DRAFT Implementation Guide

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

North West Genomics Testing Workflow (GTW) - 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
effective[x]		0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation (HL7 v2 OBX-14)
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-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated 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-6: A resource should have narrative for robust management dom-5: If a resource is contained in another resource, it SHALL NOT have a security label 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 obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not 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
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	N	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	N	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]	N	1..1	Reference(Observation)	Triggering observation. ele-1: All FHIR elements must have a @value or children
extension:type	N	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]	N	1..1	code	The type of trigger. Reflex | Repeat | Re-run ele-1: All FHIR elements must have a @value or children
extension:reason	N	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]	N	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"
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	?!N	0..*	Extension	Extensions that cannot be ignored 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
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	SΣC	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 ref-1: SHALL have a contained resource if a local reference is provided
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
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14) ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣC	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation. ele-1: All FHIR elements must have a @value or children ref-1: SHALL have a contained resource if a local reference is provided
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
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
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
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. 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.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason 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

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	Measurements and simple assertions 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 obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not 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	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
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	N	2..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:observation	N	1..1	Extension	Triggering observation
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"observation"
value[x]	N	1..1	Reference(Observation)	Triggering observation.
extension:type	N	1..1	Extension	reflex | repeat | re-run Binding: observation-triggeredbytype (??) (required)
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"type"
value[x]	N	1..1	code	The type of trigger. Reflex | Repeat | Re-run
extension:reason	N	0..1	Extension	Reason that the observation was triggered
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"reason"
value[x]	N	1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
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	?!N	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	ΣC	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order ref-1: SHALL have a contained resource if a local reference is provided
partOf	ΣC	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event ref-1: SHALL have a contained resource if a local reference is provided
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	SΣC	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about. ref-1: SHALL have a contained resource if a local reference is provided
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	ΣC	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record ref-1: SHALL have a contained resource if a local reference is provided
encounter	ΣC	0..1	Reference(Encounter)	Healthcare event during which this observation is made ref-1: SHALL have a contained resource if a local reference is provided
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14)
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣC	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation. ref-1: SHALL have a contained resource if a local reference is provided
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	C	0..1	Reference(Specimen)	Specimen used for this observation ref-1: SHALL have a contained resource if a local reference is provided
device	C	0..1	Reference(Device | DeviceMetric)	(Measurement) Device ref-1: SHALL have a contained resource if a local reference is provided
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	N	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
low	C	0..1	SimpleQuantity	Low Range, if relevant qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
high	C	0..1	SimpleQuantity	High Range, if relevant qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
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	C	0..1	Range	Applicable age range, if relevant rng-2: If present, low SHALL have a lower value than high
text		0..1	string	Text based reference range in an observation
hasMember	ΣC	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group ref-1: SHALL have a contained resource if a local reference is provided
derivedFrom	ΣC	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from ref-1: SHALL have a contained resource if a local reference is provided
component	SΣ	0..*	BackboneElement	Component / sub results.
id		0..1	string	Unique id for inter-element referencing
extension	N	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
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.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: 1 element

Structures

This structure refers to these other structures:

• NHS Number (https://hl7.mft.nhs.uk/StructureDefinition/NHSNumber)
• PractitionerRole (https://hl7.mft.nhs.uk/StructureDefinition/PractitionerRole)
• Patient (https://hl7.mft.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
effective[x]		0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation (HL7 v2 OBX-14)
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-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated 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-6: A resource should have narrative for robust management dom-5: If a resource is contained in another resource, it SHALL NOT have a security label 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 obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not 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
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	N	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	N	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]	N	1..1	Reference(Observation)	Triggering observation. ele-1: All FHIR elements must have a @value or children
extension:type	N	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]	N	1..1	code	The type of trigger. Reflex | Repeat | Re-run ele-1: All FHIR elements must have a @value or children
extension:reason	N	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]	N	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"
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	?!N	0..*	Extension	Extensions that cannot be ignored 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
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	SΣC	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 ref-1: SHALL have a contained resource if a local reference is provided
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
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14) ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣC	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation. ele-1: All FHIR elements must have a @value or children ref-1: SHALL have a contained resource if a local reference is provided
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
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. ele-1: All FHIR elements must have a @value or children
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
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. 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.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason 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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	UKCoreObservation	Measurements and simple assertions 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 obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not 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	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
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	N	2..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:observation	N	1..1	Extension	Triggering observation
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"observation"
value[x]	N	1..1	Reference(Observation)	Triggering observation.
extension:type	N	1..1	Extension	reflex | repeat | re-run Binding: observation-triggeredbytype (??) (required)
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"type"
value[x]	N	1..1	code	The type of trigger. Reflex | Repeat | Re-run
extension:reason	N	0..1	Extension	Reason that the observation was triggered
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"reason"
value[x]	N	1..1	string	Reason that the observation was triggered.
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
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	?!N	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	ΣC	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order ref-1: SHALL have a contained resource if a local reference is provided
partOf	ΣC	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event ref-1: SHALL have a contained resource if a local reference is provided
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	SΣC	1..1	Reference(Patient | Group | Device | Location)	Who and / or what the observation is about. ref-1: SHALL have a contained resource if a local reference is provided
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	ΣC	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record ref-1: SHALL have a contained resource if a local reference is provided
encounter	ΣC	0..1	Reference(Encounter)	Healthcare event during which this observation is made ref-1: SHALL have a contained resource if a local reference is provided
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation (HL7 v2 OBX-14)
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣC	0..*	Reference(PractitionerRole | Patient)	Who is responsible for the observation. ref-1: SHALL have a contained resource if a local reference is provided
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	C	0..1	Reference(Specimen)	Specimen used for this observation ref-1: SHALL have a contained resource if a local reference is provided
device	C	0..1	Reference(Device | DeviceMetric)	(Measurement) Device ref-1: SHALL have a contained resource if a local reference is provided
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	N	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
low	C	0..1	SimpleQuantity	Low Range, if relevant qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
high	C	0..1	SimpleQuantity	High Range, if relevant qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
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	C	0..1	Range	Applicable age range, if relevant rng-2: If present, low SHALL have a lower value than high
text		0..1	string	Text based reference range in an observation
hasMember	ΣC	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group ref-1: SHALL have a contained resource if a local reference is provided
derivedFrom	ΣC	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from ref-1: SHALL have a contained resource if a local reference is provided
component	SΣ	0..*	BackboneElement	Component / sub results.
id		0..1	string	Unique id for inter-element referencing
extension	N	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
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.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: 1 element

Structures

This structure refers to these other structures:

• NHS Number (https://hl7.mft.nhs.uk/StructureDefinition/NHSNumber)
• PractitionerRole (https://hl7.mft.nhs.uk/StructureDefinition/PractitionerRole)
• Patient (https://hl7.mft.nhs.uk/StructureDefinition/Patient)

Other representations of profile: CSV, Excel, Schematron