Standard Health Record FHIR Implementation Guide

SHR SubstanceUse Profile

 

The official URL for this profile is: 

http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-SubstanceUse

Assertion concerning the past or current use of a substance (alcohol, recreational drugs, illegal drugs, or abuse of prescription medication) that could negatively impact the subject's health.

This profile builds on Observation.

This profile was published on Tue Feb 27 00:00:00 EST 2018 as a draft by The MITRE Corporation: Standard Health Record Collaborative.

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

Summary

Mandatory: 0 element (3 nested mandatory elements)
Fixed Value: 5 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.category is sliced based on the value of value:coding
  • The element Observation.category.coding is sliced based on the value of value:code
  • The element Observation.component is sliced based on the value of value:coding.code

SHR Mapping Source

This structure represents the following SHR mapping definition:

shr.behavior.SubstanceUse maps to Observation:
  _Entry.CreationTime maps to issued
  RelatedEncounter maps to context	
  Subject maps to subject
  Category maps to category
  ClinicallyRelevantTime maps to effective[x]
  FindingMethod maps to method
  FindingStatus maps to status
  CodeableConcept maps to value[x]
  ValueAbsentReason maps to dataAbsentReason
  ObservationCode maps to code
  BodySite maps to bodySite
  Specimen maps to specimen
  Device maps to device
  Interpretation maps to interpretation
  Details maps to comment
  ReferenceRange maps to referenceRange
  ReferenceRange.Range.LowerBound maps to referenceRange.low
  ReferenceRange.Range.UpperBound maps to referenceRange.high
  ReferenceRange.Type maps to referenceRange.type
  ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo
  ReferenceRange.ApplicableAgeRange maps to referenceRange.age
  fix related.type to #has-member
  ObservationComponent maps to component (slice on = coding.code; slice strategy = includes)
  ObservationComponent.ObservationCode maps to component.code
  ObservationComponent.Quantity maps to component.value[x]
  ObservationComponent.CodeableConcept maps to component.value[x]
  ObservationComponent.string maps to component.value[x]
  ObservationComponent.Range maps to component.value[x]
  ObservationComponent.Ratio maps to component.value[x]
  ObservationComponent.Attachment maps to component.value[x]
  ObservationComponent.time maps to component.value[x]
  ObservationComponent.dateTime maps to component.value[x]
  ObservationComponent.TimePeriod maps to component.value[x]
  ObservationComponent.IntegerQuantity maps to component.value[x]
  ObservationComponent.ValueAbsentReason maps to component.dataAbsentReason
  ObservationComponent.Interpretation maps to component.interpretation
  ObservationComponent.ReferenceRange maps to component.referenceRange
  Members.Observation maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation SHR SubstanceUse Profile
... category Slice: Unordered, Open by value:coding
Binding: Observation Category Codes (extensible)
... category 1..1CodeableConcept
.... coding Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... system Fixed Value: http://ncimeta.nci.nih.gov
..... code Fixed Value: C024251
... category 1..1CodeableConcept
.... coding Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... system Fixed Value: http://loinc.org
..... code Fixed Value: 54511-1
... subject Reference(SHR Patient Profile), Reference(SHR Group Profile), Reference(SHR Device Profile), Reference(SHR Geoposition Profile)
... context Reference(SHR EncounterPerformed Profile)
... issued 1..1
... valueCodeableConcept CodeableConceptBinding: SHR SubstanceOfAbuseVS ValueSet (required)
... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
... interpretation Binding: Observation Interpretation Codes (required)
... bodySite Binding: SHR BodySiteVS ValueSet (required)
... specimen 0..0
... device 0..0
... referenceRange 0..0
... related
.... type Fixed Value: has-member
.... target Reference(SHR QuestionAnswer Profile)
... component Slice: Unordered, Open by value:coding.code
... component 0..1FrequencyOfUse
.... valueCodeableConcept CodeableConceptBinding: SHR SemiquantitativeFrequencyVS ValueSet (example)
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... component 0..1ExposureRoute
.... valueCodeableConcept CodeableConceptBinding: SNOMED CT Route Codes (required)
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... component 0..1ExposureMethod
.... valueCodeableConcept CodeableConcept
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... component ExposureAmount
.... value[x] SHR Ratio Profile
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... shr-base-Author-extension 0..1(Complex)SHR Author Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension
... shr-base-Informant-extension 0..1(Complex)SHR Informant Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-finding-ChangeFlag-extension 0..1CodeableConceptSHR ChangeFlag Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ChangeFlag-extension
Binding: SHR ChangeFlagVS ValueSet (required)
... shr-finding-ObservationQualifier-extension 0..*CodeableConceptSHR ObservationQualifier Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ObservationQualifier-extension
... shr-behavior-ReasonForBehavior-extension 0..*(Complex)SHR ReasonForBehavior Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReasonForBehavior-extension
... shr-behavior-ReadinessToChange-extension 0..1(Complex)SHR ReadinessToChange Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReadinessToChange-extension
... shr-action-Outcome-extension 0..*(Complex)SHR Outcome Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-action-Outcome-extension

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*SHR SubstanceUse Profile
obs-7: If code is the same as a 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 Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... shr-base-Author-extension 0..1(Complex)SHR Author Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension
... shr-base-Informant-extension 0..1(Complex)SHR Informant Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-finding-ChangeFlag-extension 0..1CodeableConceptSHR ChangeFlag Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ChangeFlag-extension
Binding: SHR ChangeFlagVS ValueSet (required)
... shr-finding-ObservationQualifier-extension 0..*CodeableConceptSHR ObservationQualifier Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ObservationQualifier-extension
... shr-behavior-ReasonForBehavior-extension 0..*(Complex)SHR ReasonForBehavior Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReasonForBehavior-extension
... shr-behavior-ReadinessToChange-extension 0..1(Complex)SHR ReadinessToChange Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReadinessToChange-extension
... shr-action-Outcome-extension 0..*(Complex)SHR Outcome Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-action-Outcome-extension
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan), Reference(DeviceRequest), Reference(ImmunizationRecommendation), Reference(MedicationRequest), Reference(NutritionOrder), Reference(ProcedureRequest), Reference(ReferralRequest)Fulfills plan, proposal or order
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding
Binding: Observation Category Codes (extensible)
... category 1..1CodeableConcept
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://ncimeta.nci.nih.gov
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: C024251
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... category 1..1CodeableConcept
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 54511-1
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code Σ1..1CodeableConceptType of observation (code / type)
Binding: LOINC Codes (example)
... subject Σ0..1Reference(SHR Patient Profile), Reference(SHR Group Profile), Reference(SHR Device Profile), Reference(SHR Geoposition Profile)Who and/or what this is about
... context 0..1Reference(SHR EncounterPerformed Profile)Healthcare event during which this observation is made
... effective[x] Σ0..1dateTime, PeriodClinically relevant time/time-period for observation
... issued Σ1..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner), Reference(Organization), Reference(Patient), Reference(RelatedPerson)Who is responsible for the observation
... valueCodeableConcept Σ1..1CodeableConceptActual result
Binding: SHR SubstanceOfAbuseVS ValueSet (required)
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
... comment 0..1stringComments about result
... bodySite 0..1CodeableConceptObserved body part
Binding: SHR BodySiteVS ValueSet (required)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... related ΣI0..*BackboneElementResource related to this observation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type 0..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required)
Fixed Value: has-member
.... target 1..1Reference(SHR QuestionAnswer Profile)Resource that is related to this one
... component ΣIBackboneElementComponent results
Slice: Unordered, Open by value:coding.code
... component ΣI0..1BackboneElementFrequencyOfUse
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... valueCodeableConcept Σ0..1CodeableConceptActual component result
Binding: SHR SemiquantitativeFrequencyVS ValueSet (example)
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation
... component ΣI0..1BackboneElementExposureRoute
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... valueCodeableConcept Σ0..1CodeableConceptActual component result
Binding: SNOMED CT Route Codes (required)
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation
... component ΣI0..1BackboneElementExposureMethod
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... valueCodeableConcept Σ0..1CodeableConceptActual component result
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation
... component ΣI0..*BackboneElementExposureAmount
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... value[x] Σ0..1SHR Ratio ProfileActual component result
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation

doco Documentation for this format

Summary

Mandatory: 0 element (3 nested mandatory elements)
Fixed Value: 5 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.category is sliced based on the value of value:coding
  • The element Observation.category.coding is sliced based on the value of value:code
  • The element Observation.component is sliced based on the value of value:coding.code

SHR Mapping Source

This structure represents the following SHR mapping definition:

shr.behavior.SubstanceUse maps to Observation:
  _Entry.CreationTime maps to issued
  RelatedEncounter maps to context	
  Subject maps to subject
  Category maps to category
  ClinicallyRelevantTime maps to effective[x]
  FindingMethod maps to method
  FindingStatus maps to status
  CodeableConcept maps to value[x]
  ValueAbsentReason maps to dataAbsentReason
  ObservationCode maps to code
  BodySite maps to bodySite
  Specimen maps to specimen
  Device maps to device
  Interpretation maps to interpretation
  Details maps to comment
  ReferenceRange maps to referenceRange
  ReferenceRange.Range.LowerBound maps to referenceRange.low
  ReferenceRange.Range.UpperBound maps to referenceRange.high
  ReferenceRange.Type maps to referenceRange.type
  ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo
  ReferenceRange.ApplicableAgeRange maps to referenceRange.age
  fix related.type to #has-member
  ObservationComponent maps to component (slice on = coding.code; slice strategy = includes)
  ObservationComponent.ObservationCode maps to component.code
  ObservationComponent.Quantity maps to component.value[x]
  ObservationComponent.CodeableConcept maps to component.value[x]
  ObservationComponent.string maps to component.value[x]
  ObservationComponent.Range maps to component.value[x]
  ObservationComponent.Ratio maps to component.value[x]
  ObservationComponent.Attachment maps to component.value[x]
  ObservationComponent.time maps to component.value[x]
  ObservationComponent.dateTime maps to component.value[x]
  ObservationComponent.TimePeriod maps to component.value[x]
  ObservationComponent.IntegerQuantity maps to component.value[x]
  ObservationComponent.ValueAbsentReason maps to component.dataAbsentReason
  ObservationComponent.Interpretation maps to component.interpretation
  ObservationComponent.ReferenceRange maps to component.referenceRange
  Members.Observation maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation SHR SubstanceUse Profile
... category Slice: Unordered, Open by value:coding
Binding: Observation Category Codes (extensible)
... category 1..1CodeableConcept
.... coding Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... system Fixed Value: http://ncimeta.nci.nih.gov
..... code Fixed Value: C024251
... category 1..1CodeableConcept
.... coding Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... system Fixed Value: http://loinc.org
..... code Fixed Value: 54511-1
... subject Reference(SHR Patient Profile), Reference(SHR Group Profile), Reference(SHR Device Profile), Reference(SHR Geoposition Profile)
... context Reference(SHR EncounterPerformed Profile)
... issued 1..1
... valueCodeableConcept CodeableConceptBinding: SHR SubstanceOfAbuseVS ValueSet (required)
... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
... interpretation Binding: Observation Interpretation Codes (required)
... bodySite Binding: SHR BodySiteVS ValueSet (required)
... specimen 0..0
... device 0..0
... referenceRange 0..0
... related
.... type Fixed Value: has-member
.... target Reference(SHR QuestionAnswer Profile)
... component Slice: Unordered, Open by value:coding.code
... component 0..1FrequencyOfUse
.... valueCodeableConcept CodeableConceptBinding: SHR SemiquantitativeFrequencyVS ValueSet (example)
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... component 0..1ExposureRoute
.... valueCodeableConcept CodeableConceptBinding: SNOMED CT Route Codes (required)
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... component 0..1ExposureMethod
.... valueCodeableConcept CodeableConcept
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... component ExposureAmount
.... value[x] SHR Ratio Profile
.... dataAbsentReason Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation Binding: Observation Interpretation Codes (required)
... shr-base-Author-extension 0..1(Complex)SHR Author Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension
... shr-base-Informant-extension 0..1(Complex)SHR Informant Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-finding-ChangeFlag-extension 0..1CodeableConceptSHR ChangeFlag Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ChangeFlag-extension
Binding: SHR ChangeFlagVS ValueSet (required)
... shr-finding-ObservationQualifier-extension 0..*CodeableConceptSHR ObservationQualifier Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ObservationQualifier-extension
... shr-behavior-ReasonForBehavior-extension 0..*(Complex)SHR ReasonForBehavior Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReasonForBehavior-extension
... shr-behavior-ReadinessToChange-extension 0..1(Complex)SHR ReadinessToChange Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReadinessToChange-extension
... shr-action-Outcome-extension 0..*(Complex)SHR Outcome Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-action-Outcome-extension

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*SHR SubstanceUse Profile
obs-7: If code is the same as a 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 Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... shr-base-Author-extension 0..1(Complex)SHR Author Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension
... shr-base-Informant-extension 0..1(Complex)SHR Informant Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-finding-ChangeFlag-extension 0..1CodeableConceptSHR ChangeFlag Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ChangeFlag-extension
Binding: SHR ChangeFlagVS ValueSet (required)
... shr-finding-ObservationQualifier-extension 0..*CodeableConceptSHR ObservationQualifier Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ObservationQualifier-extension
... shr-behavior-ReasonForBehavior-extension 0..*(Complex)SHR ReasonForBehavior Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReasonForBehavior-extension
... shr-behavior-ReadinessToChange-extension 0..1(Complex)SHR ReadinessToChange Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReadinessToChange-extension
... shr-action-Outcome-extension 0..*(Complex)SHR Outcome Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-action-Outcome-extension
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan), Reference(DeviceRequest), Reference(ImmunizationRecommendation), Reference(MedicationRequest), Reference(NutritionOrder), Reference(ProcedureRequest), Reference(ReferralRequest)Fulfills plan, proposal or order
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category CodeableConceptClassification of type of observation
Slice: Unordered, Open by value:coding
Binding: Observation Category Codes (extensible)
... category 1..1CodeableConcept
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://ncimeta.nci.nih.gov
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: C024251
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... category 1..1CodeableConcept
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ0..*Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 54511-1
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code Σ1..1CodeableConceptType of observation (code / type)
Binding: LOINC Codes (example)
... subject Σ0..1Reference(SHR Patient Profile), Reference(SHR Group Profile), Reference(SHR Device Profile), Reference(SHR Geoposition Profile)Who and/or what this is about
... context 0..1Reference(SHR EncounterPerformed Profile)Healthcare event during which this observation is made
... effective[x] Σ0..1dateTime, PeriodClinically relevant time/time-period for observation
... issued Σ1..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner), Reference(Organization), Reference(Patient), Reference(RelatedPerson)Who is responsible for the observation
... valueCodeableConcept Σ1..1CodeableConceptActual result
Binding: SHR SubstanceOfAbuseVS ValueSet (required)
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
... comment 0..1stringComments about result
... bodySite 0..1CodeableConceptObserved body part
Binding: SHR BodySiteVS ValueSet (required)
... method 0..1CodeableConceptHow it was done
Binding: Observation Methods (example)
... related ΣI0..*BackboneElementResource related to this observation
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type 0..1codehas-member | derived-from | sequel-to | replaces | qualified-by | interfered-by
Binding: ObservationRelationshipType (required)
Fixed Value: has-member
.... target 1..1Reference(SHR QuestionAnswer Profile)Resource that is related to this one
... component ΣIBackboneElementComponent results
Slice: Unordered, Open by value:coding.code
... component ΣI0..1BackboneElementFrequencyOfUse
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... valueCodeableConcept Σ0..1CodeableConceptActual component result
Binding: SHR SemiquantitativeFrequencyVS ValueSet (example)
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation
... component ΣI0..1BackboneElementExposureRoute
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... valueCodeableConcept Σ0..1CodeableConceptActual component result
Binding: SNOMED CT Route Codes (required)
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation
... component ΣI0..1BackboneElementExposureMethod
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... valueCodeableConcept Σ0..1CodeableConceptActual component result
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation
... component ΣI0..*BackboneElementExposureAmount
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINC Codes (example)
.... value[x] Σ0..1SHR Ratio ProfileActual component result
.... dataAbsentReason I0..1CodeableConceptWhy the component result is missing
Binding: SHR ValueAbsentReasonVS ValueSet (required)
.... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (required)
.... referenceRange 0..*BackboneElementProvides guide for interpretation of component result
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... low I0..1SimpleQuantityLow Range, if relevant
..... high I0..1SimpleQuantityHigh Range, if relevant
..... type 0..1CodeableConceptReference range qualifier
Binding: Observation Reference Range Meaning Codes (extensible)
..... appliesTo 0..*CodeableConceptReference range population
Binding: Observation Reference Range Applies To Codes (example)
..... age 0..1RangeApplicable age range, if relevant
..... text 0..1stringText based reference range in an observation

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron

 

Terminology Bindings

PathNameConformanceValueSet
Observation.languageCommon LanguagesextensibleCommon Languages
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodesextensibleObservation Category Codes
Observation.codeLOINC CodesexampleLOINC Codes
Observation.valueCodeableConceptSHR SubstanceOfAbuseVS ValueSetrequiredSHR SubstanceOfAbuseVS ValueSet
Observation.dataAbsentReasonSHR ValueAbsentReasonVS ValueSetrequiredSHR ValueAbsentReasonVS ValueSet
Observation.interpretationObservation Interpretation CodesrequiredObservation Interpretation Codes
Observation.bodySiteSHR BodySiteVS ValueSetrequiredSHR BodySiteVS ValueSet
Observation.methodObservation MethodsexampleObservation Methods
Observation.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToObservation Reference Range Applies To CodesextensibleObservation Reference Range Applies To Codes
Observation.related.typeObservationRelationshipTyperequiredObservationRelationshipType
Observation.component.codeLOINC CodesexampleLOINC Codes
Observation.component.valueCodeableConceptSNOMED CT Route CodesrequiredSNOMED CT Route Codes
Observation.component.dataAbsentReasonSHR ValueAbsentReasonVS ValueSetrequiredSHR ValueAbsentReasonVS ValueSet
Observation.component.interpretationObservation Interpretation CodesrequiredObservation Interpretation Codes
Observation.component.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.component.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeLOINC CodesexampleLOINC Codes
Observation.component.valueCodeableConceptSNOMED CT Route CodesrequiredSNOMED CT Route Codes
Observation.component.dataAbsentReasonSHR ValueAbsentReasonVS ValueSetrequiredSHR ValueAbsentReasonVS ValueSet
Observation.component.interpretationObservation Interpretation CodesrequiredObservation Interpretation Codes
Observation.component.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.component.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeLOINC CodesexampleLOINC Codes
Observation.component.dataAbsentReasonSHR ValueAbsentReasonVS ValueSetrequiredSHR ValueAbsentReasonVS ValueSet
Observation.component.interpretationObservation Interpretation CodesrequiredObservation Interpretation Codes
Observation.component.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.component.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes
Observation.component.codeLOINC CodesexampleLOINC Codes
Observation.component.dataAbsentReasonSHR ValueAbsentReasonVS ValueSetrequiredSHR ValueAbsentReasonVS ValueSet
Observation.component.interpretationObservation Interpretation CodesrequiredObservation Interpretation Codes
Observation.component.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.component.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes

 

Constraints

IdPathDetailsRequirements
dom-2ObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1ObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4ObservationIf 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-3ObservationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
obs-7ObservationIf code is the same as a component code then the value element associated with the code SHALL NOT be present
: value.empty() or code!=component.code
obs-6ObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
ele-1Observation.relatedAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ele-1Observation.componentAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())