DRAFT Implementation Guide

This is for collaboration and discussion purposes and is subject to change.

NHS England North West GMSA - IHE Laboratory Testing Workflow (LTW) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Content
• Detailed Descriptions
• Examples
• XML
• JSON

Resource Profile: Observation

DRAFT Extension of UKCore-Observation

Usage:

• Derived from this Resource Profile: Observation Panel
• Refer to this Resource Profile: ServiceRequest

Formal Views of Profile Content

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

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

This structure is derived from UKCoreObservation

Name	Flags	Card.	Type	Description & Constraints
Observation			UKCoreObservation
status		1..1	code	Observation Status (HL7 v2 OBX-11)
code		1..1	CodeableConcept	The type of observation (code / type). (HL7 v2 OBX-3)
subject		1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
identifier		0..1	NHSNumber	Logical reference, when literal reference is not known
encounter	S	0..1	Reference(Encounter)	Healthcare event during which this observation is made
identifier	O	0..1	CorrelationIdentifier	Logical reference, when literal reference is not known Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	O	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation (HL7 v2 OBX-14) Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
performer		0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation.
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result (HL7 v2 OBX-5)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	Measurements and simple assertions dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:triggeredByR5	N	0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for extension		2..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:observation		1..1	Extension	Triggering observation ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation. ele-1: All FHIR elements must have a @value or children
extension:type		1..1	Extension	reflex | repeat | re-run Binding: observation-triggeredbytype (??) (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
url		1..1	uri	"type"
value[x]		1..1	code	The type of trigger. Reflex | Repeat | Re-run ele-1: All FHIR elements must have a @value or children
extension:reason		0..1	Extension	Reason that the observation was triggered ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered. ele-1: All FHIR elements must have a @value or children
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:bodyStructureR5	N	0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	Observation Status (HL7 v2 OBX-11) Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
category	S	0..*	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). (HL7 v2 OBX-3) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about. ele-1: All FHIR elements must have a @value or children
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
identifier	Σ	0..1	NHSNumber	Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children
encounter	SΣ	0..1	Reference(Encounter)	Healthcare event during which this observation is made ele-1: All FHIR elements must have a @value or children
identifier	OΣ	0..1	CorrelationIdentifier	Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	SOΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14) ele-1: All FHIR elements must have a @value or children Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣ	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation. ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	0..1		Actual result (HL7 v2 OBX-5) ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
component	SΣ	0..*	BackboneElement	Component / sub results. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.extension:triggeredByR5.extension:type []	required	http://hl7.org/fhir/ValueSet/observation-triggeredbytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
Observation.component.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:triggeredByR5	N	0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:observation		1..1	Extension	Triggering observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation.
extension:type		1..1	Extension	reflex | repeat | re-run Binding: observation-triggeredbytype (??) (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"type"
value[x]		1..1	code	The type of trigger. Reflex | Repeat | Re-run
extension:reason		0..1	Extension	Reason that the observation was triggered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:bodyStructureR5	N	0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	Observation Status (HL7 v2 OBX-11) Binding: ObservationStatus (required): Codes providing the status of an observation.
category	S	0..*	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). (HL7 v2 OBX-3) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
subject	SΣ	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	NHSNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	SΣ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	OΣ	0..1	CorrelationIdentifier	Logical reference, when literal reference is not known Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
display	Σ	0..1	string	Text alternative for the resource
effective[x]	SOΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14) Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation.
value[x]	SΣC	0..1		Actual result (HL7 v2 OBX-5)
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (preferred): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	SΣ	0..*	BackboneElement	Component / sub results.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
value[x]	Σ	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
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

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

This structure is derived from UKCoreObservation

Summary

Mandatory: 2 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• NHS Number (https://fhir.north-west.england.nhs.uk/StructureDefinition/NHSNumber)
• Encounter (https://fhir.north-west.england.nhs.uk/StructureDefinition/Encounter)
• Correlation Identifier (https://fhir.north-west.england.nhs.uk/StructureDefinition/CorrelationIdentifier)
• PractitionerRole (https://fhir.north-west.england.nhs.uk/StructureDefinition/PractitionerRole)
• Patient (https://fhir.north-west.england.nhs.uk/StructureDefinition/Patient)

Differential View

This structure is derived from UKCoreObservation

Name	Flags	Card.	Type	Description & Constraints
Observation			UKCoreObservation
status		1..1	code	Observation Status (HL7 v2 OBX-11)
code		1..1	CodeableConcept	The type of observation (code / type). (HL7 v2 OBX-3)
subject		1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
identifier		0..1	NHSNumber	Logical reference, when literal reference is not known
encounter	S	0..1	Reference(Encounter)	Healthcare event during which this observation is made
identifier	O	0..1	CorrelationIdentifier	Logical reference, when literal reference is not known Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	O	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation (HL7 v2 OBX-14) Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
performer		0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation.
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result (HL7 v2 OBX-5)
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	Measurements and simple assertions dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:triggeredByR5	N	0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for extension		2..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:observation		1..1	Extension	Triggering observation ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation. ele-1: All FHIR elements must have a @value or children
extension:type		1..1	Extension	reflex | repeat | re-run Binding: observation-triggeredbytype (??) (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
url		1..1	uri	"type"
value[x]		1..1	code	The type of trigger. Reflex | Repeat | Re-run ele-1: All FHIR elements must have a @value or children
extension:reason		0..1	Extension	Reason that the observation was triggered ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered. ele-1: All FHIR elements must have a @value or children
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:bodyStructureR5	N	0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	Observation Status (HL7 v2 OBX-11) Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
category	S	0..*	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). (HL7 v2 OBX-3) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about. ele-1: All FHIR elements must have a @value or children
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
identifier	Σ	0..1	NHSNumber	Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children
encounter	SΣ	0..1	Reference(Encounter)	Healthcare event during which this observation is made ele-1: All FHIR elements must have a @value or children
identifier	OΣ	0..1	CorrelationIdentifier	Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	SOΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14) ele-1: All FHIR elements must have a @value or children Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣ	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation. ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	0..1		Actual result (HL7 v2 OBX-5) ele-1: All FHIR elements must have a @value or children
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
component	SΣ	0..*	BackboneElement	Component / sub results. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.extension:triggeredByR5.extension:type []	required	http://hl7.org/fhir/ValueSet/observation-triggeredbytype http://hl7.org/fhir/ValueSet/observation-triggeredbytype
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType
Observation.component.code	preferred	UKCoreObservationType https://fhir.hl7.org.uk/ValueSet/UKCore-ObservationType

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:triggeredByR5	N	0..*	(Complex)	Triggering observation(s). This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:observation		1..1	Extension	Triggering observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation.
extension:type		1..1	Extension	reflex | repeat | re-run Binding: observation-triggeredbytype (??) (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"type"
value[x]		1..1	code	The type of trigger. Reflex | Repeat | Re-run
extension:reason		0..1	Extension	Reason that the observation was triggered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"reason"
value[x]		1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
extension:bodyStructureR5	N	0..1	Reference(BodyStructure)	Observed body structure. This is a R5 backport. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.bodyStructure
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	Observation Status (HL7 v2 OBX-11) Binding: ObservationStatus (required): Codes providing the status of an observation.
category	S	0..*	CodeableConcept	A code that classifies the general type of observation being made. Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of observation (code / type). (HL7 v2 OBX-3) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
subject	SΣ	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	NHSNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	SΣ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	OΣ	0..1	CorrelationIdentifier	Logical reference, when literal reference is not known Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
display	Σ	0..1	string	Text alternative for the resource
effective[x]	SOΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14) Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation.
value[x]	SΣC	0..1		Actual result (HL7 v2 OBX-5)
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (preferred): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	SΣ	0..*	BackboneElement	Component / sub results.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: UK Core Observation Type (preferred): A code from the SNOMED Clinical Terminology UK coding system describing a type of observation
value[x]	Σ	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
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

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

This structure is derived from UKCoreObservation

Summary

Mandatory: 2 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• NHS Number (https://fhir.north-west.england.nhs.uk/StructureDefinition/NHSNumber)
• Encounter (https://fhir.north-west.england.nhs.uk/StructureDefinition/Encounter)
• Correlation Identifier (https://fhir.north-west.england.nhs.uk/StructureDefinition/CorrelationIdentifier)
• PractitionerRole (https://fhir.north-west.england.nhs.uk/StructureDefinition/PractitionerRole)
• Patient (https://fhir.north-west.england.nhs.uk/StructureDefinition/Patient)

Other representations of profile: CSV, Excel, Schematron