElement Component results
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... code ΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCObsOrBoth (example): Codes identifying names of simple observations.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required Observation Status 📍6.0.0-ballot5 FHIR Std.
Observation.code Base required Observation ValueSet 📦2.0.0 This IG
Observation.dataAbsentReason Base extensible Data Absent Reason 📍6.0.0-ballot5 FHIR Std.
Observation.component.​code Base example LOINC codes with Observation or Both 📍6.0.0-ballot5 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
obs-6 error Observation Observation.dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-10 error Observation Observation.component.dataAbsentReason SHALL only be present if Observation.component.value[x] is not present component.empty() or component.where(dataAbsentReason.exists()).all(value.empty())
obs-11 error Observation if organizer exists and organizer = true, then value[x], dataAbsentReason and component SHALL NOT be present (organizer.exists() and organizer.allTrue()) implies (value.empty() and dataAbsentReason.empty() and component.empty())
obs-12 warning Observation All observations SHOULD have a performer performer.exists()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... status 1..1 code registered | in-process | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
Required Pattern: final
... code 1..1 CodeableConcept Type of observation (code / type)
Binding: Observation ValueSet (required)
... subject S 1..1 Reference(Patient) Who and/or what the observation is about
.... effective[x]:effectiveDateTime 1..1 dateTime Clinically relevant time/time-period for observation
... value[x] 1..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period, Attachment Actual result

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required Observation ValueSet 📦2.0.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-10, obs-11, obs-12
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... triggeredBy 0..* BackboneElement Triggering observation(s)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... observation Σ 1..1 Reference(Observation) Triggering observation
.... type Σ 1..1 code reflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
.... reason 0..1 string Reason that the observation was triggered
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!Σ 1..1 code registered | in-process | specimen-in-process | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | unknown | cannot-be-obtained
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... statusReason 0..1 CodeableConcept Reason for current status
Binding: ObservationStatusReason (example): Codes identifying the reason for the current state of an observation.
... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code ΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: Observation ValueSet (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus ?!Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
... organizer ΣC 0..1 boolean This observation organizes/groups a set of sub-observations
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made. If you need to place the observation within one or more episodes of care, use the workflow-episodeOfCare extension
... Slices for effective[x] Σ 1..1 dateTime Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this
.... effective[x]:effectiveDateTime Σ 1..1 dateTime Clinically relevant time/time-period for observation
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService | Group) Who is responsible for the observation
... value[x] ΣC 1..1 Actual result
.... valueQuantity Quantity
.... valueCodeableConcept CodeableConcept
.... valueString string
.... valueBoolean boolean
.... valueInteger integer
.... valueRange Range
.... valueRatio Ratio
.... valueSampledData SampledData
.... valueTime time
.... valueDateTime dateTime
.... valuePeriod Period
.... valueAttachment Attachment
... dataAbsentReason C 0..1 CodeableConcept Why the result value is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... context 0..* CodeableReference(Resource) Context for understanding the observation
Binding: ObservationContextCodes (example): Codes identifying contextual factors that affect interpretation of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept DEPRECATED: Observed body part
... bodyStructure 0..* CodeableReference(BodyStructure) Observed body structure
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body Structures
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen C 0..1 Reference(Specimen | Group) Specimen used for this observation
Constraints: obs-9
... device 0..1 Reference(Device | DeviceMetric) A reference to the device that generates the measurements or the device settings for the device
... supportingDevice 0..* CodeableReference(Device) Device supporting generation of the measurement
Binding: DeviceType (example): Type of device supporting the generation of the measurement.
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... low C 0..1 Quantity Low Range, if relevant
Constraints: obs-13
.... high C 0..1 Quantity High Range, if relevant
Constraints: obs-14
.... normalValue 0..1 CodeableConcept Normal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (example): Codes identifying the normal value of the observation.
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text C 0..1 markdown Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation) Related resource from which the observation is made
... component ΣC 0..* BackboneElement Component results
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... code ΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCObsOrBoth (example): Codes identifying names of simple observations.
.... value[x] ΣC 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
..... valueAttachment Attachment
.... dataAbsentReason C 0..1 CodeableConcept Why the component result value is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result value

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base required All Languages 📍6.0.0-ballot5 FHIR Std.
Observation.triggeredBy.​type Base required triggered Bytype 📍6.0.0-ballot5 FHIR Std.
Observation.status Base required Observation Status 📍6.0.0-ballot5 FHIR Std.
Observation.statusReason Base example Observation Status Reason 📍6.0.0-ballot5 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍6.0.0-ballot5 FHIR Std.
Observation.code Base required Observation ValueSet 📦2.0.0 This IG
Observation.dataAbsentReason Base extensible Data Absent Reason 📍6.0.0-ballot5 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍6.0.0-ballot5 FHIR Std.
Observation.context Base example Observation Context Codes 📍6.0.0-ballot5 FHIR Std.
Observation.bodyStructure Base example SNOMED CT Body Structures 📍6.0.0-ballot5 FHIR Std.
Observation.method Base example Observation Methods 📍6.0.0-ballot5 FHIR Std.
Observation.supportingDevice Base example Device Type 📍6.0.0-ballot5 FHIR Std.
Observation.referenceRange.​normalValue Base example Observation Reference Range Normal Value Codes 📍6.0.0-ballot5 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍6.0.0-ballot5 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍6.0.0-ballot5 FHIR Std.
Observation.component.​code Base example LOINC codes with Observation or Both 📍6.0.0-ballot5 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Data Absent Reason 📍6.0.0-ballot5 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍6.0.0-ballot5 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation Observation.dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-9 error Observation.specimen If Observation.specimen is a reference to Group, the group can only have specimens (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)
obs-10 error Observation Observation.component.dataAbsentReason SHALL only be present if Observation.component.value[x] is not present component.empty() or component.where(dataAbsentReason.exists()).all(value.empty())
obs-11 error Observation if organizer exists and organizer = true, then value[x], dataAbsentReason and component SHALL NOT be present (organizer.exists() and organizer.allTrue()) implies (value.empty() and dataAbsentReason.empty() and component.empty())
obs-12 warning Observation All observations SHOULD have a performer performer.exists()
obs-13 error Observation.referenceRange.low If low.comparator exists, it must be '>=' or '>'. comparator.exists() implies (comparator = '>=' or comparator = '>')
obs-14 error Observation.referenceRange.high If high.comparator exists, it must be '<=' or '<'. comparator.exists() implies (comparator = '<=' or comparator = '<')

This structure is derived from Observation

Summary

Mandatory: 4 elements
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.effective[x]

 

Other representations of profile: CSV, Excel, Schematron