HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE), v0.9.0

- Local Development build (v0.9.0). See the Directory of published versions

Basophils100WBCNFrPtBldQnAutoCntLabObs


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="shr-lab-Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>Basophils100WBCNFrPtBldQnAutoCntLabObs Profile</b></p>
  <p>Basophils/​100 leukocytes in Blood by Automated count</p>
  <p><b>Mapping Summary</b></p>
  <p><pre>shr.lab.Basophils100WBCNFrPtBldQnAutoCntLabObs maps to http://fhir.org/guides/argonaut/StructureDefinition/argo-observationresults:
  _Entry.EntryId maps to id
  Language maps to language
  Narrative maps to text
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Identifier maps to identifier (slice on = type.coding.code; slice strategy = includes)
  ObservationSubjectOfRecord maps to subject
  PractitionerOrOrganizationPerformer maps to performer (slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
  Code maps to code
  Method maps to method
  CommentOrDescription maps to comments
  Category maps to category
  BodyLocation.LocationCode maps to bodySite
  BodyLocation.Laterality maps to bodySite.extension
  BodyLocation.Orientation maps to bodySite.extension
  BodyLocation.RelationToLandmark maps to bodySite.extension
  Device maps to device
  StatementDateTime maps to issued
  ReferenceRange maps to referenceRange
  ReferenceRange.Range.LowerBound maps to referenceRange.low
  ReferenceRange.Range.UpperBound maps to referenceRange.high
  ReferenceRange.Type maps to referenceRange.meaning
  Components.ObservationComponent maps to component (slice on = code.coding.code; slice strategy = includes)
  Components.ObservationComponent.Code maps to component.code
  Components.ObservationComponent.DataValue maps to component.value[x]
  Components.ObservationComponent.DataAbsentReason maps to component.dataAbsentReason
  Components.ObservationComponent.ReferenceRange maps to component.referenceRange
  fix related.type to #has-member
  PanelMembers maps to related
  PanelMembers.Observation maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
  DataValue maps to value[x]
  DataAbsentReason maps to dataAbsentReason
  Interpretation maps to interpretation
  Status maps to status
  RelevantTime maps to effective[x]
  CareContext maps to encounter
  Specimen maps to specimen
</pre></p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-lab-Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
  <identifier>
    <system value="http://hl7.org/fhir/us/mcode"/>
    <value value="shr.lab.Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
  </identifier>
  <version value="0.9.0"/>
  <name value="Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
  <display value="shr-lab-Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
  <status value="draft"/>
  <publisher value="The MITRE Corporation"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://standardhealthrecord.org"/>
      <rank value="0"/>
    </telecom>
  </contact>
  <date value="2019-04-17T00:00:00-04:00"/>
  <description value="Basophils/​100 leukocytes in Blood by Automated count"/>
  <fhirVersion value="1.0.2"/>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <constrainedType value="Observation"/>
  <abstract value="false"/>
  <base
        value="http://fhir.org/guides/argonaut/StructureDefinition/argo-observationresults"/>
  <snapshot>
    <element id="Observation">
      <path value="Observation"/>
      <name value="Observation"/>
      <short value="shr-lab-Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
      <definition value="Basophils/​100 leukocytes in Blood by Automated count"/>
      <comments
                value="Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc."/>
      <alias value="Vital Signs"/>
      <alias value="Measurement"/>
      <alias value="Results"/>
      <alias value="Tests"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="argo-observationresults"/>
      </type>
      <maxLength value="0"/>
      <constraint>
        <key value="obs-6"/>
        <severity value="error"/>
        <human
               value="SHALL only be present if Observation.value[x] is not present"/>
        <xpath
               value="not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), &#39;value&#39;)])))"/>
      </constraint>
      <constraint>
        <key value="obs-7"/>
        <severity value="error"/>
        <human value="Component code SHALL not be same as observation code"/>
        <xpath
               value="not(exists(f:component/f:code)) or count(for $coding in f:code/f:coding return parent::*/f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value and f:system/@value=$coding/f:system/@value])=0"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString
                       value="(component.empty() and related.empty()) implies (dataAbsentReason or value)"/>
        </extension>
        <key value="arg-2"/>
        <severity value="error"/>
        <human
               value="If there is no component or related element then either a value[x] or a data absent reason must be present"/>
        <xpath
               value="exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), &#39;value&#39;)]) or exists(f:dataAbsentReason)"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.diagnostics"/>
      </mapping>
    </element>
    <element id="Observation.id">
      <path value="Observation.id"/>
      <name value="Observation.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comments
                value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Observation.meta">
      <path value="Observation.meta"/>
      <name value="Observation.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Observation.implicitRules">
      <path value="Observation.implicitRules"/>
      <name value="Observation.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comments
                value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Observation.language">
      <path value="Observation.language"/>
      <name value="Observation.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments
                value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="required"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://tools.ietf.org/html/bcp47"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Observation.text">
      <path value="Observation.text"/>
      <name value="Observation.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comments
                value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <maxLength value="0"/>
      <condition value="dom-1"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Observation.contained">
      <path value="Observation.contained"/>
      <name value="Observation.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comments
                value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.extension">
      <path value="Observation.extension"/>
      <name value="Observation.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.modifierExtension">
      <path value="Observation.modifierExtension"/>
      <name value="Observation.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.identifier">
      <path value="Observation.identifier"/>
      <name value="Observation.identifier"/>
      <slicing id="2">
        <discriminator value="type.coding.code"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Unique Id for this particular observation"/>
      <definition
                  value="A unique identifier for the simple observation instance."/>
      <requirements
                    value="Allows observations to be distinguished and referenced."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="shr-core-AccessionIdentifier">
      <path value="Observation.identifier"/>
      <name value="shr-core-AccessionIdentifier"/>
      <short value="AccessionIdentifier"/>
      <definition value="Identifier assigned by the lab"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-AccessionIdentifier"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="shr-core-FillerOrderNumber">
      <path value="Observation.identifier"/>
      <name value="shr-core-FillerOrderNumber"/>
      <short value="FillerOrderNumber"/>
      <definition value="Identifier assigned by the lab carrying out the test."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-FillerOrderNumber"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="shr-core-PlacerOrderNumber">
      <path value="Observation.identifier"/>
      <name value="shr-core-PlacerOrderNumber"/>
      <short value="PlacerOrderNumber"/>
      <definition value="Identifier assigned by the requester of the lab."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-PlacerOrderNumber"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="Observation.status">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint">
        <valueString value="default: final"/>
      </extension>
      <path value="Observation.status"/>
      <name value="Observation.status"/>
      <short value="registered | preliminary | final | amended +"/>
      <definition value="The status of the result value."/>
      <requirements
                    value="Need to track the status of individual results. Some results are finalized before the whole report is finalized."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="status  Amended &amp; Final are differentiated by whether it is the subject of a ControlAct event with a type of &quot;revise&quot;"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="Observation.category">
      <path value="Observation.category"/>
      <name value="Observation.category"/>
      <short value="Classification of  type of observation"/>
      <definition
                  value="A code that classifies the general type of observation being made.  This is used  for searching, sorting and display purposes."/>
      <comments
                value="The level of granularity is defined by the category concepts in the value set.   More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in Observation.code."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/observation-category"/>
          <code value="laboratory"/>
          <userSelected value="false"/>
        </coding>
      </patternCodeableConcept>
      <maxLength value="0"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description value="Codes for high level observation categories ."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quot;].code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element id="Observation.code">
      <path value="Observation.code"/>
      <name value="Observation.code"/>
      <short value="Lab Test Name"/>
      <definition
                  value="The test that was performed.  This is element is bound to LOINC."/>
      <comments
                value="The typical patterns for codes are:  1)  a LOINC code either as a  translation from a &quot;local&quot; code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.  When using LOINC, use either the SHORTNAME or LONG_COMMON_NAME field for the display."/>
      <requirements
                    value="Knowing what kind of observation is being made is essential to understanding the observation."/>
      <alias value="Test Name"/>
      <alias value="Observation Identifer"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <description value="LOINC codes"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element id="Observation.code.id">
      <path value="Observation.code.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.code.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.code.extension">
      <path value="Observation.code.extension"/>
      <name value="Observation.code.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.code.coding">
      <path value="Observation.code.coding"/>
      <name value="Observation.code.coding"/>
      <slicing id="1">
        <discriminator value="code"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Code defined by a terminology system"/>
      <definition value="A reference to a code defined by a terminology system."/>
      <comments
                value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true."/>
      <requirements
                    value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings."/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="Coding"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
    </element>
    <element id="Fixed_706-2  ">
      <path value="Observation.code.coding"/>
      <name value="Fixed_706-2  "/>
      <short value="Basophils/​100 leukocytes in Blood by Automated count"/>
      <definition value="Basophils/​100 leukocytes in Blood by Automated count"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.id">
      <path value="Observation.code.coding.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.code.coding-Fixed-706-2--.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.extension">
      <path value="Observation.code.coding.extension"/>
      <name value="Observation.code.coding-Fixed-706-2--.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.system">
      <path value="Observation.code.coding.system"/>
      <name value="Observation.code.coding-Fixed-706-2--.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comments
                value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="http://loinc.org"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.version">
      <path value="Observation.code.coding.version"/>
      <name value="Observation.code.coding-Fixed-706-2--.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/>
      <comments
                value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.code">
      <path value="Observation.code.coding.code"/>
      <name value="Observation.code.coding-Fixed-706-2--.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
      <requirements value="Need to refer to a particular code in the system."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="706-2  "/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.display">
      <path value="Observation.code.coding.display"/>
      <name value="Observation.code.coding-Fixed-706-2--.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.userSelected">
      <path value="Observation.code.coding.userSelected"/>
      <name value="Observation.code.coding-Fixed-706-2--.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/>
      <comments
                value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
    </element>
    <element id="Observation.code.text">
      <path value="Observation.code.text"/>
      <name value="Observation.code.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/>
      <comments
                value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
    </element>
    <element id="Observation.subject">
      <path value="Observation.subject"/>
      <name value="Observation.subject"/>
      <short value="Who and/or what this is about"/>
      <definition
                  value="The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject."/>
      <comments
                value="One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.  If the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient&#39;s own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code."/>
      <requirements
                    value="Observations have no value if you don&#39;t know who or what they&#39;re about."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Patient"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Observation.encounter">
      <path value="Observation.encounter"/>
      <name value="Observation.encounter"/>
      <short value="Healthcare event during which this observation is made"/>
      <definition
                  value="The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made."/>
      <requirements
                    value="For some observations it may be important to know the link between an observation and a particular encounter."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Encounter"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="PV1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="Observation.effectivex">
      <path value="Observation.effective[x]"/>
      <name value="Observation.effectivex"/>
      <short value="Clinically relevant time/time-period for observation"/>
      <definition
                  value="For lab tests this is the specimen collection date.  For Ask at Order Entry Questions (AOE)&#39;s this is the date the question was asked."/>
      <comments
                value="At least a date should be present unless this observation is a historical report."/>
      <requirements
                    value="Knowing when an observation was deemed true is important to its relevance as well as determining trends."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.effective[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <maxLength value="0"/>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-expression">
          <valueString value="length() &gt;= 8"/>
        </extension>
        <key value="arg-1"/>
        <severity value="error"/>
        <human value="Datetime must be at least to day."/>
        <xpath
               value="f:matches(./\d{4}-[01]\d-[0-3]\dT[0-2]\d:[0-5]\d([+-][0-2]\d:[0-5]\d|Z)/)"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
    </element>
    <element id="Observation.issued">
      <path value="Observation.issued"/>
      <name value="Observation.issued"/>
      <short value="Date/Time this was made available"/>
      <definition
                  value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified."/>
      <comments value="Updated when the result is updated."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.issued"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element id="Observation.performer">
      <path value="Observation.performer"/>
      <name value="Observation.performer"/>
      <short value="Who is responsible for the observation"/>
      <definition
                  value="Who was responsible for asserting the observed value as &quot;true&quot;."/>
      <requirements
                    value="May give a degree of confidence in the observation and also indicates where follow-up questions should be directed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Practitioner"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Organization"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4=&#39;RO&#39; /  (Device)  OBX-18 , PRT-10:PRT-4=&#39;EQUIP&#39; / (Organization)  OBX-23,  PRT-8:PRT-4=&#39;PO&#39;"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=PRF]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits">
      <path value="Observation.valueQuantity"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits"/>
      <short value="Actual result"/>
      <definition
                  value="If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.value[x]"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-lab-QuantityWithRequiredUnits"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.id">
      <path value="Observation.valueQuantity.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.extension">
      <path value="Observation.valueQuantity.extension"/>
      <name
            value="Observation.valueQuantity-QuantityWithRequiredUnits.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.value">
      <path value="Observation.valueQuantity.value"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.value"/>
      <short value="Numerical value (with implicit precision)"/>
      <definition
                  value="The value of the measured amount. The value includes an implicit precision in the presentation of the value."/>
      <comments
                value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)."/>
      <requirements
                    value="Precision is handled implicitly in almost all cases of measurement."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="decimal"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="SN.2  / CQ - N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.comparator">
      <path value="Observation.valueQuantity.comparator"/>
      <name
            value="Observation.valueQuantity-QuantityWithRequiredUnits.comparator"/>
      <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value"/>
      <definition
                  value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is &quot;&lt;&quot; , then the real value is &lt; stated value."/>
      <comments
                value="This is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value."/>
      <requirements
                    value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <meaningWhenMissing
                          value="If there is no comparator, then there is no modification of the value"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description
                     value="How the Quantity should be understood and represented."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SN.1  / CQ.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="IVL properties"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.unit">
      <path value="Observation.valueQuantity.unit"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.unit"/>
      <short value="Unit representation"/>
      <definition value="A human-readable form of the unit."/>
      <requirements
                    value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="(see OBX.6 etc.) / CQ.2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="PQ.unit"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.system">
      <path value="Observation.valueQuantity.system"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.system"/>
      <short value="System that defines coded unit form"/>
      <definition
                  value="The identification of the system that provides the coded form of the unit."/>
      <requirements
                    value="Need to know the system that defines the coded form of the unit."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="http://unitsofmeasure.org"/>
      <maxLength value="0"/>
      <condition value="qty-3"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="(see OBX.6 etc.) / CQ.2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CO.codeSystem, PQ.translation.codeSystem"/>
      </mapping>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.code">
      <path value="Observation.valueQuantity.code"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.code"/>
      <short value="Coded form of the unit"/>
      <definition
                  value="A computer processable form of the unit in some unit representation system."/>
      <comments
                value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system."/>
      <requirements
                    value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="%"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="(see OBX.6 etc.) / CQ.2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="PQ.code, MO.currency, PQ.translation.code"/>
      </mapping>
    </element>
    <element id="Observation.dataAbsentReason">
      <path value="Observation.dataAbsentReason"/>
      <name value="Observation.dataAbsentReason"/>
      <short value="Why the result is missing"/>
      <definition
                  value="Provides a reason why the expected value in the element Observation.value[x] is missing."/>
      <comments
                value="Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  &quot;detected&quot;, &quot;not detected&quot;, &quot;inconclusive&quot;, or  &quot;specimen unsatisfactory&quot;.   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code &quot;error&quot; could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values."/>
      <requirements
                    value="For many results it is necessary to handle exceptional values in measurements."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Observation.dataAbsentReason"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-6"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value.nullFlavor"/>
      </mapping>
    </element>
    <element id="Observation.interpretation">
      <path value="Observation.interpretation"/>
      <name value="Observation.interpretation"/>
      <short value="High, low, normal, etc."/>
      <definition
                  value="The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag."/>
      <requirements
                    value="For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result."/>
      <alias value="Abnormal Flag"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.interpretation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/mcode/shr/core/vs/QuantitativeResultInterpretationVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element id="Observation.comments">
      <path value="Observation.comments"/>
      <name value="Observation.comments"/>
      <short value="Comments about result"/>
      <definition
                  value="May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result."/>
      <requirements
                    value="Need to be able to provide free text additional information."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.comments"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map
             value="NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="subjectOf.observationEvent[code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element id="Observation.bodySite">
      <path value="Observation.bodySite"/>
      <name value="Observation.bodySite"/>
      <short value="Observed body part"/>
      <definition
                  value="Indicates the site on the subject&#39;s body where the observation was made (i.e. the target site)."/>
      <comments
                value="Only used if not implicit in code found in Observation.code.  If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html)."/>
      <requirements
                    value="Knowing where the observation is made is important for tracking if multiple sites are possible."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Observation.bodySite"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/mcode/shr/core/vs/BodyLocationVS"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="targetSiteCode"/>
      </mapping>
    </element>
    <element id="Observation.method">
      <path value="Observation.method"/>
      <name value="Observation.method"/>
      <short value="How it was done"/>
      <definition
                  value="Indicates the mechanism used to perform the observation."/>
      <comments value="Only used if not implicit in code for Observation.code."/>
      <requirements
                    value="In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.method"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description value="Methods for simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-methods"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-17"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="methodCode"/>
      </mapping>
    </element>
    <element id="Observation.specimen">
      <path value="Observation.specimen"/>
      <name value="Observation.specimen"/>
      <short value="Specimen used for this observation"/>
      <definition
                  value="The specimen that was used when this observation was made."/>
      <comments
                value="Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.specimen"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Specimen"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM segment"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SPC].specimen"/>
      </mapping>
    </element>
    <element id="Observation.device">
      <path value="Observation.device"/>
      <name value="Observation.device"/>
      <short value="(Measurement) Device"/>
      <definition value="The device used to generate the observation data."/>
      <comments
                value="An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.device"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Device"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-17 / PRT -10"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=DEV]"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange">
      <path value="Observation.referenceRange"/>
      <name value="Observation.referenceRange"/>
      <short value="Provides guide for interpretation"/>
      <definition
                  value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
      <comments
                value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient&#39;s age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties."/>
      <requirements
                    value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <maxLength value="0"/>
      <constraint>
        <key value="obs-3"/>
        <severity value="error"/>
        <human value="Must have at least a low or a high or text"/>
        <xpath value="(exists(f:low) or exists(f:high)or exists(f:text))"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.id">
      <path value="Observation.referenceRange.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.referenceRange.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.extension">
      <path value="Observation.referenceRange.extension"/>
      <name value="Observation.referenceRange.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.referenceRange.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.modifierExtension">
      <path value="Observation.referenceRange.modifierExtension"/>
      <name value="Observation.referenceRange.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.referenceRange.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.low">
      <path value="Observation.referenceRange.low"/>
      <name value="Observation.referenceRange.low"/>
      <short value="Low Range, if relevant"/>
      <definition
                  value="The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is &lt;=2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.low"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-3"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.low"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.high">
      <path value="Observation.referenceRange.high"/>
      <name value="Observation.referenceRange.high"/>
      <short value="High Range, if relevant"/>
      <definition
                  value="The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is &gt;= 2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.high"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-3"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.high"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.meaning">
      <path value="Observation.referenceRange.meaning"/>
      <name value="Observation.referenceRange.meaning"/>
      <short value="Indicates the meaning/use of this range of this range"/>
      <definition value="Code for the meaning of the reference range."/>
      <comments
                value="This SHOULD be populated if there is more than one range."/>
      <requirements
                    value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.meaning"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <description value="Code for the meaning of a reference range."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-10?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.age">
      <path value="Observation.referenceRange.age"/>
      <name value="Observation.referenceRange.age"/>
      <short value="Applicable age range, if relevant"/>
      <definition
                  value="The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so."/>
      <requirements value="Some analytes vary greatly over age."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.age"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Range"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].value"/>
      </mapping>
    </element>
    <element id="Observation.referenceRange.text">
      <path value="Observation.referenceRange.text"/>
      <name value="Observation.referenceRange.text"/>
      <short value="Text based reference range in an observation"/>
      <definition
                  value="Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of &quot;Negative&quot; or a list or table of &#39;normals&#39;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.referenceRange.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:ST"/>
      </mapping>
    </element>
    <element id="Observation.related">
      <path value="Observation.related"/>
      <name value="Observation.related"/>
      <short value="Resource related to this observation"/>
      <definition
                  value="A  reference to another resource (usually another Observation but could  also be a QuestionnaireAnswer) whose relationship is defined by the relationship type code."/>
      <comments
                value="For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4)."/>
      <requirements
                    value="Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Observation.related"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Relationships established by OBX-4 usage"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outBoundRelationship"/>
      </mapping>
    </element>
    <element id="Observation.related.id">
      <path value="Observation.related.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.related.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.related.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.related.extension">
      <path value="Observation.related.extension"/>
      <name value="Observation.related.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.related.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.related.modifierExtension">
      <path value="Observation.related.modifierExtension"/>
      <name value="Observation.related.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.related.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.related.type">
      <path value="Observation.related.type"/>
      <name value="Observation.related.type"/>
      <short
             value="has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by"/>
      <definition
                  value="A code specifying the kind of relationship that exists with the target resource."/>
      <comments
                value="&quot;derived-from&quot; is only logical choice when referencing QuestionnaireAnswer resource."/>
      <requirements value="A relationship type SHOULD be provided."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.related.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="has-member"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="required"/>
        <description value="Codes specifying how two observations are related."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/observation-relationshiptypes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".typeCode"/>
      </mapping>
    </element>
    <element id="Observation.related.target">
      <path value="Observation.related.target"/>
      <name value="Observation.related.target"/>
      <short value="Resource that is related to this one"/>
      <definition
                  value="A reference to the observation or [[[QuestionnaireResponse]]] resource that is related to this observation."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.related.target"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Observation"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".targetObservation"/>
      </mapping>
    </element>
    <element id="Observation.component">
      <path value="Observation.component"/>
      <name value="Observation.component"/>
      <short value="Component results"/>
      <definition
                  value="Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations."/>
      <comments
                value="For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4)."/>
      <requirements
                    value="Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Observation.component"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="containment by OBX-4?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outBoundRelationship[typeCode=COMP]"/>
      </mapping>
    </element>
    <element id="Observation.component.id">
      <path value="Observation.component.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.component.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.component.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.component.extension">
      <path value="Observation.component.extension"/>
      <name value="Observation.component.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.component.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.component.modifierExtension">
      <path value="Observation.component.modifierExtension"/>
      <name value="Observation.component.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.component.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.component.code">
      <path value="Observation.component.code"/>
      <name value="Observation.component.code"/>
      <short value="Type of component observation (code / type)"/>
      <definition
                  value="Describes what was observed. Sometimes this is called the observation &quot;code&quot;."/>
      <requirements
                    value="Knowing what kind of observation is being made is essential to understanding the observation."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Observation.component.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-7"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes identifying names of simple observations."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element id="Observation.component.valuex">
      <path value="Observation.component.value[x]"/>
      <name value="Observation.component.valuex"/>
      <short value="Actual component result"/>
      <definition
                  value="The information determined as a result of making the observation, if the information has a simple value."/>
      <comments
                value="Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from &lt;http://hl7.org/fhir/ValueSet/v2-0136&gt; (These &quot;yes/no&quot; concepts can be mapped to the display name &quot;true/false&quot; or other mutually exclusive terms that may be needed&quot;).  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is &quot;&#39;value&#39; + the type name&quot; with a capital on the first letter of the type)."/>
      <requirements
                    value="An observation exists to have a value, though it may not if it is in error, or it represents a group of observations."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.component.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.2, OBX.5, OBX.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value"/>
      </mapping>
    </element>
    <element id="Observation.component.dataAbsentReason">
      <path value="Observation.component.dataAbsentReason"/>
      <name value="Observation.component.dataAbsentReason"/>
      <short value="Why the component result is missing"/>
      <definition
                  value="Provides a reason why the expected value in the element Observation.value[x] is missing."/>
      <comments
                value="&quot;Null&quot; or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  &quot;detected&quot;, &quot;not detected&quot;, &quot;inconclusive&quot;, or  &quot;test not done&quot;.   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code &quot;error&quot; could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values."/>
      <requirements
                    value="For many results it is necessary to handle exceptional values in measurements."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Observation.component.dataAbsentReason"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-6"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value.nullFlavor"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange">
      <path value="Observation.component.referenceRange"/>
      <name value="Observation.component.referenceRange"/>
      <short value="Provides guide for interpretation of component result"/>
      <definition
                  value="Guidance on how to interpret the value by comparison to a normal or recommended range."/>
      <comments
                value="Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient&#39;s age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties."/>
      <requirements
                    value="Knowing what values are considered &quot;normal&quot; can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Observation.component.referenceRange"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.id">
      <path value="Observation.component.referenceRange.id"/>
      <representation value="xmlAttr"/>
      <name value="Observation.component.referenceRange.id"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.extension">
      <path value="Observation.component.referenceRange.extension"/>
      <name value="Observation.component.referenceRange.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.modifierExtension">
      <path value="Observation.component.referenceRange.modifierExtension"/>
      <name value="Observation.component.referenceRange.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comments
                value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.low">
      <path value="Observation.component.referenceRange.low"/>
      <name value="Observation.component.referenceRange.low"/>
      <short value="Low Range, if relevant"/>
      <definition
                  value="The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is &lt;=2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-3"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.low"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.high">
      <path value="Observation.component.referenceRange.high"/>
      <name value="Observation.component.referenceRange.high"/>
      <short value="High Range, if relevant"/>
      <definition
                  value="The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is &gt;=5 - &lt;=9).   If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is &gt;= 2.3)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <maxLength value="0"/>
      <condition value="obs-3"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:IVL_PQ.high"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.meaning">
      <path value="Observation.component.referenceRange.meaning"/>
      <name value="Observation.component.referenceRange.meaning"/>
      <short value="Indicates the meaning/use of this range of this range"/>
      <definition value="Code for the meaning of the reference range."/>
      <comments
                value="This SHOULD be populated if there is more than one range."/>
      <requirements
                    value="Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description value="Code for the meaning of a reference range."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-10?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="interpretationCode"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.age">
      <path value="Observation.component.referenceRange.age"/>
      <name value="Observation.component.referenceRange.age"/>
      <short value="Applicable age range, if relevant"/>
      <definition
                  value="The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so."/>
      <requirements value="Some analytes vary greatly over age."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Range"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=&quot;age&quot;].value"/>
      </mapping>
    </element>
    <element id="Observation.component.referenceRange.text">
      <path value="Observation.component.referenceRange.text"/>
      <name value="Observation.component.referenceRange.text"/>
      <short value="Text based reference range in an observation"/>
      <definition
                  value="Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of &quot;Negative&quot; or a list or table of &#39;normals&#39;."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="value:ST"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Observation">
      <path value="Observation"/>
      <name value="Observation"/>
      <short value="shr-lab-Basophils100WBCNFrPtBldQnAutoCntLabObs"/>
      <definition value="Basophils/​100 leukocytes in Blood by Automated count"/>
      <min value="0"/>
      <type>
        <code value="argo-observationresults"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.identifier">
      <path value="Observation.identifier"/>
      <name value="Observation.identifier"/>
      <slicing id="2">
        <discriminator value="type.coding.code"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <min value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="shr-core-AccessionIdentifier">
      <path value="Observation.identifier"/>
      <name value="shr-core-AccessionIdentifier"/>
      <short value="AccessionIdentifier"/>
      <definition value="Identifier assigned by the lab"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-AccessionIdentifier"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="shr-core-FillerOrderNumber">
      <path value="Observation.identifier"/>
      <name value="shr-core-FillerOrderNumber"/>
      <short value="FillerOrderNumber"/>
      <definition value="Identifier assigned by the lab carrying out the test."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-FillerOrderNumber"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="shr-core-PlacerOrderNumber">
      <path value="Observation.identifier"/>
      <name value="shr-core-PlacerOrderNumber"/>
      <short value="PlacerOrderNumber"/>
      <definition value="Identifier assigned by the requester of the lab."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-PlacerOrderNumber"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.code">
      <path value="Observation.code"/>
      <name value="Observation.code"/>
      <min value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.code.coding">
      <path value="Observation.code.coding"/>
      <name value="Observation.code.coding"/>
      <slicing id="1">
        <discriminator value="code"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <min value="1"/>
      <max value="*"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Fixed_706-2  ">
      <path value="Observation.code.coding"/>
      <name value="Fixed_706-2  "/>
      <short value="Basophils/​100 leukocytes in Blood by Automated count"/>
      <definition value="Basophils/​100 leukocytes in Blood by Automated count"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.system">
      <path value="Observation.code.coding.system"/>
      <name value="Observation.code.coding-Fixed-706-2--.system"/>
      <min value="0"/>
      <fixedUri value="http://loinc.org"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.code.coding-Fixed-706-2--.code">
      <path value="Observation.code.coding.code"/>
      <name value="Observation.code.coding-Fixed-706-2--.code"/>
      <min value="0"/>
      <fixedCode value="706-2  "/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.subject">
      <path value="Observation.subject"/>
      <name value="Observation.subject"/>
      <min value="0"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Patient"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.encounter">
      <path value="Observation.encounter"/>
      <name value="Observation.encounter"/>
      <min value="0"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Encounter"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.performer">
      <path value="Observation.performer"/>
      <name value="Observation.performer"/>
      <min value="0"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Practitioner"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Organization"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits">
      <path value="Observation.valueQuantity"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits"/>
      <min value="0"/>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-lab-QuantityWithRequiredUnits"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.system">
      <path value="Observation.valueQuantity.system"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.system"/>
      <min value="0"/>
      <fixedUri value="http://unitsofmeasure.org"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.valueQuantity-QuantityWithRequiredUnits.code">
      <path value="Observation.valueQuantity.code"/>
      <name value="Observation.valueQuantity-QuantityWithRequiredUnits.code"/>
      <min value="0"/>
      <fixedCode value="%"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.dataAbsentReason">
      <path value="Observation.dataAbsentReason"/>
      <name value="Observation.dataAbsentReason"/>
      <min value="0"/>
      <max value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Observation.interpretation">
      <path value="Observation.interpretation"/>
      <name value="Observation.interpretation"/>
      <min value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/mcode/shr/core/vs/QuantitativeResultInterpretationVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Observation.bodySite">
      <path value="Observation.bodySite"/>
      <name value="Observation.bodySite"/>
      <min value="0"/>
      <max value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/mcode/shr/core/vs/BodyLocationVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Observation.specimen">
      <path value="Observation.specimen"/>
      <name value="Observation.specimen"/>
      <min value="0"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Specimen"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.device">
      <path value="Observation.device"/>
      <name value="Observation.device"/>
      <min value="0"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Device"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.referenceRange">
      <path value="Observation.referenceRange"/>
      <name value="Observation.referenceRange"/>
      <min value="0"/>
      <max value="1"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.referenceRange.meaning">
      <path value="Observation.referenceRange.meaning"/>
      <name value="Observation.referenceRange.meaning"/>
      <min value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <description value="Code for the meaning of a reference range."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/referencerange-meaning"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Observation.related">
      <path value="Observation.related"/>
      <name value="Observation.related"/>
      <min value="0"/>
      <max value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.related.type">
      <path value="Observation.related.type"/>
      <name value="Observation.related.type"/>
      <min value="0"/>
      <fixedCode value="has-member"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.related.target">
      <path value="Observation.related.target"/>
      <name value="Observation.related.target"/>
      <min value="0"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Observation"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.component">
      <path value="Observation.component"/>
      <name value="Observation.component"/>
      <min value="0"/>
      <max value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.component.valuex">
      <path value="Observation.component.value[x]"/>
      <name value="Observation.component.valuex"/>
      <min value="0"/>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Observation.component.dataAbsentReason">
      <path value="Observation.component.dataAbsentReason"/>
      <name value="Observation.component.dataAbsentReason"/>
      <min value="0"/>
      <maxLength value="0"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/data-absent-reason"/>
        </valueSetReference>
      </binding>
    </element>
  </differential>
</StructureDefinition>