Usage scenarios

The following are supported usage scenarios for this profile:

• Query for pathology results for a patient
• Query for category of pathology results (e.g. all chemistry)
• Record or update pathology results belonging to a patient

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

• IPA-Observation
• US Core Laboratory Result Observation
• and MAY be conformant to
  • Observation Results: laboratory (IPS) if patient is supported as Observation.subject.reference, Observation.status is final and Observation.performer is supplied
  • Observation Results: pathology (IPS) if patient is supported as Observation.subject.reference and Observation.performer is supplied

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access, International Patient Summary, or US Core MAY NOT conform to AU Core.

Profile specific implementation guidance

• Observation.category provides an efficient way of supporting system interactions, e.g. restricting searches. Implementers need to understand that data categorisation is somewhat subjective. The categorisation applied by the source may not align with a receiver’s expectations.
• The observations MAY have additional codes that translate or map to the Observation code or category codes. For example:
  • providing a local code
  • providing a more specific code
• The use of coding can vary significantly across systems, client applications need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Servers SHOULD populate Observation.code.text and/or Observation.code.coding.display so that client applications can at least display the observation even if the client application does not recognise the code supplied.
• The Observation resource can represent a result using one or both of a single value with Observation.value, or set of results using either Observation.component.value or Observation.hasMember.
  • Although all are marked as must support, servers are not required to support all choices, but they SHALL support at least one of these elements
  • A client application SHALL support both elements
• Observation.identifier may contain the same identifier as in the order or report connecting the resources that are related to a single request fulfilment workflow
• Unless the specimen is explicitly clear in Observation.code, specimen information SHOULD be made available in Observation.specimen.
• Source system identifiers that identify the business process (order ids and reporting identifiers) MAY be included as AU Local Order Identifier and AU Local Report Identifier to support workflow and deduplication of Observation resources.
  • See guidance on the construction of an identifier on the relevant Identifier profile page and the section on Business Identifiers in AU Base.

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

This structure is derived from AUBasePathologyResult

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	AUBasePathologyResult	A pathology test result in an Australian healthcare context au-core-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present
identifier	S	0..*	Identifier	Business Identifier for observation
status	S	1..1	code	preliminary | final | amended + Binding: https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 (required)
category	S	1..*	CodeableConcept	Classification of the service requested as laboratory + more specific discipline where available
code	S	1..1	CodeableConcept	Pathology test or test group Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
subject	S	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
effective[x]	SC	1..1	dateTime, Period	Time of specimen collection au-core-obs-01: Date shall be at least to day
performer	S	0..*	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Who is responsible for the observation
value[x]	SC	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing
interpretation	S	0..*	CodeableConcept	High, low, normal, etc.
note	S	0..*	Annotation	Comments about the observation
method	S	0..1	CodeableConcept	How it was done
specimen	S	0..1	Reference(AU Core Specimen)	Specimen used for this observation
reference		1..1	string	Literal reference, Relative, internal or absolute URL
referenceRange	S	0..*	BackboneElement	Provides guide for interpretation
low	S	0..1	SimpleQuantity	Low Range, if relevant
high	S	0..1	SimpleQuantity	High Range, if relevant
type	S	0..1	CodeableConcept	Reference range qualifier
text	S	0..1	string	Text based reference range in an observation
hasMember	S	0..*	Reference(AU Core Pathology Result Observation)	Individual observations in a group, study, or panel
reference		1..1	string	Literal reference, Relative, internal or absolute URL
component	SC	0..*	BackboneElement	Individual tests in a group or panel au-core-obs-06: The component shall at least have a value or a data absent reason
code	S	1..1	CodeableConcept	Individual pathology test Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
value[x]	SC	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.status	required	https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1
Observation.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.component.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10
au-core-obs-05	error	Observation	If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
au-core-obs-06	error	Observation.component	The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	AUBasePathologyResult	A pathology test result in an Australian healthcare context au-core-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Business Identifier for observation
status	?!SΣ	1..1	code	preliminary | final | amended + Binding: https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 (required)
Slices for category	S	1..*	CodeableConcept	Classification of the service requested as laboratory + more specific discipline where available Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:lab		1..1	CodeableConcept	Observation generated by laboratories Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	Σ	1..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
category:specificDiscipline		0..*	CodeableConcept	Specific discipline of pathology Binding: https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1 (extensible)
code	SΣ	1..1	CodeableConcept	Pathology test or test group Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
effective[x]	SΣC	1..1		Time of specimen collection au-core-obs-01: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
performer	SΣ	0..*	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note	S	0..*	Annotation	Comments about the observation
method	S	0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen	S	0..1	Reference(AU Core Specimen)	Specimen used for this observation
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
referenceRange	SC	0..*	BackboneElement	Provides guide for interpretation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	SC	0..1	SimpleQuantity	Low Range, if relevant
high	SC	0..1	SimpleQuantity	High Range, if relevant
type	S	0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
text	S	0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(AU Core Pathology Result Observation)	Individual observations in a group, study, or panel
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
component	SΣC	0..*	BackboneElement	Individual tests in a group or panel au-core-obs-06: The component shall at least have a value or a data absent reason
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Individual pathology test Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
value[x]	SΣC	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1
Observation.category	preferred	ObservationCategoryCodes
Observation.category:lab	preferred	ObservationCategoryCodes
Observation.category:specificDiscipline	extensible	https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1
Observation.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.component.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.component.dataAbsentReason	extensible	DataAbsentReason

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10
au-core-obs-05	error	Observation	If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
au-core-obs-06	error	Observation.component	The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	AUBasePathologyResult	A pathology test result in an Australian healthcare context au-core-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	preliminary | final | amended + Binding: https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 (required)
Slices for category	S	1..*	CodeableConcept	Classification of the service requested as laboratory + more specific discipline where available Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:lab		1..1	CodeableConcept	Observation generated by laboratories Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category:specificDiscipline		0..*	CodeableConcept	Specific discipline of pathology Binding: https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1 (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Pathology test or test group Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		Time of specimen collection au-core-obs-01: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note	S	0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen	S	0..1	Reference(AU Core Specimen)	Specimen used for this observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	SC	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	SC	0..1	SimpleQuantity	Low Range, if relevant
high	SC	0..1	SimpleQuantity	High Range, if relevant
type	S	0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	S	0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(AU Core Pathology Result Observation)	Individual observations in a group, study, or panel
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	SΣC	0..*	BackboneElement	Individual tests in a group or panel au-core-obs-06: The component shall at least have a value or a data absent reason
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Individual pathology test Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
value[x]	SΣC	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1
Observation.category	preferred	ObservationCategoryCodes
Observation.category:lab	preferred	ObservationCategoryCodes
Observation.category:specificDiscipline	extensible	https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1
Observation.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.specimen.type	extensible	ResourceType
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.hasMember.type	extensible	ResourceType
Observation.component.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10
au-core-obs-06	error	Observation.component	The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists()

Differential View

This structure is derived from AUBasePathologyResult

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	AUBasePathologyResult	A pathology test result in an Australian healthcare context au-core-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present
identifier	S	0..*	Identifier	Business Identifier for observation
status	S	1..1	code	preliminary | final | amended + Binding: https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 (required)
category	S	1..*	CodeableConcept	Classification of the service requested as laboratory + more specific discipline where available
code	S	1..1	CodeableConcept	Pathology test or test group Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
subject	S	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
effective[x]	SC	1..1	dateTime, Period	Time of specimen collection au-core-obs-01: Date shall be at least to day
performer	S	0..*	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Who is responsible for the observation
value[x]	SC	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing
interpretation	S	0..*	CodeableConcept	High, low, normal, etc.
note	S	0..*	Annotation	Comments about the observation
method	S	0..1	CodeableConcept	How it was done
specimen	S	0..1	Reference(AU Core Specimen)	Specimen used for this observation
reference		1..1	string	Literal reference, Relative, internal or absolute URL
referenceRange	S	0..*	BackboneElement	Provides guide for interpretation
low	S	0..1	SimpleQuantity	Low Range, if relevant
high	S	0..1	SimpleQuantity	High Range, if relevant
type	S	0..1	CodeableConcept	Reference range qualifier
text	S	0..1	string	Text based reference range in an observation
hasMember	S	0..*	Reference(AU Core Pathology Result Observation)	Individual observations in a group, study, or panel
reference		1..1	string	Literal reference, Relative, internal or absolute URL
component	SC	0..*	BackboneElement	Individual tests in a group or panel au-core-obs-06: The component shall at least have a value or a data absent reason
code	S	1..1	CodeableConcept	Individual pathology test Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
value[x]	SC	0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.status	required	https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1
Observation.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.component.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10
au-core-obs-05	error	Observation	If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
au-core-obs-06	error	Observation.component	The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	AUBasePathologyResult	A pathology test result in an Australian healthcare context au-core-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Business Identifier for observation
status	?!SΣ	1..1	code	preliminary | final | amended + Binding: https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 (required)
Slices for category	S	1..*	CodeableConcept	Classification of the service requested as laboratory + more specific discipline where available Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:lab		1..1	CodeableConcept	Observation generated by laboratories Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
coding	Σ	1..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
category:specificDiscipline		0..*	CodeableConcept	Specific discipline of pathology Binding: https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1 (extensible)
code	SΣ	1..1	CodeableConcept	Pathology test or test group Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
effective[x]	SΣC	1..1		Time of specimen collection au-core-obs-01: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
performer	SΣ	0..*	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note	S	0..*	Annotation	Comments about the observation
method	S	0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen	S	0..1	Reference(AU Core Specimen)	Specimen used for this observation
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
referenceRange	SC	0..*	BackboneElement	Provides guide for interpretation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	SC	0..1	SimpleQuantity	Low Range, if relevant
high	SC	0..1	SimpleQuantity	High Range, if relevant
type	S	0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
text	S	0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(AU Core Pathology Result Observation)	Individual observations in a group, study, or panel
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
component	SΣC	0..*	BackboneElement	Individual tests in a group or panel au-core-obs-06: The component shall at least have a value or a data absent reason
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Individual pathology test Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
value[x]	SΣC	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1
Observation.category	preferred	ObservationCategoryCodes
Observation.category:lab	preferred	ObservationCategoryCodes
Observation.category:specificDiscipline	extensible	https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1
Observation.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.component.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.component.dataAbsentReason	extensible	DataAbsentReason

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10
au-core-obs-05	error	Observation	If there is no component or hasMember element then at least value or data absent reason shall be present : (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
au-core-obs-06	error	Observation.component	The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	AUBasePathologyResult	A pathology test result in an Australian healthcare context au-core-obs-05: If there is no component or hasMember element then at least value or data absent reason shall be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	preliminary | final | amended + Binding: https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1 (required)
Slices for category	S	1..*	CodeableConcept	Classification of the service requested as laboratory + more specific discipline where available Slice: Unordered, Open by value:coding.system, value:coding.code Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:lab		1..1	CodeableConcept	Observation generated by laboratories Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category:specificDiscipline		0..*	CodeableConcept	Specific discipline of pathology Binding: https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1 (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Pathology test or test group Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
subject	SΣ	1..1	Reference(AU Core Patient)	Who and/or what the observation is about
focus	ΣTU	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣC	1..1		Time of specimen collection au-core-obs-01: Date shall be at least to day
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1		Actual result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation	S	0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note	S	0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen	S	0..1	Reference(AU Core Specimen)	Specimen used for this observation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	SC	0..*	BackboneElement	Provides guide for interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	SC	0..1	SimpleQuantity	Low Range, if relevant
high	SC	0..1	SimpleQuantity	High Range, if relevant
type	S	0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text	S	0..1	string	Text based reference range in an observation
hasMember	SΣ	0..*	Reference(AU Core Pathology Result Observation)	Individual observations in a group, study, or panel
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	SΣC	0..*	BackboneElement	Individual tests in a group or panel au-core-obs-06: The component shall at least have a value or a data absent reason
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Individual pathology test Binding: https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1 (extensible)
value[x]	SΣC	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	SC	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	https://healthterminologies.gov.au/fhir/ValueSet/observationstatus-result-available-1
Observation.category	preferred	ObservationCategoryCodes
Observation.category:lab	preferred	ObservationCategoryCodes
Observation.category:specificDiscipline	extensible	https://healthterminologies.gov.au/fhir/ValueSet/pathology-diagnostic-service-category-1
Observation.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.specimen.type	extensible	ResourceType
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.hasMember.type	extensible	ResourceType
Observation.component.code	extensible	https://healthterminologies.gov.au/fhir/ValueSet/spia-pathology-reporting-1
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-obs-01	error	Observation.effective[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10
au-core-obs-06	error	Observation.component	The component shall at least have a value or a data absent reason : value.exists() or dataAbsentReason.exists()

This structure is derived from AUBasePathologyResult

Summary

Mandatory: 0 element (2 nested mandatory elements)
Must-Support: 23 elements

Structures

This structure refers to these other structures:

• AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)
• AU Core Practitioner (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitioner)
• AU Core PractitionerRole (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole)
• AU Core Organization (http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization)
• AU Core RelatedPerson (http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson)
• AU Core Specimen (http://hl7.org.au/fhir/core/StructureDefinition/au-core-specimen)
• AU Core Pathology Result Observation (http://hl7.org.au/fhir/core/StructureDefinition/au-core-diagnosticresult-path)

Maturity: 0

Below is an overview of the mandatory and optional search parameters and combined search parameters. FHIR search operations and the syntax used to describe the interactions is described here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the patient search parameter:
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

   GET [base]/Observation?patient={Type/}[id] or optionally GET [base]/Observation?patient.identifier=[system|][code]

   Example:

   1. GET [base]/Observation?patient=5678
   2. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
   3. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient (how to search by reference and how to search by token)

2. SHALL support searching using the combination of the patient and category search parameters:
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

   GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory

   Example:

   1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = laboratory (how to search by reference and how to search by token)

3. SHALL support searching using the combination of the patient and code search parameters:
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
   • SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)

   GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/Observation?patient=5678&code=http://loinc.org|6690-2,http://loinc.org|789-8

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). The Observation code parameter searches `Observation.code only. (how to search by reference and how to search by token)

4. SHALL support searching using the combination of the patient and category and date search parameters:
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
   • SHALL support these date comparators: gt,lt,ge,le
   • SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...)

   GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date=ge2020-01-01T00:00:00Z 1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date=ge2020-01-01T00:00:00Z&_revinclude=Provenance:target

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = laboratory (how to search by reference and how to search by token and how to search by date)

Optional Search Parameters:

The following search parameters and search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and category and status search parameters:
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
   • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

   GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&status=final

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and status (how to search by reference and how to search by token)

2. SHOULD support searching using the combination of the patient and code and date search parameters:
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code]
   • SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)
   • SHALL support these date comparators: gt,lt,ge,le
   • SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...)

   GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/Observation?patient=5678&code=http://loinc.org|6690-2,http://loinc.org|789-8&date=ge2020-01-01T00:00:00Z
   2. GET [base]/Observation?patient.identifier=http://example.org/fhir/mrn|12345&code=http://loinc.org|6690-2,http://loinc.org|789-8&date=ge2020-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and observation code(s). (how to search by reference and how to search by token and how to search by date)